Does Medicare cover wheelchairs?

Medicare Part B will help cover a wheelchair if you meet all of the following requirements:¹

1. The doctor treating your condition must submit a written order to Medicare, called a Certificate of Necessity, stating you have a medical need for a wheelchair or scooter for use in your home
2. You have limited mobility and meet all of these conditions:
   1. You have a health condition that causes significant difficulty moving around in your home.
   2. You’re unable to do daily living activities (like bathing, dressing, getting in or out of a bed or chair, or using the bathroom) even with the help of a cane, crutch or walker.
   3. You’re able to safely operate and get on and off the wheelchair or scooter, or have someone who is always available to help you safely use the device.
   4. The doctor treating you for the condition that requires a wheelchair or scooter, and the supplier, both accept Medicare.
   5. Your doctor or supplier has visited your home and verified that you can use the equipment within your home (example: it’s not too big to fit through doorways in your home or blocked by floor surfaces or things in its path).

If you meet these requirements, there are 3 main types of wheelchairs Medicare helps cover.¹

Manual wheelchairs

A manual wheelchair is propelled by the user by pushing on round bars that surround the wheels. You may qualify for a manual wheelchair if you can’t use a cane or walker safely but have enough upper body strength (or someone to help you).

Power scooters

A power scooter is an electric vehicle that is built more like a motor scooter than a wheelchair. You may qualify for a power-operated scooter if you don’t have the strength to use a cane or walker or can’t operate a manual wheelchair. You must be able to get in and out of a power scooter safely and strong enough to sit up and operate the controls.

Power wheelchairs

A power wheelchair consists of a seat, arm rests with controls and an electric motor. You may qualify for a power wheelchair if you can’t use a manual wheelchair or don’t qualify for a power-operated scooter. Before you get a power wheelchair, you must have a face-to-face exam with your doctor. If your doctor determines you can safely operate a power wheelchair, they’ll submit a written order to Medicare.

Here are some common steps to get a wheelchair from Medicare:

1. Schedule a doctor’s appointment. Your doctor will need to determine that you meet the requirements to get support from Medicare.
2. Tell your doctor why you need a wheelchair. Explain the mobility problems you’re having and why you need help.
3. Make sure you can operate a wheelchair safely. Practice getting in and out of a wheelchair and using it safely.
4. Choose the best type of wheelchair for your needs. The Certificate of Necessity your doctor sends to Medicare must include the type of wheelchair you need: a manual wheelchair, power scooter or power wheelchair.
5. Get your Certificate of Necessity signed. Once you’ve chosen the best wheelchair for your needs, your doctor can sign your certificate.
6. Check if you’ve met your Part B deductible. Medicare will not pay for your wheelchair until you’ve met your Part B deductible ($226 in 2023).
7. Determine whether you should rent or buy. If you don’t plan to need the wheelchair for a long time, renting may be a better option.
8. Find a wheelchair supplier approved by Medicare. Medicare will only help pay for a wheelchair bought from a Medicare-approved supplier.
9. Contact the supplier. Once your Certificate of Necessity is ready, you have 45 days to contact a supplier to set up a home consultation.

After you pay your Part B deductible for the year, Medicare pays 80% of the approved amount. You pay the other 20%.¹

Medicare may deny your request if they believe you don’t medically require a wheelchair or you didn’t submit the correct information. If Medicare denies your request, you have the right to appeal that decision.

Here are the steps to file an appeal to Medicare:²

1. Start by looking at your Medicare Summary Notice (MSN). You must file your appeal by the date in the MSN.
2. Submit your appeal in 1 of 2 ways:
   1. Fill out a Redetermination Request Form, PDF and send it to the company that handles your Medicare claims.
   2. Send a written request to the company that handles your Medicare claims.
3. Be sure to include this information in your appeal:
   1. Your name, address, and the Medicare Number on your red, white and blue Medicare card
   2. The decision you’re appealing
   3. Why you’re appealing the decision
   4. Any other information that will help your case