What's the deal with Medicare covering medical equipment like wheelchairs- do I need a special approval?

Question

Deb Haley · Accepted Answer

Most items that are covered under durable medical equipment by Medicare Will have a 20% copay to the member. Certain items such as a wheelchair with customizations may require a doctor's prescription and others, for example a shower chair, would not require a prescription. If you are enrolled in a Medicare Advantage plan you will want to check with the plan to ensure that you are using an in-network supplier to keep your cost at the lowest possible rate. And oftentimes places like senior centers will have received donations for things like transport chairs, walkers, shower chairs that you can borrow.

Answered by Deb Haley on April 30, 2025

Broker Licensed in MA, AZ, CA & 11 other states

Answered by Deb Haley Medicare Insurance Agent

Steve and Sue Brauer · Answer

Hi. Thanks for watching. My name is Steve and I'm the husband, half of the husband and wife Medicare team here in Arizona. Thank you for watching. The question today is, what's the deal with Medicare covering medical equipment like wheelchairs and that sort of thing? Do I need special approval?

So all that stuff, the acronym Medicare is big on acronyms. The acronym for that is DME. It stands for Durable Medical Equipment. It's almost always, and like I say, always. But 99% of the time it's covered on any plan that you get. And typically the coinsurance on that, not copay but coinsurance, is 20% of the cost.

But here's the thing. A physician, your provider, has to sign off on that, and they have to show or verify that it's medically necessary for you to get that. It's not, I don't, I wouldn't say it's denied very often, but it does happen. And when that happens, you need to get your Medicare agent involved and have them help you with that. But it should be a fairly easy process.

Mike Alexander · Answer

This is considered Durable Medical and yoy must hqve a prescription for the equipment before you can use it

Lt Col Tim Brown · Answer

Your doctor starts that process.  If you have a Medicare Supplement and already met your deductible then it pays for it.  If your on a Medicare Advantage Plan, it pays 80% leaving you 20% to pay.

William Lawler · Answer

Medicare Part B covers medical equipment like wheelchairs. You do not need special approval. Bill, contact me.

George Ibanez · Answer

Special approvals will depend upon what type of Medicare plan that you have, but will require a prescription from your doctor to get a wheel chair paid by Medicare.

Mark Maliwauki · Answer

Your plan should cover 80% of the cost to rent a wheel chair. It is defined as DME or Durable Medical Equipment.

Charise Karjala · Answer

Thank you for the question regarding wheelchairs. The question is: what's the deal with Medicare and getting wheelchairs? So, here's the specific answer. Wheelchairs are categorized as durable medical equipment, and they have to be ordered by prescription. That means a doctor has to write a prescription for a piece of durable medical equipment. It’s in the same category as prosthetics, orthotics, and artificial limbs. It seems a bit overkill, but it's just a CMS rule. Medicare has that category of product, so wheelchairs, walkers, and that kind of thing are all under durable medical equipment and they're available by prescription. It seems kind of ridiculous to have to go through all of that for a $200 wheelchair, so as a result, most people just go out and buy them. However, bear in mind that the wheelchair you're getting is also in the same cluster as wheelchairs for people who have, for example, quadriplegia. It's an unfortunate way that the system codes it, but just be aware that typically durable medical equipment has a 20% co-insurance with your Medicare Advantage policy. Yeah, you do have to have a prescription or you can go out and buy it yourself. Hope that helps. Have a great day.

Shelly Hefley · Answer

It has to be ordered by your physician and approved by your health insurance plan to get them to pay for it. Unless you just want to purchase out of pocket, which is an expensive option but an option nonetheless.

Answered by Shelly Hefley on November 13, 2025

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Brian Moore · Answer

Medicare Part B covers durable medical equipment (DME) like wheelchairs when deemed medically necessary, but you must have a doctor’s prescription and obtain prior approval from Medicare to confirm it meets their criteria, such as being essential for use within your home. This includes items supplied by Medicare-approved DME providers, though many beneficiaries don’t realize this until a need arises, often prompting a last-minute call to advisors for clarification. Without proper approval, coverage won’t apply, and you’d face full costs, so verifying these requirements early is key.

Answered by Brian Moore on March 27, 2025

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Cheri Rogers · Answer

You need a prescription from your doctor for durable medical equipment (DME). Then your cost will depend on the Medicare Insurance you are enrolled in.

Darlene Murphy · Answer

Your provider needs to submit for the equipment and get it covered by way of being medically necessary. Most times it is more than just writing an order for the device, it requires further documentation.

