What's the deal with Medicare covering medical equipment like wheelchairs- do I need a special approval?
Answered by 41 licensed agents
Answered by Deb Haley on April 30, 2025
Broker Licensed in MA, AZ, CA & 11 other states
Answered by Mike Alexander on January 18, 2026
Broker Licensed in TX, AL, AR & 16 other states
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.
Answered by Steve and Sue Brauer on November 3, 2025
Broker Licensed in AZ & CA
Answered by Lt Col Tim Brown on March 28, 2025
Broker Licensed in TN, AL, CO & 10 other states
Answered by William Lawler on August 9, 2025
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Answered by Cheri Rogers on January 28, 2026
Broker Licensed in NM & TX
Answered by Darlene Murphy on May 27, 2025
Broker Licensed in CA, AZ, ID & 7 other states
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.
Answered by Sandra Teel on June 2, 2025
Broker Licensed in WV, AZ, CA & 13 other states
Answered by Sandy Johnson on October 27, 2025
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Answered by Wagdy Saadalla on October 3, 2025
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Answered by Joel Gregory Craven on August 22, 2025
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Answered by Nolan Popel on June 2, 2025
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Answered by Shawn Brown on March 25, 2025
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Answered by Jackson Stodgel on December 12, 2025
Broker Licensed in FL, CA, IL & 12 other states
Answered by Jolynn Allen on April 21, 2025
Agent Licensed in CO
Answered by Andrew Zurbuch, MBA on February 4, 2026
Broker Licensed in IN, FL, KY, MO, OH & TN
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.
Answered by Kris Moen on December 24, 2025
Agent Licensed in ND
Answered by Diana Salisbury on April 19, 2025
Broker Licensed in OH, IN & MI
Answered by Kelly Linster on March 16, 2026
Agent Licensed in ND, AZ, CO, IA & SD
Answered by Jason Vallejos on November 24, 2025
Broker Licensed in CA, AZ, CO & 17 other states
Answered by Cody Brown on March 31, 2025
Agent Licensed in MO, AL, AR & 10 other states
Answered by Armand Smith on December 8, 2025
Broker Licensed in AZ, CA, CO & 8 other states
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.
Answered by John Zentner on April 20, 2026
Agent Licensed in CA
Answered by Duane Boebel on May 27, 2025
Broker Licensed in AL, FL, GA & 9 other states
Answered by Frank Adkisson on May 1, 2025
Broker Licensed in NE, AR, AZ & 13 other states
Answered by Gary Henderson on April 19, 2025
Agent Licensed in TX, AK, AL & 46 other states
Answered by Marcie Barnes on April 21, 2025
Agent Licensed in TX, AK, AL & 48 other states
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.
Answered by Charise Karjala on May 5, 2025
Broker Licensed in CA, AZ, CO, PA & WA
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.
Answered by Antonio Rodriguez on November 12, 2025
Broker Licensed in OR
Answered by Ken Banks on September 8, 2025
Broker Licensed in GA, AL, DC & 5 other states
Answered by Amy Jones on March 30, 2026
Broker Licensed in WV, AL, AZ & 29 other states
Answered by Anthony Albano on October 28, 2025
Agent Licensed in FL
Answered by Theodore Carpenter on August 25, 2025
Broker Licensed in IA, AZ, IL & TN
Answered by Tai Thao on August 5, 2025
Broker Licensed in WI, AR, NC & OK
1. Wheelchairs are definitely covered and it would be easier if your surgeon/Dr. gives a prescription for the DME required to avoid issues.
2. If your DME vendor submits the paperwork to CMS that is best, but many don’t.
3. You need to keep original receipts and submit your claim to CMS with receipts within 1 year.
4. Keep copies of everything submitted.
5. Make sure your claim is sent to the correct CMS address as the DME claim address is different from other CMS claims submitted.
Answered by Jeff LeSourd on June 29, 2026
Agent Licensed in VA, DC, FL & 6 other states
Answered by Derek Warren on November 10, 2025
Broker Licensed in OH & MI
Answered by Maureen Breslin on October 7, 2025
Broker Licensed in NY
Tags: Coverage The Medicare System
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