Does Medicare Pay for Transport Chairs?

A transport chair is a lightweight, portable chair designed to be pushed by a caregiver, offering mobility assistance for individuals who cannot propel themselves. These chairs are often considered for short trips or specific situations where independent mobility is not the primary need. Many people wonder if Medicare will cover the cost of such equipment, which often depends on specific medical necessity criteria.

Understanding Durable Medical Equipment

Medicare Part B covers durable medical equipment (DME), which encompasses items that are medically necessary and used in the home. For an item to qualify as DME, it must be durable, meaning it can withstand repeated use and is expected to last for at least three years. The equipment must also serve a medical purpose, not primarily for convenience, and generally not be useful to someone without an illness or injury. A doctor or other healthcare provider enrolled in Medicare must prescribe the item for use in your home.

DME includes a variety of items such as wheelchairs, walkers, hospital beds, and oxygen equipment. The supplier providing the DME must also be enrolled in Medicare, and for Medicare Advantage plans, the supplier may need to be within the plan’s network. Medicare typically pays for most DME on a rental basis, although some inexpensive items or complex rehabilitative power wheelchairs may be purchased.

Specific Coverage Criteria for Transport Chairs

Medicare generally covers mobility assistive equipment like manual wheelchairs, power wheelchairs, and scooters when medically necessary for use within the home. Transport chairs are viewed differently from self-propelled wheelchairs because they are designed to be pushed by a caregiver. For a transport chair to be considered for coverage, it must meet both general DME and specific medical necessity criteria.

A doctor treating the condition must provide a written order stating the medical need for the transport chair for use in the patient’s home. The patient must have a mobility limitation that significantly impairs their ability to move around their home, making them unable to perform daily activities like bathing or dressing even with the help of a cane, crutch, or walker. A transport chair may be covered as an alternative to a standard manual wheelchair if the patient is unable to use one on their own. This requires documentation explaining why a self-propelled wheelchair cannot be used and confirming a caregiver is available to assist.

Medicare may not cover a transport chair if it is primarily for convenience, for use outside the home, or if a standard wheelchair would sufficiently address the patient’s medical needs. If a patient has previously received a self-propelled wheelchair or power mobility device, obtaining coverage for a transport chair might be more challenging, as Medicare aims to avoid providing multiple devices for the same mobility justification. The prescribing physician must provide a Certificate of Medical Necessity documenting the specific medical need.

Navigating the Coverage Process

Obtaining Medicare coverage for a transport chair involves several steps. The process begins with securing a prescription and medical necessity documentation from your doctor. The doctor must conduct a face-to-face examination to assess your mobility limitations and determine the medical necessity for the transport chair. This documentation should clearly state why the transport chair is needed for use within your home.

Next, you must find a Medicare-approved Durable Medical Equipment (DME) supplier. Confirm that the supplier is enrolled in Medicare and accepts Medicare assignment, meaning they agree to accept the Medicare-approved amount as full payment. The supplier will then submit the claim to Medicare on your behalf.

For certain types of DME, including some power wheelchairs, prior authorization may be required before Medicare will cover the cost. Your DME supplier can help determine if prior authorization is needed and submit the request along with supporting documentation to Medicare.

Financial Responsibilities

Even when Medicare covers a transport chair, beneficiaries typically have financial responsibilities. Coverage for DME falls under Medicare Part B. After meeting the annual Part B deductible, Medicare generally pays 80% of the Medicare-approved amount. In 2025, the Part B deductible is $257, and you are responsible for the remaining 20% coinsurance.

To avoid unexpected costs, ensure your DME supplier accepts Medicare assignment. 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, an alternative to Original Medicare, must offer at least the same coverage, but their out-of-pocket costs can vary. If you have a Medigap policy, it may cover some or all of your Part B deductible and coinsurance, reducing your out-of-pocket expenses.