Answered by Darlene Murphy on May 27, 2025

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Sandra Teel · Answer

Things like wheels chairs, walkers, canes, sleep apnea machines, insulin pump etc. are considered durable medical equipment or DME.  If you are only covered by original Medicare, (meaning that you do not have any additional Medicare coverage like an Advantage Plan or Medicare Supplement Plan), DME is covered by Part B and you will pay 20% of your DME costs.  

If you are on a Medicare Advantage Plan or Medicare Supplement Plan you will likely pay less for your DME depending on the type of plan you have.  

Your doctor must write you a prescription for the DME.  You then take that prescription to a durable medical equipment place to fill it.  Be careful filling it at a pharmacy, they often will bill it incorrectly to the Part D of Medicare and not Part B.

Sandy Johnson · Answer

Durable Medical Equipment such as wheelchairs are covered under Part B or 80% of cost by Medicare. you are responsible for the remaining 20% of the Medicare approved cost. It does require approval from your doctors as being medically necessary prior to purchase.

Answered by Sandy Johnson on October 27, 2025

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Wagdy Saadalla · Answer

Medicare cover only 80%. The only time you will not pay anuthing if you have Medicare Supplement, but tjar after you had pay part B deductible. if you have Medicare advantage party, you’ll pay 20% of the cost.

Answered by Wagdy Saadalla on October 3, 2025

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Joel Gregory Craven · Answer

Yes your doctor has to prescribe it and you have to have a durable medical supply company  to provide the wheelchair or power chair speak to your agent for guidance

Nolan Popel · Answer

Durable medical equipment like wheelchairs are covered under Medicare Part B. The special approval you are referring to is called a prior authorization. In some cases prior authorization is required before Medicare will pay 80% for durable medical equipment.

Answered by Nolan Popel on June 2, 2025

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Shawn Brown · Answer

Medicare does cover durable medical equipment. You would need approval from your doctor and is typically covered at 80%

Answered by Cody Brown on March 31, 2025

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Jackson Stodgel · Answer

Medicare Part B covers durable medical equipment (DME) like wheelchairs when deemed medically necessary, but you must have a doctor’s prescription and obtain prior approval from Medicare to confirm it meets their criteria, such as being essential for use within your home. This includes items supplied by Medicare-approved DME providers, though many beneficiaries don’t realize this until a need arises, often prompting a last-minute call to advisors for clarification. Without proper approval, coverage won’t apply, and you’d face full costs, so verifying these requirements early is key.

Answered by Brian Moore on March 27, 2025

Broker Licensed in OH

Jolynn Allen · Answer

Your doctor does a prescription for durable medical equipment and supplies such as oxygen, wheelchairs, a CPAP, etc. They just use a prescription to show the equipment would be medically necessary and appropriate for you.

Answered by Jolynn Allen on April 21, 2025

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Andrew Zurbuch, MBA · Answer

A wheelchair is covered under Original Medicare Part B Durable Medical Equipment. You need to have Part B and have a written order from a Doctor. If approved, generally you pay 20% of the approved amount. Unless you have a Medicare Supplement insurance policy inforce. Thank you.

Answered by Andrew Zurbuch, MBA on February 4, 2026

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Kris Moen · Answer

Yes — most medical equipment like wheelchairs, walkers, and hospital beds require special approval called “prior authorization.”

A few key points:

You must get the equipment from a Medicare-approved supplier.

Your doctor must provide a written order stating it’s medically necessary.

Some items (like power wheelchairs) require Medicare to approve the request before you get it.

You’ll typically pay 20% of the cost under Part B after your deductible.

Diana Salisbury · Answer

Yes - your doctor needs to write an order for this and/or any durable medical equipment that would help you at home. If you don't get one from the doctor you can figure on paying for most of the cost out of pocket.

Answered by Diana Salisbury on April 19, 2025

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Kelly Linster · Answer

Wheelchair is considered durable medical equipment. Most advantage plans are most likely you will have a coinsurance payment while a supplement will pay for it if you have satisfied your Medicare part B deductible.

Answered by Kelly Linster on March 16, 2026

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Jason Vallejos · Answer

If you are in a Managed Care Plan, you need to submit a referral request through your treating physician for approval by the contracted plan and medical group.

Cody Brown · Answer

Medicare does cover durable medical equipment. You would need approval from your doctor and is typically covered at 80%

Armand Smith · Answer

When medical equipment is required I recommend working with the supplier to submit the invoices for medicare. Many times Medicare will come back asking for a letter from the Doctor.

