As long as you are on some type of medical insurance, the answer is yes, but with some caveats. Most private insurance providers pay for a portion of the cost of durable medical equipment (DME) such as wheelchairs.

A wheelchair is a medical expense, and just like any other, the amount of coverage varies from plan to plan. In addition, other factors can affect the price of your hardware, such as buying or renting, if your provider is in the network, and even where you get your chair.

Read here to learn how much insurance will cover, the steps you need to follow, and the types of wheelchairs insurance can cover.

How Much Does Insurance Cover for a Wheelchair?

Medicare Part B states that it covers 80% of the cost of a wheelchair after you've met your annual deductible. You are responsible for 20% of the price and any other premiums and copay costs from doctor visits necessary to acquire your chair.

Aetna, Humana, or any other private insurance plan will cover more or less, depending on the plan you pay for. Contact your provider to confirm the amount you are responsible for and if your providers and suppliers are in-network.

Can I Use More Than One Insurance?

For the most part, yes. If you have two insurance providers, such as two health plans through work (Cigna and United, for example) or a plan through work (Blue Cross Blue Shield, for example) and Medi-Cal, you may be able to use both to help with the cost of your chair. Your private insurance is typically the primary coverage, meaning they are billed and contacted first. Your other insurance will be the secondary coverage, meaning they will pick up whatever is left over from the primary.

While you can use two insurances (sometimes three, in rare cases), you may still be liable to pay some portion of your wheelchair bill. Get in contact with your providers to understand your financial requirements.

What Do I Need To Get A Wheelchair From Insurance?

Private insurance follows similar, or occasionally the same, guidelines as Medicare Part B.

Medicare states that it will cover most of the cost of your wheelchair if your primary care physician or one of your healthcare providers treating you for your condition writes an order for a wheelchair. The doctor's order should clearly state:

  • A medical condition actively causing mobility issues that prevent you from accomplishing daily needs. For example, your medical condition prevents you from getting to the bathroom or kitchen safely, even if you use other mobility aids like a walker or cane.
  • You’re capable of safely utilizing the requested equipment. Alternatively, you have someone in your home who is always available to help you use the equipment when you need it.
  • Your doctor and medical equipment supplier accept your insurance. Ask your doctor and supplier what insurance take.
  • You can operate the device safely in your home. This means no risk of injuries or accidents due to uneven floors, obstacles in your path, or narrow doorways.

Types of Wheelchairs Insurance Covers

Wheelchairs are under an umbrella term for equipment called "durable medical equipment." There are three types of wheelchairs: manual wheelchairs, power scooters, and power wheelchairs.

The type of wheelchair your insurance covers depends on your physical condition and your healthcare provider's recommendations.

Manual Wheelchair

If you're strong enough to get into and out of a manual wheelchair and operate one when needed, this chair may be a good choice.

If you don't have the upper body strength to use a manual chair, you may still qualify as long as someone is home with you who can get you into and out of it, along with operating it safely.

Power Scooters

If you want to qualify for a power scooter, you'll need an in-person visit with your healthcare professional to confirm you're strong enough to get in and out but also hold yourself upright while operating.

Power Wheelchairs

To qualify for a power wheelchair, your doctor needs to examine you in person. After the exam, your doctor needs to write an order stating you're capable of using a power wheelchair safely and explaining the reasons you need one.

Ready to Qualify for Your Wheelchair?

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