Does Medicare Cover Mobility Scooters?

Medicare, a federal health insurance program, provides health coverage for millions of Americans. Many individuals rely on Medicare for various healthcare needs, including assistance with mobility. Mobility scooters serve as valuable aids, offering enhanced independence and supporting daily living for those with limited mobility. Understanding how Medicare covers these devices can help individuals navigate the process of obtaining necessary equipment.

Understanding Medicare Part B Coverage

Medicare Part B provides coverage for medically necessary durable medical equipment (DME), including scooters and power wheelchairs. For coverage, DME must be durable, meaning it can withstand repeated use, used for a medical reason, primarily useful to someone ill or injured, intended for home use, and expected to last at least three years.

Medicare Part B covers these mobility devices when a Medicare-enrolled doctor or other healthcare provider prescribes them for use in the beneficiary’s home. The device must be medically necessary to diagnose or treat an illness, injury, condition, or its symptoms, meeting accepted medical standards. Medicare Advantage Plans also provide coverage for mobility scooters, though their specific rules and networks may vary.

Establishing Medical Necessity

For Medicare to cover a mobility scooter, medical necessity must be clearly established and documented. A doctor must prescribe the equipment, confirming its necessity through a face-to-face examination. The doctor’s written order must state the medical need for the device for use within the home environment.

An individual must have a health condition that significantly impairs their ability to move around within their home. This includes an inability to perform activities of daily living (ADLs), such as bathing, dressing, getting in or out of a bed or chair, or using the bathroom, even with the assistance of a cane, crutch, or walker. The home environment must also be suitable for the safe operation and maneuvering of the scooter, ensuring it is not too large to fit through doorways or navigate living spaces. The individual must be able to safely operate and transfer onto and off the scooter, or have consistent assistance available for these actions.

Steps to Obtain a Covered Scooter

Once medical necessity has been determined, specific steps follow to acquire a mobility scooter through Medicare. The process begins with obtaining a prescription from a Medicare-enrolled doctor following a required face-to-face examination. This prescription serves as the initial documentation of the medical need for the device. The written order should include the beneficiary’s name, the order date, and a general description of the item needed.

After securing the prescription, work with a Medicare-approved durable medical equipment (DME) supplier. Confirm the supplier is enrolled in Medicare and accepts Medicare assignment to ensure proper billing and coverage. The DME supplier submits the claim to Medicare, often requiring prior authorization for certain power wheelchairs and scooters. The supplier gathers necessary documentation from the patient’s medical record to support the claim and ensure all coverage criteria are met.

Financial Responsibilities

When Medicare covers a mobility scooter, beneficiaries are responsible for certain financial contributions. Coverage for durable medical equipment like scooters falls under Medicare Part B. After meeting the annual Medicare Part B deductible, Medicare pays 80% of the Medicare-approved amount for the equipment. For 2025, the annual deductible for Medicare Part B beneficiaries is $257.

The remaining 20% of the Medicare-approved amount is the beneficiary’s coinsurance responsibility. It is important to choose a supplier who accepts Medicare assignment. A supplier who accepts assignment agrees to accept the Medicare-approved amount as full payment for the service and can only charge the beneficiary the deductible and coinsurance. If a supplier does not accept assignment, they may charge more than the Medicare-approved amount, potentially leading to higher out-of-pocket costs.