What Mobility Scooters Does Medicare Cover?
Decipher Medicare's guidelines for mobility scooter coverage. Understand the essentials for obtaining support and managing associated expenses.
Medicare Part B may cover mobility scooters, categorized as Durable Medical Equipment (DME), when medically necessary. Understanding the specific conditions and processes involved is important for beneficiaries seeking this coverage.
Understanding Medicare’s Criteria for Coverage
Medicare’s coverage for a mobility scooter depends on its medical necessity. A physician must determine that the scooter is required due to a health condition that significantly limits an individual’s ability to move within their home. This limitation means the person experiences considerable difficulty performing daily living activities, even with the assistance of a cane, crutch, or walker.
The individual must be unable to use a cane, walker, or manual wheelchair, or their condition makes using such devices unsafe or impractical. The patient must be able to safely operate the mobility scooter themselves, or have a caregiver consistently available to assist them. The scooter must be primarily for use within the home.
A physician or DME supplier may visit the home to confirm that the scooter can be used effectively within the living environment, ensuring it is not too large for doorways or maneuvering.
Types of Covered Mobility Equipment
Medicare Part B covers various types of mobility equipment as Durable Medical Equipment (DME), including power-operated vehicles (POVs), commonly known as mobility scooters, and power wheelchairs (PWCs). Mobility scooters typically feature a tiller for steering, a seat, and a platform for the feet. Power wheelchairs, by contrast, are often controlled with a joystick and may offer more complex seating options.
While both types of equipment are covered as DME, the specific medical necessity criteria can differ. For instance, a power wheelchair might be considered if an individual cannot safely operate a mobility scooter or a manual wheelchair due to strength limitations. Medicare generally covers only one type of mobility aid for in-home use at a time.
The Process to Obtain Medicare Coverage
Obtaining Medicare coverage for a mobility scooter begins with a face-to-face examination by a Medicare-enrolled doctor. During this visit, the doctor assesses the patient’s medical condition and mobility limitations to determine if a mobility scooter is medically necessary for use in the home. The doctor must then provide a prescription or a Detailed Written Order (DWO) for the scooter.
This order must be provided to the supplier before the equipment is delivered. It includes the patient’s name, a description of the item, the quantity, the date of the order, and the treating practitioner’s name and signature. For power mobility devices, the order generally needs to be completed within six months of the face-to-face examination.
Beneficiaries must work with a Medicare-approved supplier. These suppliers are enrolled in Medicare and will handle the billing directly to Medicare, ensuring the approved amount is accepted as full payment. The supplier will not deliver the scooter until all required documentation, including the detailed written order and any necessary prior authorization, is complete and approved by Medicare. Prior authorization may be required for certain types of power wheelchairs or scooters, which the supplier helps facilitate.
Your Financial Responsibility
Even with Medicare coverage, beneficiaries typically have some financial responsibility for a mobility scooter. Durable Medical Equipment (DME), including mobility scooters, is covered under Medicare Part B. After the annual Medicare Part B deductible is met, Medicare generally covers 80% of the Medicare-approved amount. For 2025, the standard Medicare Part B annual deductible is $257.
The beneficiary is responsible for the remaining 20% coinsurance. If the mobility scooter is rented, Medicare Part B covers 80% of the monthly rental fee after the deductible, with ownership often transferring to the beneficiary after 13 months of rental payments. Medicare also covers repairs and maintenance for mobility scooters. If rented, the supplier is responsible for repairs and maintenance without additional charge. If owned, Medicare covers 80% of the approved amount for professional repairs and maintenance not covered by a warranty.
Secondary insurance plans, such as Medigap policies, Medicaid, or employer-sponsored health plans, may help cover the 20% coinsurance and the Part B deductible. If Medicare denies coverage, the beneficiary is responsible for the full cost, though an appeals process is available.