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Will Medicare cover the cost of my power wheelchair?

Audrey K. Chun, MD
Geriatric Medicine
Medicare will pay 80% of the charges of a power wheelchair if you need one because you have a mobility-related condition -- for example, a respiratory or cardiac problem -- but only if you need it to get around in your home, not just outdoors. Medicare is vigilant about screening requests for reimbursement. In my experience, suppliers are requesting more and more documentation in order to obtain reimbursement from Medicare. The wording of the medical documentation must be very precise, so it's important to work closely with the supplier and follow the directions to the letter about completion of forms.

If your claim is based on needing the wheelchair to get around outside your home, it will be denied as not medically necessary, because the wheelchair will be considered as being used for leisure activities. Significant visual or cognitive deficits will also preclude reimbursement. Periodically we have family members requesting power wheelchairs for demented and/or visually impaired people. They say that they can walk beside the patient and steer the wheelchair or scooter, but this is not appropriate or safe. The individual patient must have the capacity to operate the wheelchair safely.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.