Mobility scooters may be partially covered under Part B. The mobility scooter must be purchased or rented from a Medicare-approved supplier within 45 days of seeing your doctor.
If you or a loved one finds it hard to get around at home, you’re in good company. At least
If you’re enrolled in Medicare and meet specific requirements, Part B can partially cover the cost of purchasing or renting a mobility scooter.
Medicare is made up of parts A, B, C, D, and Medigap.
Part A, which is hospital insurance, doesn’t offer coverage for in-home services. Part D, which is prescription drug coverage, doesn’t apply to mobility scooters.
Part B coverage for scooters
Part B covers the partial cost or rental fee for power mobility devices (PMDs), such as mobilized scooters and other types of durable medical equipment (DME), including manual wheelchairs.
Part B pays 80% of the Medicare-approved portion of the cost of a scooter after you meet your annual Part B deductible.
Part C coverage for scooters
Part C plans cover DME, too. Some plans also cover motorized wheelchairs.
The level of DME coverage you get with a Part C plan can vary. Some plans offer significant discounts, but others don’t.
It’s important to check your plan to determine what you can expect to pay out of pocket for a scooter.
Medigap coverage for scooters
Medigap plans may also help cover out-of-pocket costs, such as your Part B deductible. Individual plans vary, so be sure to check first.
Before Medicare will help pay for a scooter, you must be enrolled in Original Medicare and meet specific PMD eligibility requirements.
Scooters are only approved by Medicare if you need a scooter to move around in your home. Medicare won’t pay for a power wheelchair or scooter that is only needed for outside activities.
Getting a scooter prescription
Medicare requires a face-to-face meeting with your doctor. Make sure your doctor accepts Medicare.
At the visit, your doctor will evaluate your medical condition and prescribe DME if needed. Your doctor’s prescription is referred to as a seven-element order, which tells Medicare that a scooter is medically necessary.
Your doctor will submit the seven-element order to Medicare for approval.
Criteria you must meet
The seven-element order should say that a scooter is medically necessary for use in your home because you have limited mobility and meet all the following criteria:
- you have a health condition that makes it extremely hard for you to get around within your own home
- you can’t do daily living activities, such as using the bathroom, bathing, and dressing, even with a walker, cane, or crutches
- you can safely operate a mobilized device and are strong enough to sit up on it and use its controls
- you are able to get on and off the scooter safely; if not, you must always have someone with you who can assist you and ensure your safety
- your home can accommodate scooter use; for example, a scooter will fit in your bathroom, through your doors, and in hallways
You must go to a DME supplier who accepts Medicare. The approved seven-element order must be sent to your supplier within 45 days of your face-to-face doctor’s visit.
After you pay your Part B deductible of $240 in 2024, Medicare will cover 80% of the cost to rent or buy a scooter. The remaining 20% is your responsibility, although it may be covered by some Part C or Medigap plans.
To keep costs down and ensure that Medicare pays a portion of the scooter costs, you must use a Medicare-approved supplier that accepts assignments.
If you don’t, the supplier may charge you a much higher amount, which you will be responsible for.
Ask about Medicare participation before you commit to purchasing a scooter.
A Medicare-approved supplier will send the bill for your scooter directly to Medicare. However, you may be required to pay the entire cost up front and wait for Medicare to reimburse you for 80% of the scooter’s cost.
If you decide to rent a scooter, Medicare will make monthly payments on your behalf for as long as the scooter is medically necessary. The supplier should come to your home to pick up the scooter when the rental period ends.
Many Medicare recipients have trouble getting around at home. When a cane, crutches, or walker isn’t enough, a mobility scooter may help.
Part B covers 80% of the cost of mobility scooters as long as you meet some specific requirements.
To have your scooter approved and covered by Medicare, you must go through a Medicare-approved supplier and Medicare-approved doctor who accepts assignments.