Living at home looks different later in life. At some point, you’ll need to start thinking about ways to remain safe and comfortable in your home as you age in place — and mobility is an important part of that plan. Support devices like canes and walkers are relatively inexpensive, but wheelchairs and scooters can cost $500 to $3,000 (or more for customized electric versions). Understanding Medicare coverage for wheelchairs can help you get the equipment you need without breaking the bank.
What is Durable Medical Equipment?
Medicare Part B pays for durable medical equipment (DME) – healthcare equipment you may need when you’re sick or injured. To be classified as DME under Medicare, the equipment has to:
- Be durable enough to be used repeatedly.
- Assist you with a medical condition.
- Be used in your home.
- Last at least three years.
Some types of DME include oxygen tanks, CPAP machines, blood glucose monitors, and wheelchairs. Medicare covers both rentals and purchases of DME, depending on what kind of equipment you need and how long you’ll use it.
Wheelchair coverage: Manual versus power
The standard coverage under Medicare Part B is for a manual wheelchair. Part B covers wheelchairs if your doctor says it’s medically necessary for you to have one in your home.
For something to be medically necessary under Medicare, it must be needed to treat a condition or illness and not just used for convenience. To get a wheelchair through Medicare, you’ll need to show:
- You have significant difficulty getting around your house.
- A crutch or cane isn’t enough to help you complete daily activities.
- You can safely use the wheelchair in your house, or have someone there to help you.
- The wheelchair fits in your house (the doorways and hallways are wide enough to accommodate it).
- Your doctor and wheelchair supplier participate in/are covered under Medicare.
If you’re strong enough to push yourself, or you have someone at home who can help you, Medicare will pay for a manual chair.
In some cases, you may meet the Medicare requirements for a power wheelchair. You’ll need your doctor to verify that a motorized wheelchair or scooter is needed and provide a Certificate of Medical Necessity. Medicare Part B will cover the motorized version, and your Medigap policy will help cover the added expense of a motorized wheelchair that fits your needs.
Medicare Supplement coverage for DME
Medicare Part B pays 80% of the approved amount for your wheelchair. Medicare Supplement coverage for DME pays part, or all, of your 20% coinsurance after you’ve paid your Part B deductible (which is $283 in 2026).
If you meet the power wheelchair Medicare requirement and you’re getting a motorized wheelchair, the cost split with a Medicare Supplement plan could look like this:
- Medicare approves coverage for a $3,000 power wheelchair.
- You pay the Part B deductible of $283.
- Part B covers 80% of the remaining cost ($2,173.60).
- You would be responsible for the remaining 20%, but your Medigap plan (like Plan G) covers this, which is more than $500, making the equipment no cost to you after your deductible.
To ensure Medicare coverage, make sure you check that your wheelchair supplier participates in Medicare. When you choose a wheelchair supplier, ask if they accept Medicare “assignment.” This means they can only charge the Medicare-approved amount for the chair. If the supplier doesn’t participate in Medicare, they can charge you a higher rate for the equipment. If you’re renting your wheelchair, ask the supplier if they accept assignment for all of the months you’ll be using the equipment.
The ramp conundrum
Your wheelchair may be a lifesaver when you are aging in place, allowing you to get to your bathroom safely, accept deliveries at your front door, and spend time in main living areas with family. But getting up those front porch steps to get inside the house is a whole other challenge.
Wheelchairs are covered under Medicare because they are considered DME. A ramp to get you inside, however, is considered a home modification and isn’t covered under Medicare Part B.
Luckily, your Medicare Supplement covers your 20% DME coinsurance for the wheelchair, saving you money. These savings can help you pay for a ramp and installation. Additionally, some organizations may have funding assistance if you qualify. These include:
- Your local Area Agency on Aging.
- Other senior resources in your community that can be found on the Eldercare Locator.
- Your state Medicaid program.
- Veteran’s Affairs.
You should never have to settle for limited mobility in your own home — and a wheelchair can increase your safety and give you full access to your house again. Talk to your doctor and check your Medicare Supplement coverage to find out what you qualify for and how to get the best device for your health needs.