John Zentner · Answer

Yes, Medicare Part B covers wheelchairs and power-operated vehicles (scooters) as Durable Medical Equipment (DME). 

For Manual Wheelchairs: You generally do not need "prior authorization," but you must have a doctor's prescription and a face-to-face evaluation. For Power Wheelchairs/Scooters: Yes, you may need "prior authorization" (prior approval) for certain power-operated vehicles and power wheelchairs. Your doctor and the supplier handle this paperwork, which must be approved by Medicare before they deliver the chair.

Duane Boebel · Answer

Medical equipment like wheel chairs are first authorized under a doctor's order. These are considered Durable Medical Equipment and are normally purchased or leased through a local vendor that accepts Medicare assignment.

Answered by Duane Boebel on May 27, 2025

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Frank Adkisson · Answer

You can't just go out and say, "I need a wheelchair." There needs to be a prescription from a doctor typically. Medicare does cover it, but not at 100%. Depending upon the type of Medicare plan, there could be some out-of-pocket.

Answered by Frank Adkisson on May 1, 2025

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Gary Henderson · Answer

Yes, it needs to be medically necessary. See your family physician. They can help you provide a letter so that you can get any durable medical equipment that is covered by Medicare. And yes that would include wheelchairs and even motorized wheelchairs

Answered by Gary Henderson on April 19, 2025

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Marcie Barnes · Answer

You will require a preauthorization ordered from your doctor. You will be responsible for 20% of the cost under original Medicare Part B after the $255 Part B Deductible is met or a Medicare Advantage plan

Answered by Marcie Barnes on April 21, 2025

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Antonio Rodriguez · Answer

Good question!
Yes — Medicare does cover medical equipment like wheelchairs, walkers, hospital beds, and oxygen, but there are a few rules to follow.

You’ll need a doctor’s order (a written prescription) that says the equipment is medically necessary for use in your home. After that, you must get it from a Medicare-approved supplier — not every store or website qualifies.

For some items, especially power wheelchairs or scooters, Medicare may require “prior authorization” — basically, an extra approval step before they’ll pay. Your doctor and the supplier usually handle that paperwork.

If you have a Medicare Advantage plan, it might have its own approval process or preferred suppliers, so it’s always good to check with the plan first.

Ken Banks · Answer

Yes, Medicare can cover wheelchairs if they are deemed medically necessary for home use, but approval is required, often including prior authorization for power wheelchairs. You'll need a doctor's prescription after a face-to-face examination, and your supplier must be Medicare-approved. Medicare Part B covers 80% of the cost, with you responsible for the remaining 20% coinsurance and deductible.

Answered by Ken Banks on September 8, 2025

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Amy Jones · Answer

Medicare will cover medical equipment such as wheelchairs if they are deemed medically necessary by your doctor and obtained from a Medicare approved supplier of medical devices. You should be able to obtain a list of approved suppliers from your insurance carrier or by calling Medicare at 1-800-MEDICARE.

Answered by Amy Jones on March 30, 2026

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Anthony Albano · Answer

Yes & yes, depending on the plan you may have a 20% copay. It also must be ordered by a doctor and must use in network Durable medical equipment provider.

Theodore Carpenter · Answer

You do, in fact, have to get prior approval, especially for the powered wheelchair. These are covered under part B, and once you have met the part B deductible, it will be covered 100%. You have to make sure that you are getting the equipment from a Medicare-approved provider.

Answered by Theodore Carpenter on August 25, 2025

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Tai Thao · Answer

Durable Medical Equipment are cover under Medicare Part B. Things like Wheelchairs, Walkers, Hospital Beds, Oxygen Equipment and CPAP Machines. You will need Prior Authorization from your Insurance carrier and it has to be a medical necessary for you.

Answered by Tai Thao on August 5, 2025

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Derek Warren · Answer

It should be considered Durable Medical Equipment. The cost is usually 20% coninsurance. I would notify your doctor who most likely will coordinate benefits with your plan. In addition you could also contact your plan to see where your best cost sharing would be. I hope this helps.

Answered by Derek Warren on November 10, 2025

Broker Licensed in OH & MI

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Maureen Breslin · Answer

Medicare can cover wheelchairs as "durable medical equipment". You will probably need to see your doctor first to get a prescription and their authorization, though. Once you have the doctor's prescription, you can take it to any Medicare-enrolled supplier.

Answered by Maureen Breslin on October 7, 2025

Broker Licensed in NY

Answered by Maureen Breslin Medicare Insurance Agent

What's the deal with Medicare covering medical equipment like wheelchairs- do I need a special approval?

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