How do I Determine if I Qualify for a Power Wheelchair Instead of a Manual One under Medicare?

To determine if you qualify for a power wheelchair under Medicare Part B, you must demonstrate a medical necessity due to limited walking ability. We recommend following these three fundamental steps to ensure you meet the eligibility requirements:

  1. Attend a Face-to-Face Examination: You must have a personal meeting with your attending physician. During this visit, your doctor will evaluate your mobility needs and determine why a power wheelchair is essential for your condition rather than a manual one.
  2. Obtain a Written Prescription: Following the exam, your doctor must provide a written prescription that specifies the chair’s features and intended use. This documentation must confirm that you have a diagnosis that limits your ability to walk.
  3. Use a Medicare-Enrolled Supplier: You must obtain your equipment from a supplier enrolled in Medicare who accepts assignment. We’re here to help by conducting an initial patient evaluation, verifying your benefits, and managing the paperwork required for the prior authorization process.

Most power wheelchairs require prior authorization, which we coordinate on your behalf by submitting clinical documentation to Medicare. Once approved and after meeting your Part B deductible, you typically pay 20% of the Medicare-approved amount.

Results may vary. Please consult your treating healthcare professional for medical necessity, as we do not guarantee coverage.


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