Does Medicare Cover Mobility Scooters?

Medicare does sometimes cover power scooters and wheelchairs for people who have a medical need for these mobility devices. But coverage of mobility scooters can be pretty complex, so it's important to understand the requirements and limitations if you're considering one of these devices. Below we explore the question of will Medicare pay for mobility scooters?

What Medicare Plans Cover Mobility Scooters?

Scooter and power wheelchairs are considered durable medical equipment. That means they're covered under Medicare Part B. So, before you can get Medicare to pay for a mobility scooter, you need to make sure you have Part B.

If you have a Medicare Advantage (Medicare Part C) plan, it may also cover the cost of a scooter. This is because Medicare Advantage plans must provide the same level of coverage that's afforded under Medicare Parts A and B together.

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When Does Medicare Pay for Mobility Scooters?

So when will Medicare pay for a mobility scooter? The short answer is that Medicare will pay for a mobility scooter if it is deemed medically necessary. You have to get prior authorization through the medical equipment provider before you can be provided with a scooter, though.

Typically for prior authorization to be granted, you need:

• An order from a prescribing physician for the mobility scooter
  
  
• A diagnosis that indicates a need for the scooter — typically, Medicare looks for a diagnosis that indicates you are physically unable to ambulate a certain amount without assistance or that you are unable to walk across a room without having serious breathing issues or other duress
  
  
• An evaluation from a medical provider that addresses your limited ability to ambulate — depending on the situation, the evaluation might be conducted by a physical therapist, occupational therapist, physician or other qualified provider

If you can work with a durable medical equipment company to appropriately document your medical need for a mobility scooter, Medicare may approve the equipment. The DME company can then provide you with the scooter and bill Medicare for either rental payments or purchase price, depending on the situation.

How Much Does Medicare Pay for Mobility Scooters?

Medicare Part B has a deductible and a 20% coinsurance. If you've already met your deductible, Medicare Part B will pay 80% of the cost of an approved mobility scooter. You will be responsible for the remaining amount. If you have a Medicare Advantage plan, your copay may be different.

Those with a Medicare supplement insurance plan may not have to pay the copay out of pocket. These plans pick up the cost of copays and deductibles, potentially saving you hundreds on a mobility scooter.