People with difficulty operating a manual wheelchair may benefit from an electric wheelchair, also called a power wheelchair.
Under Original Medicare, Medicare Part B may cover the cost of an electric wheelchair for individuals facing home mobility challenges as part of the durable medical equipment (DME) benefit.
Medicare may provide coverage for different types of electric wheelchairs, though this depends on prior authorization and medical necessity.
A person’s options include:
- a sling wheelchair or one featuring a solid seat and back
- a wheelchair with an adjustable seat, known as a captain’s chair
- a power-operated vehicle offering greater size and durability compared to a typical electric wheelchair
A person can get an electric wheelchair through Medicare if a medical condition affects their mobility. This condition must make it unsafe for them to move with other assistive devices such as crutches, a walker, or a cane. Additionally, the individual must not be able to operate a manual wheelchair.
Does a person need a prescription for an electric wheelchair?
Typically, to get an electric wheelchair with Medicare, a person needs a prescription from a Medicare-affiliated doctor.
This prescription must note that:
- the individual qualifies based on the above criteria
- the person plans to get it from an authorized Medicare supplier
- the prescribing doctor evaluated the person within 6 months before writing the order
In this case, Medicare will classify the wheelchair as DME and cover it under Part B.
Power wheelchairs range from
Part C plans have to offer the same benefits as Original Medicare, but they have different copays, deductibles, and premiums, depending on the plan.
How long does it take Medicare to approve an electric wheelchair?
Typically, prior authorization approval takes around 10 business days with Original Medicare. The approval time frame for Part C will vary depending on the plan.
How often will Medicare pay for a wheelchair?
Part B covers one piece of equipment, such as a wheelchair, once every 5 years.
Does Medicare pay for wheelchairs in nursing homes?
If a person requires a wheelchair during a hospital stay or while residing in a nursing home, the facility will supply one under Medicare Part A.