How Medicare Covers Wheelchairs: What You Need to Know

Medicare covers wheelchairs through Part B, but only if a doctor writes an order and you meet specific medical requirements

Medicare will pay for a wheelchair if your doctor documents that you cannot walk safely without one, and you have the right kind of insurance. Part B (medical insurance) covers manual wheelchairs, power wheelchairs, and scooters — but the coverage depends on what your doctor says you need, not what you want. You will need a written order from your doctor, proof that you have tried other mobility aids first, and a supplier enrolled in Medicare.

The process takes time. From the moment your doctor submits the order to the moment you receive the wheelchair, expect four to eight weeks. Medicare pays 80 percent of the approved amount after you meet your Part B deductible; you pay the remaining 20 percent. If you have a Medigap or Medicare Advantage plan, your out-of-pocket cost may be lower.

Key Takeaways

• Your doctor must write a written order stating that you cannot walk safely without a wheelchair, and Medicare will only cover it if the medical reason is documented in your chart.
• Medicare requires you to have tried a cane, walker, or other aid first — you cannot jump straight to a wheelchair without that documented attempt.
• You must use a Medicare-enrolled supplier; using a non-enrolled supplier means you pay the full cost yourself.
• Medicare pays 80 percent after your Part B deductible; the supplier bills Medicare directly, and you pay your 20 percent share when you pick up the wheelchair.
• Power wheelchairs and scooters have stricter requirements than manual wheelchairs and usually require a face-to-face doctor visit within the past six months.

What your doctor needs to document

Medicare does not cover a wheelchair based on age, diagnosis alone, or your own judgment that you need one. Your doctor must document in your medical record that you have a condition that prevents you from walking safely — arthritis, stroke recovery, spinal cord injury, severe heart disease, or advanced Parkinson's disease are common reasons. The documentation must say why walking is unsafe, not just that it is difficult.

The doctor's order must also state whether you need a manual wheelchair, a power wheelchair, or a scooter. These are treated differently by Medicare. A manual wheelchair is the easiest to get covered because it has fewer restrictions. A power wheelchair or scooter requires additional proof that you cannot operate a manual chair — for example, because of arm weakness or limited endurance.

If your doctor has not seen you in person within the past six months, Medicare may deny the order. This is especially true for power wheelchairs. Schedule a visit with your doctor before you ask for the wheelchair order, and bring up mobility during that visit so the doctor can document the conversation.

The step-by-step process

Start by calling your doctor's office and asking for a wheelchair order. Tell them you want Medicare to cover it. The office staff will know what form is needed — it is called a Certificate of Medical Necessity, or CMN. Your doctor fills this out and signs it.

Once you have the signed CMN, find a Medicare-enrolled supplier. You can search for suppliers on the Medicare website under "Durable Medical Equipment Suppliers," or call 1-800-MEDICARE and ask for a list of suppliers in your area. Call at least two suppliers and compare their prices for your 20 percent share — the approved amount varies, and you want to know what you will actually pay.

Give the supplier your signed CMN and your Medicare card. The supplier sends the CMN to Medicare for approval. This step usually takes one to two weeks. Once Medicare approves it, the supplier will contact you to schedule a fitting or delivery. You will pay your 20 percent share at that time, unless you have a Medigap plan or Medicare Advantage that covers durable medical equipment differently.

Manual wheelchairs versus power wheelchairs

Medicare covers manual wheelchairs more readily than power wheelchairs because they cost less and have fewer medical requirements. For a manual wheelchair, your doctor needs to document that you cannot walk safely. That is usually enough.

Power wheelchairs and scooters have stricter rules. Medicare requires proof that you cannot operate a manual wheelchair — either because your arms are too weak, your endurance is too limited, or your home layout makes a manual chair impossible to use. Your doctor must document this specific reason on the CMN. You will also need a face-to-face visit with your doctor within six months of the order; a telehealth visit does not count for power wheelchairs.

Some suppliers will rent you a manual wheelchair first to see if it works, then help you move to a power wheelchair if it does not. This can speed up the approval process because it shows Medicare you tried the less expensive option first.

