How to Get a Motorized Scooter Through Medicare

Motorized scooters offer a means of mobility for individuals facing certain physical limitations. Medicare Part B may provide coverage for these devices under specific conditions, aiming to support beneficiaries in maintaining independence within their home environments. Understanding the requirements and processes involved is an important step for those considering a scooter. This article outlines the pathway to potentially obtaining a motorized scooter through Medicare.

Medicare Coverage and Medical Necessity for Motorized Scooters

Motorized scooters are classified as Durable Medical Equipment under Medicare Part B. For a scooter to be covered, it must meet several criteria, including being durable, used for a medical reason, primarily useful to someone who is sick or injured, appropriate for use in the home, and expected to last at least three years.

Medicare’s coverage for a motorized scooter hinges on a determination of medical necessity, specifically for use within the home. This means a physician must confirm that a patient’s medical condition significantly impairs their ability to move around their home. The patient must be unable to perform essential activities of daily living, such as bathing, dressing, or using the bathroom, even with the assistance of other mobility aids like a cane, crutches, or a walker.

Furthermore, the patient must be able to safely operate the scooter or have consistent assistance from someone who can help them do so. Medicare generally does not cover scooters for convenience or for use primarily outside the home, emphasizing their role in facilitating mobility within the residential setting.

Required Documentation for Your Scooter Request

Obtaining Medicare coverage for a motorized scooter necessitates a thorough documentation process, beginning with your treating physician. A detailed prescription or order from your doctor is a mandatory first step, initiating the formal request for the equipment.

A face-to-face examination with your treating physician is required within six months prior to the written order for the scooter. During this visit, the physician must document in your medical records that a scooter is medically necessary, explaining why other mobility aids are insufficient and how the scooter will meet your needs. The physician’s chart notes must clearly reflect this assessment and the medical justification for the device.

Following the face-to-face encounter, a Detailed Written Order (DWO) must be completed. This document confirms the specific items being ordered. The DWO must include the patient’s name, a detailed description of the item, and the physician’s signature and date. The DWO must be signed by the physician and provided to the supplier before the scooter is delivered. Suppliers will likely request copies of your medical records from your physician to support the documented medical necessity.

Working with a Supplier and Submitting Your Claim

After preparing the necessary medical documentation, engage with a Medicare-approved supplier. Select a supplier that is enrolled in Medicare and accepts Medicare assignment, which means they agree to accept Medicare’s approved amount as full payment. You can locate Medicare-approved suppliers through the Medicare.gov supplier directory by entering your zip code.

The supplier will typically manage the claim submission process to Medicare on your behalf. They will use the completed documentation to support the medical necessity of the scooter. In some cases, particularly for certain types of power wheelchairs or scooters, prior authorization from Medicare may be required before coverage is granted.

After Medicare reviews the submitted information, a decision letter regarding the claim will be sent to the supplier. Your supplier will then coordinate the delivery of the scooter and provide instructions on its proper and safe operation. You can also contact your supplier or call 1-800-MEDICARE to inquire about the status of your claim.

Patient Financial Responsibilities

Beneficiaries generally have certain financial responsibilities for a motorized scooter. Medicare Part B covers durable medical equipment, but it does so after the annual Part B deductible has been met. For 2025, the annual deductible for Medicare Part B is $257.

Once the deductible is satisfied, Medicare typically pays 80% of the Medicare-approved amount for the durable medical equipment. This means you will be responsible for the remaining 20% coinsurance. If Medicare determines the scooter is not medically necessary, you would be responsible for the full cost of the device. Similarly, if you obtain the scooter from a supplier who does not accept Medicare assignment, you may be responsible for a greater portion or even the entire cost.

For those with supplemental insurance, such as a Medigap policy or Medicaid, these plans may help cover some or all of your out-of-pocket costs, including the Part B deductible and coinsurance.