Medicare Wheelchair Coverage: Requirements & Benefits

As people age, they are often unable to get around or function in their daily lives without assistance, especially if they're also physically disabled. Instead of opting for personal care, a manual or power wheelchair may provide a sensible solution. In many cases, Medicare will help cover up to 80 percent of the wheelchair costs, but only if patients meet certain requirements.

Daily Living Activities

• Medicare will cover a manual or power wheelchair if you need assistance with your daily living activities at home, including feeding, bathing, dressing and toileting.

Needs Assessment

• You must acquire a needs assessment from your doctor that is fully documented in your file, as well as a written order or prescription.

Confinement

• If it's proven that you would spend most all of your time confined to a chair or bed without a wheelchair, Medicare will provide coverage.

Independent Mobility Needs

• Wheelchair coverage is only provided if you need the chair for independent mobility, not to prevent an injury from an accident.

CMN

• Medicare coverage for wheelchairs requires a CMN (Certificate of Medical Necessity); this is not the same as a doctor's needs assessment.

Home Coverage

• Medicare will only cover wheelchairs for daily living activities at home. You may use the wheelchair or scooter outside the home, but that cannot be its primary function.