Does Medicare Cover Wheelchairs and Walkers?

Medicare, a federal health insurance program, provides coverage for individuals aged 65 or older, certain younger people with disabilities, and those with End-Stage Renal Disease. This program helps beneficiaries manage healthcare costs, including those for essential medical equipment. Understanding how Medicare covers items like wheelchairs and walkers can help individuals navigate their healthcare needs and access necessary mobility support.

Eligibility and Coverage Criteria

Medicare Part B, Medical Insurance, covers durable medical equipment (DME) like wheelchairs and walkers under specific conditions. For coverage, the equipment must be medically necessary, meaning a doctor determines it is needed to treat an illness, injury, or medical condition. This medical necessity must be documented and prescribed for use in the beneficiary’s home.

A physician must provide a written order or prescription for the equipment, certifying the medical need. This often involves a face-to-face examination to assess the beneficiary’s condition and confirm the requirement. The equipment must be suitable for use primarily within the beneficiary’s home, though it can also be used outside the home.

Both the prescribing doctor and the durable medical equipment supplier must be enrolled in Medicare for coverage to be valid. Medicare expects DME to be durable, able to withstand repeated use, and have an expected lifetime of at least three years.

Medicare has specific rules regarding rental or purchase of equipment. For many items, including some wheelchairs, Medicare may initially cover rental costs, with ownership transferring after a certain period, often 13 continuous months of rental payments. Other items may be purchased directly or offer a choice between rental and purchase, depending on the item and its expected use. The decision is guided by Medicare’s payment policies for that specific type of equipment.

Types of Covered Mobility Equipment

Medicare’s DME coverage extends to various types of wheelchairs and walkers, each designed to address specific mobility needs. Covered wheelchairs include manual wheelchairs (standard, lightweight, or ultra-lightweight) and power wheelchairs or scooters. Power mobility devices often have more stringent medical necessity requirements; the beneficiary must be unable to use a cane, walker, or manual wheelchair, and be able to safely operate the powered device.

Walkers covered by Medicare include standard walkers (with two wheels or no wheels) and rollators (with four wheels, a seat, and brakes). These devices are covered when medically necessary to assist with mobility within the home. The design, such as the presence of wheels, is determined by specific medical requirements and the beneficiary’s ability to use the device safely.

Medicare generally pays for the most basic equipment that meets the medical need. Luxury features or additions not primarily for a medical purpose are typically not covered. For example, some specialized or advanced walkers may not be covered if they do not meet Medicare’s specific criteria for medically necessary DME.

Process for Obtaining Equipment

Obtaining covered mobility equipment begins with a medical evaluation. The beneficiary must visit their doctor, who assesses their medical condition and determines the specific need for a wheelchair or walker. The doctor must document medical necessity and provide a written prescription detailing the specific mobility aid required.

Once the doctor’s order is secured, work with a Medicare-enrolled durable medical equipment supplier. Confirm the supplier accepts Medicare assignment, meaning they agree to accept Medicare’s approved amount as full payment. This helps ensure out-of-pocket costs are limited to the deductible and coinsurance. The supplier will work with the doctor to ensure all necessary documentation is submitted to Medicare.

For certain items, particularly power wheelchairs and scooters, prior authorization may be required. The supplier submits a request and supporting documentation to Medicare for approval. Medicare reviews this information to confirm eligibility and medical necessity before authorizing coverage. If approved, the supplier delivers the equipment to the beneficiary’s home.

Medicare also addresses maintenance and repair of covered durable medical equipment. If the beneficiary owns the equipment, Medicare may cover repairs and replacement parts, generally paying 80% of the approved amount. For rented equipment, the supplier is responsible for all repairs and maintenance at no additional cost. Medicare covers replacement if equipment is lost, stolen, damaged beyond repair, or has exceeded its useful lifetime (often five years).

Financial Responsibility and Costs

Medicare Part B beneficiaries are responsible for certain costs associated with covered durable medical equipment. Before Medicare pays, individuals must meet their annual Part B deductible, which is $257 in 2025. After the deductible is satisfied, Medicare typically covers 80% of the approved amount for the wheelchair or walker. The beneficiary is responsible for the remaining 20% coinsurance.

Supplemental insurance plans can help manage these out-of-pocket expenses. Medigap policies, or Medicare Supplement Insurance, can cover some or all deductibles and coinsurance not covered by Original Medicare. Medicare Advantage Plans (Part C) must cover at least the same benefits as Original Medicare, though their cost-sharing amounts may vary. Beneficiaries should consult their Medicare Advantage Plan for details on financial obligations and network suppliers.

Financial implications can differ based on whether the equipment is rented or purchased. If Medicare determines an item should be rented, monthly payments are made, with ownership potentially transferring after a set period, such as 13 months. If the item is purchased, a lump-sum payment may be made by Medicare. Should a beneficiary choose equipment or features beyond what Medicare deems medically necessary, they are responsible for the cost difference.