Does Medicare Cover Mobility Scooters? [How to Qualify]

If you or a loved one has mobility issues, a mobility scooter can be an invaluable aid in maintaining independence and improving your quality of life. 

But the cost of a mobility scooter can be a significant financial burden, especially for those on a fixed income or with limited savings.

When looking for a mobility scooter you should weigh out all of your options, and Medicare can be a great alternative.

Contrary to what many believe, Medicare part B covers “power-operated vehicles”, in most cases up to 80%, and in some special situations, it may pay for mobility aid in full.

The downside to this is that this coverage requires that the patient goes through a very thorough qualification process, which many people might fail.

In this article, I will go through this process step by step, and help you determine your eligibility for this benefit.

Finally, if you consider you won’t qualify for Medicare’s coverage of a mobility scooter, I will give you some alternatives for getting either a discounted unit or even a free one.

Whether you’re just starting to research your available options, or you’re ready to go ahead with the request for coverage, this article will provide you with the information you need to make the most out of this process.

Key takeaways:

• With prices ranging from $700 to $2000 mobility scooters can be too expensive for many people in need
• Medicare usually covers 80% of the cost of such assistive devices and on some rare occasions the complete price
• The application process for this benefit is comprised of a series of well-defined steps and can take up to 90 days
• Qualifying for a mobility scooter will require your physician to sign off documentation stating that you can’t perform basic daily activities without this kind of powered device
• For this to be true, the doctor must explain why any other kind of assistive equipment such as a cane, crutches, or a manual wheelchair will not work for your case
• Thorough range of movement, strength, flexibility, and gait examinations are required to support these claims
• A home survey will be performed by an assistive technology professional to verify that your house is suitable for a mobility scooter
• Medicare will cover only base models of scooters intended for indoor use
• Out-of-pocket or hidden costs such as small home adaptations, maintenance, or depreciation are not taken care of
• If your application is rejected, there are other alternatives to get a discounted or even free mobility scooter

Qualifying for Medicare Mobility Scooter Coverage

In order to get the cost of your mobility scooter funded by Medicare you have to go through a qualification process.

To be brief, what this process tries to determine is whether you absolutely need a powered mobility aid to maintain or regain the quality of life you lost due to physical conditions.

Basically, you will need a signed paper from your doctor stating that you can’t perform basic tasks at home without a mobility aid and that no other assistive device other than a scooter would work for your particular condition.

This document that a physician should sign off on needs to include objective measurements of your range of motion, strength, flexibility, and characterization of your gait, among other things.

These assessments are usually outsourced to a physical therapist or an occupational therapist and then sent back to your doctor.

It’s because of this that Medicare covering a scooter solely intended for outdoor use is out of the question.

The qualification process focuses on determining the need for the device as a daily in-home necessity.

Here are some qualifying questions that you can try to answer to have a rough estimate of your eligibility:

• Can the person perform basic activities with a cane, crutches, or a walker? Why not?
• Can the person perform basic activities with a manual wheelchair? Why not?
• Can the person safely operate a mobility scooter, and get on and off it without assistance?

Medicare will also require a survey of your house made by a specialized agent, called an assistive technology professional, indicating that there’s enough space for a scooter, that the layout is compatible with this kind of mobility aid, and that there’s enough room for storing it.

How is the Process for Medicare to Cover a Scooter?

The qualifying process mentioned earlier can get a bit complicated and might feel like it’s going back and forth on many occasions.

Fortunately, most medical practitioners know how everything works since they are likely to have done it multiple times.

Another great source of information to get answers to your questions about this are scooter retailers, since they have incentives to help you get coverage, and they are even involved in the affair at the home surveying stage.

Usually, the whole process looks something like this:

• In-person doctor evaluation for a “Medicare Face to Face mobility evaluation”. It’s important that this is the reason for the visit and that’s stated in the records.
• The doctor must address the Medicare eligibility guidelines and provide objective measurements in the visit notes
• It’s likely that the doctor will recommend a physical or occupational therapist to do these strength and flexibility evaluations, these examinations can take up to 30 minutes
• The doctor sends the report to a medical equipment provider
• The medical equipment provider sends a surveyor to verify your house is suitable for a scooter
• The doctor signs off all the paperwork and sends it to Medicare
• Medicare approves or denies the request in two to four weeks
• When Medicare approves the coverage, the medical equipment provider orders the scooter and ships it to your home

What are Medicare Mobility Related Activities of Daily Living (MRADL)?

I mentioned a few times now that Medicare focuses their decision on determining how beneficial a scooter can be for you in the performance of certain activities.

These activities are referred to as “Mobility Related Activities of Daily Living”, and they include:

• Bathing
• Toileting
• Personal Care
• Feeding
• Dressing

As you can see, these are the most essential things you do on a daily basis to maintain a base-level quality of life.

