Medicare Your Coverage Options

Two things to do if you or someone you know needs a wheelchair from Medicare

Written by Diane Archer

Wheelchairs can cost a crazy amount of money, anywhere from $500 to $6000.  Fortunately, Medicare will pay for a manual or motorized wheelchair if you meet the coverage conditions, and a doctor prescribes one.  If you think you or someone you love needs a wheelchair, here are the two steps you need to take:

1. What you need from your doctor:

  • You must see your doctor and the doctor must prescribe a wheelchair for you.
  • The doctor must explain in writing that you need the wheelchair to get around in your home, that a walker or cane will not give you the mobility you need.
  • If the doctor is prescribing a power wheelchair or scooter, you must not be able to use a manual wheelchair.
  • Whether a manual or a power wheelchair, the doctor must describe the reason you need the wheelchair—for example, you have difficulty getting out of bed, getting dressed, going to the bathroom and performing other activities of daily living. The doctor also must state that you are able to use the wheelchair on your own or with assistance from someone who will be with you in your home.

2. Where to get your wheelchair

  • If you have traditional Medicare, you must get the wheelchair from a Medicare contract supplier. Call Medicare at 1-800-633-4227 to find out where to go for your wheelchair. Or you can visit the Medicare.gov web site.
  • If you are enrolled in a Medicare HMO or other private Medicare plan, call the plan and follow the plan’s rules.

Keep in mind that Medicare will not cover a wheelchair if you do not need it for use in your home, even if you need it to get around outside. However, if you need it for use in your home, you are free to use it outside your home as well.

Here’s more from Just Care:

2 Comments

  • I am disabled and I think it’s bulls*it that Medicare won’t pay for a scooter if it’s only used outside. I need one for when I go out because I can’t do a lot of walking around when I go shopping due to painful degenerative disc disease in my lower back. I can get around in my apartment.

    • Yeah you would think quality of life would be a factor and that being able to get around outside your home would be a part of that equation. My home isn’t even wheelchair accessible.

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