Medicare Funding for Power Wheelchairs

Overview

Medicare is a federally funded program, designed to provide health insurance to people age 65 and over and certain people with disabilities, who are blind, totally and permanently disabled and have been receiving Social Security disability payments for 24 months, or who have end-stage renal disease. The Centers for Medicare & Medicaid Services (CMS) runs the Medicare program, and the Social Security Administration helps by enrolling qualified participants into the program. Medicare has several parts. Part B is the medical insurance part of Medicare that pays for Durable Medical Equipment (DME), such as an electric wheelchair or mobility scooter.  For Part B carriers to reimburse for DME, such as a power mobility device, certain conditions must be met. The DME must be necessary and reasonable either in the treatment of an injury or illness, or in improving the function of an impaired body part. The DME must also be for use primarily in the individual’s home. The Medicare beneficiary must have a face-to-face mobility-focused examination and a written prescription from a doctor or other treating practitioner, and the equipment must be medically necessary based on Medicare‚Äôs coverage guidelines.

Will Medicare Pay for an Electric Wheelchair?

Medicare may pay for an electric wheelchair if you qualify. Medicare may cover the cost of a power mobility device for use in your home. Motorized wheelchairs are covered only when they are deemed medically necessary. To qualify, there are several steps that need to be completed.

  1. Schedule a face-to-face examination with your doctor or other treating provider to discuss your limited mobility.  Your doctor must first consider the use of a cane, walker, manual wheelchair and scooter before considering an electric wheelchair. You must have a face-to-face exam and a special prescription from your doctor before Medicare helps pay for a power wheelchair.
     
  2. Have your physician send the prescription and your medical records to your authorized Pride provider. The provider must receive all paperwork within 45 days from the date of your face-to-face examination with your doctor. Once your provider receives the prescription and your medical records, they will work with you and your doctor to determine the best electric wheelchair that meets your needs.
     
  3. Your provider will assess your home to ensure you have enough space to drive and maneuver an electric wheelchair. If you have Traditional Medicare, the primary reason for DME is to enhance mobility within the home. A provider will consider your ability to perform activities of daily living, such as eating, grooming, bathing and toileting with the help of a power wheelchair. The home assessment is vital to ensure your living environment can support the use of an electric wheelchair.
     
  4. Following a successful home assessment, your provider will order a power wheelchair as prescribed by your doctor. The provider will deliver it to your home and instruct you how to use it.

Important Links

To begin the process of obtaining a power wheelchair or mobility scooter through Medicare, you need to find a local DME supplier in your area. Click here to find a Pride provider. The Official U.S. Government Site for MedicareMedicare Coverage of Manual Wheelchairs and Power Mobility Devices

Published by Pride Mobility

Welcome to Pride Mobility! We are a leading manufacturer of mobility products, including power chairs, scooters, lift chairs, and more. Our goal is to help people with mobility challenges live their best lives by providing innovative, high-quality, and reliable products that enhance their independence and comfort. Our company was founded in 1986 with a mission to improve the quality of life for people with mobility limitations. Since then, we have grown to become a global leader in the industry, with a wide range of products designed to meet the unique needs of individuals with varying levels of mobility. At Pride Mobility, we are committed to delivering exceptional customer service and support. Our team of knowledgeable and experienced professionals is dedicated to helping our customers find the right products to meet their specific needs, and we are always here to answer any questions or concerns. We take pride in our products and stand behind them with a comprehensive warranty and service program. Whether you are looking for a power chair to help you navigate your home or a scooter to explore the outdoors, you can trust Pride Mobility to provide the quality, comfort, and reliability you deserve. Thank you for choosing Pride Mobility as your partner in mobility. We look forward to helping you live your best life!

12 thoughts on “Medicare Funding for Power Wheelchairs

  1. I am disable and my only insurance is Medicaid will I qualify for a mobility scooter my health has been going down hill as I fall at times and I seem to not have enough strength in my leg…

    1. Hi Elizabeth!

      I am happy to help point you in the right direction. Different types of insurance policies have coverage criteria. My best suggestion would be to speak with your insurance company to see what they cover, and also have a conversation with your primary care physician who can help with the prescription/supporting documentation. After that, you can search for a retailer here: https://www.pridemobility.com/find-a-dealer.asp

      Sincerely,
      Amanda

  2. Im 46 I have NON alcoholic cirrhosis of the liver and acities. I have a hard time walking distances like grocery shopping and the stores are in short supply of motorized carts or going to see my family or go anywhere that involves walking. I trip and fall a lot, a lot more than I let on or tell my family about dont want them worrying more. I need help i have disability and Medicaid.

    1. Hi Stephanie!

      I will be happy to help direct you, many of our products are created to help individuals ambulate more safely across walking distances much like in the scenarios you listed. The first step would be to contact your primary care physician and let them know you’d like to discuss some options for your mobility. The next step would be to also get into contact with a dealer. You can locate one here: https://www.pridemobility.com/find-a-dealer.asp

      I’ll be happy to answer any additional questions you have, and I hope you have a wonderful day!

  3. My mother is disabled with MS and has medicaid and medicare. She was previously approved for a motorized wheel chair however, years later, she is in need for a new one. Will she have to go through all the same steps?

  4. I am 87 yrs. old, 88 on may 13th. my name is Frank Lettera! I am diabetic but thankfully have not had to take insulin yet! I walk with a cane for stability, and have fallen a few times, when my legs just seem to give way under me. When shopping with my wife at our Publix, I get a electric cart with a list of items from my wife, and she goes one way & I go another! Even with a cane, I can’t walk any distance before I must sit, before I fall, due to not being able to go any further!

  5. Hello, I am looking into the power chair for my grandparent and mother-in-law and we were wondering if there would be out if pocket expenses and are the scooters theirs to keep?

  6. My aunt is a double amppertee. She us a nursing home but soon will be home how do we get her a wheelchair

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