What happens if Medicare denies the order

Medicare denies wheelchair orders for three main reasons: the doctor's order is incomplete, you do not have the required medical documentation, or you have not tried other mobility aids first. If your order is denied, the supplier will send you a letter explaining why. Read it carefully — it will say whether you can appeal.

You have 120 days from the denial date to file an appeal. You do not need a lawyer. Write a letter to the address on the denial notice and explain why you believe Medicare should cover the wheelchair. Include any new medical information — for example, if your condition has worsened since the original order. Ask your doctor to write a letter supporting your appeal and send it with your letter.

If the appeal is also denied, you can request a hearing before a Medicare official. The supplier can help you understand your appeal options, and some suppliers have staff who handle appeals regularly.

Your costs and what insurance covers

After Medicare approves the wheelchair, you pay 20 percent of the approved amount. The approved amount is set by Medicare, not by the supplier — so even if a supplier charges more, you only pay 20 percent of what Medicare says the wheelchair is worth. For a basic manual wheelchair, the approved amount is usually between $800 and $1,200, so your 20 percent share would be $160 to $240. Power wheelchairs have higher approved amounts, typically $4,000 to $6,000, so your share could be $800 to $1,200.

You must meet your Part B deductible first. In 2024, the Part B deductible is $240 per year. If you have already met your deductible for the year, you only owe the 20 percent. If you have not, you pay the deductible first, then 20 percent of the remaining cost.

If you have a Medigap plan (supplemental insurance), it may cover some or all of your 20 percent share. If you have a Medicare Advantage plan, your coverage depends on your specific plan — call your plan to ask what you will pay for a wheelchair. Some Medicare Advantage plans cover durable medical equipment with a copay instead of 20 percent coinsurance.

Medicare coverage does not include repairs or replacement

Medicare covers the wheelchair itself, but not routine maintenance or repairs. If your wheelchair breaks, you pay for the repair out of pocket. The supplier can usually fix it, but you will be charged.

Medicare will cover a replacement wheelchair only if your original wheelchair is lost, stolen, or irreparably damaged — not simply worn out. You would need a new doctor's order and would go through the approval process again. Most people keep their Medicare-covered wheelchair for five to ten years.

If you need a wheelchair cushion or other accessories, ask your doctor whether Medicare will cover them. Some accessories are covered as part of the wheelchair order; others are not. The supplier can tell you which items are covered under your specific wheelchair model.

Frequently Asked Questions

Can I use my wheelchair right away or do I have to wait for Medicare approval?

You have to wait. Medicare must approve the order before the supplier can bill Medicare and deliver the wheelchair. If you need a wheelchair urgently, you can buy one out of pocket and then submit the Medicare order — but Medicare will not reimburse you for a wheelchair you already own. Some suppliers offer short-term rentals while you wait for approval.

What if my doctor will not write a wheelchair order?

Ask your doctor why. If the reason is that your condition does not meet Medicare's requirements, you may need to pay out of pocket. If your doctor is simply unfamiliar with the process, bring printed information about Medicare's wheelchair coverage and ask again. If you see a specialist (physical therapist, occupational therapist, or physiatrist), they can also write the order.

Does Medicare cover wheelchairs for temporary use, like after surgery?

Medicare covers wheelchairs for temporary medical needs if your doctor documents that the need will last at least a few months. For very short-term needs (a few weeks), Medicare usually will not cover it — you would rent instead. Ask your doctor to specify on the order whether the need is temporary or permanent.

Can I choose any wheelchair or does Medicare limit my options?

Medicare covers standard manual wheelchairs and power wheelchairs that meet Medicare specifications. You cannot choose a luxury model or a specialized sports wheelchair and expect Medicare to pay. The supplier will show you the models Medicare covers at the approved price. You can pay extra out of pocket for upgrades or a different model.

What if I have both Medicare and Medicaid?

Medicare is the primary payer, so Medicare processes the order first. Medicaid may cover your 20 percent share if you may have access to for both programs. Contact your Medicaid office to ask whether they cover durable medical equipment coinsurance — rules vary by state.