Will Medicare Pay for a Power Wheelchair

Yes, Medicare may cover a power wheelchair if it's deemed medically necessary for use in your home. Here's how you can qualify and what to expect:​

✅ Eligibility Requirements

To qualify for Medicare coverage of a power wheelchair:

1. Medical Necessity: Your doctor must determine that you have a mobility limitation that significantly impairs your ability to perform activities of daily living (such as bathing, dressing, or moving around your home) and that a power wheelchair is the most appropriate mobility device for you.​

2. Face-to-Face Examination: You must have an in-person visit with your doctor, which should occur no more than 45 days before the prescription is written.​

3. Written Prescription: Your doctor must provide a written order or prescription stating that a power wheelchair is medically necessary.​

4. Use in the Home: The power wheelchair must be used primarily in your home; Medicare does not cover wheelchairs for use outside the home.​

   
   

📄 Prior Authorization

Some models of power wheelchairs require prior authorization from Medicare before they can be provided. This means your doctor or supplier must submit a request to Medicare to confirm coverage eligibility. If the prior authorization is denied, you may appeal the decision or, if you choose to proceed without authorization, you may be responsible for the full cost.

💰 Costs

• Original Medicare (Part B): After meeting the annual Part B deductible ($257 in 2025), Medicare pays 80% of the Medicare-approved amount for the power wheelchair. You are responsible for the remaining 20%, plus any applicable coinsurance. ​

  
  

🛠️ Next Steps

1. Consult Your Doctor: Discuss your mobility needs and whether a power wheelchair is appropriate for you.​

2. Obtain a Prescription: If your doctor agrees, ensure you receive a written prescription for the power wheelchair.

3. Choose a Medicare-Approved Supplier: (Like Transcend Medical) Use a supplier that accepts Medicare assignment to ensure coverage.​

4. Understand Prior Authorization Requirements: Determine if your chosen wheelchair model requires prior authorization and ensure all necessary documentation is submitted.​

5. Review Costs: Be aware of your financial responsibilities, including the 20% coinsurance after the deductible.​

   
   

If you need assistance Transcend Medical is a Medicare-approved supplier and covers all of Northeast Alabama, or have further questions about the process, feel free to ask!