The physical evaluation required in the coverage application process is designed to determine the degree of need you have for a scooter or assistive device.

Physical Exam to Determine Medicare Coverage Eligibility for a Scooter

By measuring your range of motion, strength, and flexibility, and evaluating your gait, health professionals can determine what’s the best tool to assist you in your daily activities. 

For instance, you might not be fit to walk with a cane, or even to stand up with a walker, nor have the upper-body strength to move with a traditional wheelchair.

In these situations, the resulting verdict will be that a powered mobility device, such as an electric wheelchair or a scooter is the best option for you.

What is a DME Provider?

DME stands for Durable Medical Equipment.

A DME provider is a retailer that specializes in assistive devices and other products required by patients to improve or maintain their quality of life, such as those needed for home adaptation, specific therapies, or to keep track of health indicators. 

Your DME Provider Should be Enrolled in Medicare

Something to take into consideration before deciding on a medical equipment retailer is that they need to be enrolled in Medicare to be selected as your coverage beneficiaries.

It usually takes asking them to know this, but if you don’t have any particular supplier in mind, here you will find a way to search for a supplier provided by Medicare.

Home Survey for Coverage Qualification

A foundational part of the qualification process required by Medicare is the survey that the DME supplier needs to do of your house.

Here they will check if there’s enough room to maneuver with a scooter, specifically checking if there’s space to turn around, based on the manufacturer’s informed turning radius.

Another important aspect they will check is if the layout of your house makes sense for a scooter.

For instance, if the bedrooms need to be accessed with stairs, you might also require a stair lift.

Finally, and among other things, details such as the material of your floors, and if there’s carpeting do matter.

It’s not uncommon to hear from doctors that carpets can make the recommendation of a manual wheelchair not possible, because the patient will require great upper-body strength to move over it.

Does Medicare Cover the Full Price of a Mobility Scooter?

Medicare Part B usually covers up to 80% of the cost of a Mobility Scooter.

It doesn’t take into consideration any other hidden costs such as required small home adaptations, depreciation, and maintenance, among others.

In some situations, Medicare could cover the full price of the mobility aid, but this is not common and will depend greatly on a case-by-case basis.

Even with 80% coverage, getting an expensive powered device such as a scooter might still be prohibitive for the economies of many people.

Luckily, there are alternatives to cover the remaining 20% such as Medicaid, or Social Security benefits, but these vary from state to state.

What Kinds of Mobility Scooters Does Medicare Cover?

Medicare will cover the most base models of all scooters.

Usually, 3-wheel scooters are preferred because of their tighter turning radius which makes them a better choice for at-home use.

Here is an article I wrote about the differences between 3-wheel and 4-wheel scooters that you might find helpful:

3-Wheel vs. 4-Wheel Mobility Scooters: 7 Differences

And given that the coverage is only intended for indoor needs, all-terrain, heavy-duty scooters, or tandem ones, are completely out of the question.

Out-of-Pocket Costs After Medicare Approval

In most cases, your out-of-pocket cost after Medicare approves your scooter will be 20% of the total value of the unit.

With mobility scooters commonly ranging between $700 to $2000, we are talking about $140 to $400.

You will need to add any accessories you deem necessary for the scooter, small home adaptations like ramps or evening out of floors, maintenance costs, and depreciation.

Scooters are usually rated for 5 years of continuous usage.

In some places, Medicare has a competitive bidding program, where multiple DME suppliers will bid against each other lowering the quoted price of assistive devices, making them ultimately cheaper for the beneficiary.

Alternatives if Medicare Doesn’t Approve your Request

Sadly, Medicare might not be the best alternative to get a mobility scooter for many people, since their requirements are rather strict.

You might not comply with their physical guidelines and even really have your quality of life affected, and be in need of an assistive mobility device.

If this is your case, don’t get discouraged.

There are many other alternatives for getting a free mobility scooter, or at least a discounted one.

I discussed all of them in the following article:

Free Mobility Scooter: 9 Proven Ways to Get One

Does Medicare Advantage Cover Mobility Scooters?

Medicare Advantage or Medicare Part C are Medicare-approved plans offered by private insurers.

Since these plans have the condition of offering the same benefits that Medicare offers to their beneficiaries, you can expect coverage of 80% of the price of a mobility scooter if you are deemed eligible for one.

In the cases where your application is denied, you have to right to appeal the decision and go forward with an independent review.

Does Medigap Cover Mobility Scooters?

Medigap is a form of private insurance designed to pay for the expenses that Medicare usually not covers.

Coverage will vary from insurer to insurer, but usually, Medigap insurance can be a great alternative for offsetting the out-of-pocket costs that come with Medicare’s approval of a mobility scooter.