Does Medicare Pay for a Mobility Scooter?
Understand Medicare's coverage for mobility scooters, including eligibility requirements and potential costs for necessary equipment.
Medicare, a federal health insurance program, provides coverage for millions of Americans, primarily those aged 65 or older and individuals with certain disabilities. It helps manage healthcare costs by covering a range of medical services and supplies. Understanding how Medicare operates can clarify what benefits are available for specific needs, such as mobility equipment. This article outlines Medicare’s provisions for mobility scooters, detailing the coverage criteria, the process for obtaining equipment, and associated financial responsibilities.
Medicare Coverage for Mobility Equipment
Mobility scooters are categorized by Medicare as Durable Medical Equipment (DME). DME is equipment that is durable, used for a medical reason in the home, and expected to last at least three years. Medicare Part B, which covers medical services and supplies, provides coverage for DME, including power-operated vehicles like scooters and power wheelchairs. For a mobility scooter to be covered, it must be medically necessary for use in your home. This means the equipment is needed to diagnose or treat an illness, injury, or condition, and meets accepted medical standards. Medicare only covers a power mobility device if it is needed for navigating within the home, not solely for outdoor activities.
Meeting Medicare’s Coverage Requirements
To determine medical necessity, Medicare requires you to have a mobility limitation that significantly impairs your ability to perform mobility-related activities of daily living (MRADLs) within your home. These activities include bathing, dressing, getting in or out of a bed or chair, or using the bathroom. The limitation must prevent you from accomplishing MRADLs entirely, place you at heightened risk when attempting them, or prevent completion within a reasonable timeframe.
Before coverage, a physician treating your condition must conduct a face-to-face examination addressing your mobility needs. The doctor assesses your medical condition and determines if a scooter is appropriate, especially if simpler mobility aids like a cane, crutch, or walker are insufficient. Medical records must document this evaluation, explaining why a scooter is medically necessary for in-home mobility and confirming your ability to safely operate the device or that assistance is available. Vague descriptions of mobility issues are not sufficient for Medicare’s review.
Following the examination, the physician must issue a written order (prescription) for the mobility scooter. This order must be provided to the Durable Medical Equipment (DME) supplier before delivery and completed within six months after the face-to-face encounter. Both the prescribing physician and the DME supplier must be enrolled with Medicare. Some power wheelchairs or scooters may also require prior authorization from Medicare.
Obtaining Mobility Equipment Through Medicare
After a physician determines medical necessity and provides the written order, work with a Medicare-approved Durable Medical Equipment (DME) supplier. Confirm the supplier is enrolled in Medicare and agrees to “accept assignment” for your claim. Accepting assignment means the supplier accepts the Medicare-approved amount as full payment and bills Medicare directly, limiting your out-of-pocket costs to the deductible and coinsurance.
To locate Medicare-approved DME suppliers, use the online Medicare Supplier Directory on Medicare.gov or contact 1-800-MEDICARE. The supplier submits the claim to Medicare on your behalf, using specific coding and attaching all necessary documentation, including the physician’s order and medical records.
Medicare reviews the submitted information to confirm coverage criteria are met. If prior authorization was required, Medicare’s Durable Medical Equipment Medicare Administrative Contractor (DME MAC) responds within ten business days. Upon approval, the supplier arranges delivery, fitting, and instruction for the scooter. Delivery must occur within 120 days of the face-to-face examination; otherwise, a new evaluation may be required.
Understanding Your Financial Responsibilities
When Medicare Part B covers a mobility scooter, you have financial responsibilities. You must first meet the annual Medicare Part B deductible, which is $257 in 2025. After meeting the deductible, Medicare Part B covers 80% of the Medicare-approved cost for the durable medical equipment.
The remaining 20% of the Medicare-approved amount is your coinsurance, paid to the DME supplier. Use a supplier that “accepts assignment” to limit your costs to the Medicare-approved amount. If a supplier does not accept assignment, they may charge more, and you would be responsible for the difference, known as an “excess charge.”
If you are enrolled in a Medicare Advantage (Part C) plan instead of Original Medicare, your cost-sharing rules for durable medical equipment, including mobility scooters, differ. Medicare Advantage plans cover at least the same medically necessary services as Original Medicare, but they can have different deductibles, copayments, and coinsurance amounts. Consult your plan documents or contact your plan provider to understand your out-of-pocket costs and network requirements for DME suppliers.