Does Medicare Cover Wheelchair Rental?

Medicare is a federal health insurance program that provides coverage for millions of Americans. This program helps manage healthcare costs, including those associated with necessary medical equipment. This article will explain how Medicare covers durable medical equipment (DME), specifically wheelchairs and scooters, for eligible beneficiaries.

Medicare Coverage for Wheelchairs and Scooters

Medicare Part B, which is medical insurance, covers medically necessary durable medical equipment (DME). Wheelchairs and scooters are categorized as DME, meaning they are designed for repeated use and serve a medical purpose. To qualify as DME, the equipment must typically be useful only to someone who is sick or injured and is expected to last for at least three years.

Coverage for these items is specifically for use in a beneficiary’s home. Medicare covers various types of mobility equipment, including manual wheelchairs, power wheelchairs, and power-operated scooters. The overarching requirement for any coverage is that the item must be medically necessary for the beneficiary’s condition.

Eligibility Requirements for Coverage

For Medicare to cover a wheelchair or scooter, a doctor must determine and document its medical necessity. This means the equipment is required due to a medical condition or injury that significantly impairs the beneficiary’s ability to move within their home. The beneficiary must be unable to perform daily living activities, such as bathing or dressing, even with the aid of a cane, crutch, or walker. A physician enrolled in Medicare must provide a written order for the equipment, specifying the type needed and its medical necessity for safe movement inside the home. The equipment must also be obtained from a supplier enrolled in and accepting Medicare, ensuring adherence to Medicare’s guidelines for equipment provision.

Rental, Purchase, and Financial Considerations

Medicare often determines whether it will cover the rental or purchase of a wheelchair. For some durable medical equipment, Medicare may initially require rental, especially for a trial period or if the medical need is temporary. For wheelchairs, Medicare typically covers either a purchase or a long-term rental, which often includes an option for the beneficiary to own the equipment after 13 months of continuous rental.

Beneficiaries have specific financial responsibilities for covered equipment. The annual Medicare Part B deductible must first be met; for 2025, this deductible is $257. After the deductible is satisfied, Medicare typically pays 80% of the Medicare-approved amount. The beneficiary is then responsible for the remaining 20% coinsurance. Ensure the supplier accepts “assignment,” meaning they agree to accept the Medicare-approved amount as full payment, limiting out-of-pocket costs.

The Process of Obtaining a Covered Wheelchair

The initial step in obtaining a Medicare-covered wheelchair involves consulting with your doctor. During this consultation, you will discuss your mobility limitations and specific needs within your home environment. Your doctor will then provide the necessary prescription and documentation, detailing the equipment’s medical necessity.

After receiving the prescription, select a durable medical equipment supplier that is enrolled in Medicare and accepts assignment. The chosen supplier will typically handle the submission of the claim to Medicare on your behalf. Once approved, the supplier will arrange for the delivery of the wheelchair or scooter to your home. They may also provide instructions on its safe operation and any necessary follow-up care or maintenance.