Q: Will Medicare cover the cost of wheelchairs and walkers?
A: Yes. Medicare Part B covers a portion of the cost for medically-necessary wheelchairs, walkers and other in-home medical equipment. (Medicare will not cover power wheelchairs that are only needed for use outside the home.) Talk with your doctor about your needs. He or she can write an order for the medically necessary equipment, which can be filled at a designated medical supply company.
Are there special requirements for my doctor to be able to order a wheelchair?
Both the doctor and the medical equipment supplier must be enrolled in Medicare in order for the claim to be covered, so double check before you purchase medical equipment.
And you’ll want to understand the difference between providers that accept assignment with Medicare and those that don’t. A durable medical equipment supplier that’s enrolled in Medicare might not accept assignment, which means that the patient will end up paying more for the equipment. As long as the supplier is enrolled in Medicare and also accepts assignment, the patient will not have to pay more than the Part B deductible and 20% of the rest of the cost.
What if I have coverage through Medigap or Medicare Advantage?
If a person has a Medigap (Medicare supplemental insurance) plan, it will likely pay all or a portion of the 20% coinsurance for durable medical equipment like wheelchairs. And if a person still has Medigap Plan C or Plan F, it will also cover the Part B deductible (the other Medigap plans do not cover the Part B deductible; this includes all Medigap plans available to beneficiaries who became eligible for Medicare after the end of 2019).
Coverage of durable medical equipment will vary from plan to plan if the enrollee has Medicare Advantage coverage. These plans are required to cover the same things that Original Medicare covers, so they do provide benefits for durable medical equipment. But the specifics of the coverage will vary depending on the plan. In that case, the Medicare Advantage insurer will be able to explain the coverage details and what steps need to be taken (eg. a prescription from a doctor, prior authorization, etc.) in order to have coverage under the plan.
Used wheelchairs, walkers and basic medical supplies can also be found at even greater savings as church bazaars, estate sales, garage sales, and online.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.
Tags: Competitive Bidding Program, durable medical equipment, in-home care, medical equipment, Medicare Part B, Medicare supplement, Medigap
