I have arthritis in my hips and knees and have a difficult time getting around. What do I need to do to get a Medicare-covered electric-powered scooter or wheelchair?
If you are enrolled in Medicare, getting an electric-powered mobility scooter or wheelchair that is covered by Medicare starts with a visit to your doctor's office.
If you are eligible for this benefit, Medicare will pay 80% of the cost after you have met your Part B deductible ($203 in 2021). You will be responsible for the remaining 20% unless you have supplemental insurance. Here is a breakdown of how it works.
Schedule an Appointment
Your first step is to contact your primary care provider and schedule a mandatory face-to-face mobility evaluation to determine your need for a power scooter or wheelchair. To be eligible, you will need to meet all of the following conditions:
- Your health condition makes moving around your home very difficult, even with the help of a cane, crutch, walker or manual wheelchair.
- You have significant problems performing activities of daily living like bathing, dressing, getting in or out of a bed or chair, or using the bathroom.
- You are able to safely operate, and get on and off the scooter or wheelchair, or have someone with you who is always available to help you safely use the device.
If eligible, your doctor will determine what kind of mobility equipment you will need based on your condition, abilities and home environment. If your mobility needs are only for when you are outside of your home, the equipment may not be considered medically necessary and will not qualify for the benefit.
Where to Buy
If your doctor determines you need a power scooter or wheelchair, your doctor will fill out a written order or prescription. Once you receive it, you will need to take it to a Medicare approved supplier within 45 days. To find Medicare approved suppliers in your area, visit Medicare.gov/medical-equipment-suppliers
or call 800-633-4227.
There are, however, circumstances where you may need "prior authorization" for certain types of power wheelchairs. In this case, you will need permission from Medicare before you can get one.
If you have a Medicare supplemental (Medigap) policy, it may cover some or all of the 20% cost of the scooter or wheelchair that is not covered by Medicare. If you do not have supplemental insurance and cannot afford the 20%, you may be able to get help through Medicare Savings Programs. Call your local Medicaid office for eligibility information.
If you find that you are not eligible or cannot afford a Medicare covered scooter or wheelchair, you may consider renting a mobility device as a short-term solution. Talk to a supplier about this option.
For more information about power mobility devices call Medicare at 800-633-4227 or visit Medicare.gov/coverage/wheelchairs-scooters
If you happen to have a Medicare Advantage plan (like an HMO or PPO), you will need to call your plan to find out the specific steps you need to take to get a power-wheelchair or scooter. Many Advantage plans require you to use specific suppliers within the plan's network.
Savvy Living is written by Jim Miller, a regular contributor to the NBC Today Show and author of "The Savvy Living" book. Any links in this article are offered as a service and there is no endorsement of any product. These articles are offered as a helpful and informative service to our friends and may not always reflect this organization's official position on some topics. Jim invites you to send your senior questions to: Savvy Living, P.O. Box 5443, Norman, OK 73070.