I need a new wheelchair, and I'm not sure if Medicare will cover it. What's the process for getting durable medical equipment?

Question

Norman Smith · Accepted Answer

Original Medicare pays for DME, unless noted anywhere within its policy Medicare Advantage plans do not.
You will have the 20% Co-pay responsibility, unless you have a Supplement plan that covers those charges.
That is an important feature in keeping your Original Medicare pays- it handles your DME, Medicare Advantage is typically handled Out-of-pocket by the insured.

Dana Dane · Answer

First, your doctor needs to prescribe this.  Next, please call your agent who can contact your insurance company to see if you qualify for a replacement.

Gary Henderson · Answer

Your doctor must provide you a letter AKA a prescription for any durable medical equipment. Contact your primary care physician

Vachik Chakhbazian · Answer

you'll need a prescription from your doctor stating the medical necessity and then find a Medicare-approved supplier.

Robert Simm · Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/medicare-coverage-process-durable-medical-equipment#robert-simm

David Christian · Answer

Hello there.  A wheelchair falls under Medicare Part B as Durable Medical Equipment (DME).  The 
first thing you must do is get a prescription from your physician stating that you need the wheelchair and why?  

The process of getting the wheelchair will depend on what type of Medicare coverage you have. 

1. If you have Original Medicare only (Parts A & B only) or Original Medicare with a Medi-Gap plan, you will reach out to a Medicare Approved Supplier. 
2. If you have a Medicare Advantage Plan (MAPD), you put in the request through the Medical Group or Insurance Carrier and go through their contracted provider.

Randy Hill · Answer

If you need a new wheelchair and want Medicare to help pay for it, there’s a special process you have to follow — kind of like going on a little treasure hunt where you collect the right “clues”  to get what you need.

Here’s how it works, step-by-step:

1. See Your Doctor First:
You can’t just go pick out a wheelchair by yourself. First, you need to visit your doctor. Your doctor has to say, in writing, that a wheelchair is medically necessary — meaning you need it to move around safely at home.

2. Get a Prescription:
Your doctor will give you a prescription that says you need a wheelchair. Without this note, Medicare won’t pay!

3. Choose a Medicare-Approved Supplier:
You have to get your wheelchair from a store that’s approved by Medicare. 

You can find one by asking your doctor or by looking it up at 
www.medicare.gov/medical-equipment-suppliers.

4. The Supplier Checks With Medicare:
Sometimes, the supplier needs to send paperwork to Medicare to ask for approval first. This is called prior authorization. (It’s just Medicare’s way of double-checking.)

5. Pay Your Share:
If Medicare says yes, they’ll usually pay 80% of the cost. You will pay the other 20%, plus any deductible if you haven’t paid it yet this year.

Important Tips:

Make sure both your doctor and your supplier accept Medicare assignment — this helps keep your costs as low as possible.

Keep copies of everything your doctor and supplier give you!


That’s the whole treasure map!
Start by talking to your doctor, and soon you’ll be rolling along with your new wheelchair.

If you have any more questions, just let me know — I’m happy to help!

Betty McCarty · Answer

Prior authorization is usually required for Durable Medical Equipment. 

You might need to take the following steps: 

1.) Meet with your doctor to assess your physical condition.

2.) Check your Medicare plan. Medicare Part B covers 80% of the chair's costs after you meet your deductible.

3.) Evaluate your costs. Most manual and power wheelchairs are rented for the first 13 months, and you pay 20% coinsurance. 

4.) Schedule a doctor's appointment and explain why you need a wheelchair. 

5.) Obtain a doctor's prescription for the chair and contact your local Social Security office for an application for Medicare Part B benefits.

Scott Klag · Answer

Depending on your Health Plan you will be given a list of approved Durable Medical Equipment providers that you can use. The copays range from $0 to 20% of the cost of the equipment.

Justin Hundley · Answer

Medicare Part B will help cover the cost of prescribed Durable Medical Equipment, but how this works can vary based on whether you just have Original Medicare, a Medicare supplement, or a Medicare advantage plan. 

If you are on original Medicare you will be responsible for your part B deductible, as well as a 20% coinsurance. You will need to confirm that the doctor (your primary care physician) prescribing the wheelchair, as well as the supplier for the wheelchair, are both enrolled with Medicare.

If you are on a Medicare advantage plan, then you will need to follow your insurance companies rules for getting Durable Medical Equipment. You can contact your current plan provider to learn about their rules and what they will cover.

A Medicare supplement plan can help cover the remaining costs that are covered by Original Medicare as well. Coverage can vary by plan type so it's important to review what plan you are on and what it covers. 

You can always reach out to an agent (like myself) to assist you in understand your unique situation.

Eric Stokley · Answer

Medicare part B will cover 80% of Medical durable equipment after you have met your part B deductible. The equipment must be deemed medically necessary by your doctor and prescribed by you doctor for use at home.

Answered by Eric Stokley on April 22, 2025

Agent Licensed in GA & MS

Answered by Eric Stokley Medicare Insurance Agent

I need a new wheelchair, and I'm not sure if Medicare will cover it. What's the process for getting durable medical equipment?

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I need a new wheelchair, and I'm not sure if Medicare will cover it. What's the process for getting durable medical equipment?

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