Does Medicare Cover Walkers and What Are the Requirements?

Mobility aids like walkers enhance independence and safety for individuals facing movement and balance challenges. Understanding Medicare coverage for these devices is a common question. This article clarifies the specifics of Medicare coverage for walkers, outlining the requirements and financial considerations involved.

Medicare Part B Coverage for Walkers

Medicare categorizes walkers as Durable Medical Equipment (DME). These are items that are durable, used for a medical reason, generally not useful to someone without an illness or injury, used in the home, and expected to last at least three years. Medicare Part B provides coverage for medically necessary DME, including walkers. For Original Medicare, Part B covers 80% of the Medicare-approved amount for the walker once the yearly Part B deductible has been satisfied.

Medicare Advantage Plans (Part C) are offered by private insurance companies but must provide at least the same level of coverage as Original Medicare. While Medicare Advantage plans cover walkers, their rules regarding suppliers, networks, and cost-sharing amounts, such as copayments or coinsurance, may differ. Contact your Medicare Advantage plan for precise details on their DME coverage policies.

Requirements for Coverage

For Medicare to cover a walker, a healthcare professional must deem it medically necessary. Medical necessity means the walker is required to diagnose or treat an illness, injury, condition, or its symptoms, meeting accepted medical standards. A doctor’s assessment should document how the walker will assist with your daily activities and resolve a functional mobility deficit due to a medical condition that significantly impairs your mobility at home.

A physician’s order or prescription is required, outlining the medical diagnosis, the reason the walker is needed, and the type of walker prescribed. This prescription helps demonstrate that the equipment addresses your medical condition. The walker must be obtained from a supplier enrolled in Medicare. These suppliers have met specific quality and compliance standards and are approved to bill Medicare directly. It is beneficial to choose a supplier who accepts “assignment,” meaning they agree to accept the Medicare-approved amount as full payment, limiting your out-of-pocket costs to the deductible and coinsurance.

Cost Considerations

When Medicare Part B covers a walker, beneficiaries are responsible for out-of-pocket costs. This includes meeting the annual Medicare Part B deductible, which is $257 for 2025. This deductible must be paid before Medicare begins to cover its share of the costs for covered services and equipment.

Once the Part B deductible has been satisfied, Medicare pays 80% of the Medicare-approved amount for the walker. The remaining 20% is the beneficiary’s coinsurance responsibility. Choosing a supplier who accepts “assignment” ensures they will not bill you for more than the Medicare deductible and coinsurance for the Medicare-approved amount. If a supplier does not accept assignment, they may charge more than the Medicare-approved amount, leaving you responsible for the difference in addition to the coinsurance and deductible. Medicare Advantage plans may have different cost-sharing structures, such as varying copayments or coinsurance, but they must cover at least what Original Medicare covers.

Obtaining Your Walker

The process of acquiring a Medicare-covered walker begins with a consultation with your doctor. During this visit, your doctor will assess your medical needs and determine if a walker is medically necessary for your condition. If medically justified, your doctor will provide a detailed prescription or order for the specific type of walker required, ensuring it contains all necessary information for Medicare coverage.

After securing the prescription, find a Medicare-approved supplier. Confirm the chosen supplier is enrolled in Medicare and accepts assignment to help manage your out-of-pocket expenses. Provide the supplier with your doctor’s prescription and your Medicare information. The supplier is responsible for submitting the claim directly to Medicare on your behalf.

Once the claim is submitted and processed, you can expect to receive an Explanation of Benefits (EOB) from Medicare. This document will detail the items received, the amount Medicare approved, the amount Medicare paid, and your remaining financial responsibility. Reviewing the EOB is important to ensure proper billing and coverage. Walkers may be rented or purchased, and in some cases, Medicare may allow a choice between these options, with rental payments potentially leading to ownership over time.