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Medicare Coverage for Wheelchairs: Approved Types & Information

Motorized Electric wheelchair for senior elder patient who cannot walk. Contact Wise Insurance today.

Does Medicare cover wheelchairs? Medicare categorizes durable medical equipment, such as wheelchairs, as prescription items. As such, they cover the costs of buying a wheelchair to enhance mobility.
However, the process of obtaining wheelchair coverage through Medicare can be far from straightforward for many people.
It involves seeking a prescription from a doctor and choosing a suitable wheelchair. Moreover, you have to meet Medicare deductible requirements to get covered.
Wise Insurance is here to explain the whole process in detail and offer assistance when you or a loved one needs it.

How Does Medicare Cover Wheelchairs?

How does Medicare cover wheelchairs?
Medicare Part B covers the cost of buying a wheelchair if you have mobility issues. However, to secure a Medicare-approved wheelchair, you must comply with several requirements. These include:

  • Having a qualifying mobility issue. Qualification for a Medicare-approved wheelchair is dependent on if you have a condition that impairs your mobility. Some of these ailments range widely and can include severe arthritis, musculoskeletal disorders, and even certain neurological disorders, just to name a few.
  • Securing a certificate of necessity. A certificate of necessity is another requirement for securing a wheelchair. The certificate is a formal document detailing the nature and extent of your mobility limitations. Medicare uses it to substantiate your need for a wheelchair.
  • Buy from a Medicare-approved supplier. Medicare can only cover the costs of a wheelchair bought from approved suppliers. The reason? The suppliers adhere to Medicare’s quality, safety, and pricing regulations. So, before buying, confirm that the supplier has Medicare approval.
  • Contacting the supplier. After meeting all the provisions, contact the supplier within 45 days. The supplier will send a representative to assess your mobility needs and home environment. This evaluation will help ensure that your wheelchair aligns with your needs.

What Wheelchairs are Covered by Medicare?

Medicare recognizes the diverse mobility challenges faced by its beneficiaries. For this reason, Medicare provides coverage for three types of wheelchairs, so everyone can find one that fits their mobility needs. These wheelchairs covered by Medicare include:

  • Manual wheelchairs. A manual wheelchair is propelled by the user or an assisting caregiver. This wheelchair is an ideal fit for beneficiaries with sufficient upper body strength. Additionally, manual wheelchairs are suitable for beneficiaries with someone to assist with pushing.
  • Power scooters. Unlike a manual wheelchair, a power scooter has an electric motor to propel it around. The wheelchair is ideal for individuals with difficulties self-propelling a manual wheelchair. Note that the wheelchair uses a tiller handle, requiring both hands to steer.
  • Electric wheelchair. An electric wheelchair is suitable for beneficiaries with challenges propelling a manual wheelchair or power scooter. The electric wheelchairs are typically controlled by a gaming-style joystick. It uses an electric motor to propel.

Are There Any Out-of-Pocket Costs for Wheelchairs Covered by Medicare?

Assuming you’ve met your deductible for the year under Medicare Part B, Medicare would pay for 80% of the total cost of a wheelchair.
This means you would need to pay only 20% of the total cost of a wheelchair after you’ve met your Medicare Part B Deductible for the year.
For example, if a wheelchair covered by Medicare were to cost $5,000, Medicare would cover $4,000 of that total cost, leaving you with a cost of $1,000.

Get The Help Navigating Medicare You Deserve

Although Medicare covers wheelchairs, navigating the process is quite cumbersome. From seeking a certificate of necessity to choosing a wheelchair, it is easy to make some mistakes that can lead to denials or delays.
Wise Insurance helps Medicare beneficiaries in Houston, TX, navigate the mentioned intricacies. With years of experience navigating the complexities of Medicaid and marketplace policies, our team understands the ins and outs of all of Medicare’s regulations. This knowledge enables us to walk you through the process of seeking benefits with certainty.
Contact us to schedule your appointment and get the help you need with Medicare today!

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