Updated: Nov 21, 2024

If you’re finding it difficult to get around due to limited mobility, a mobility scooter can be a valuable tool for regaining independence. Look into how Medicare can help cover the cost of a mobility scooter, making it a more affordable option for your daily needs.

Mobility scooters offer an essential means of transportation for people with mobility challenges, allowing them to navigate everyday tasks and maintain independence. However, mobility scooters can be a significant financial investment. The good news is that Medicare may cover part or all of the cost if you qualify. In this guide, we’ll explain how Medicare coverage works for mobility scooters, eligibility criteria, and tips for securing financial assistance through Medicare to get the right scooter for your needs.

How Does Medicare Cover Mobility Scooters?

Medicare Part B, which covers durable medical equipment (DME), provides coverage for medically necessary mobility aids, including scooters, walkers, and wheelchairs. If certain criteria are met, Medicare may help cover the cost of a mobility scooter under DME guidelines.

• Medicare Part B: Covers up to 80% of the approved cost of mobility scooters after you’ve met your annual Part B deductible.
• Out-of-Pocket Costs: You’ll be responsible for 20% of the Medicare-approved cost for the scooter, plus any remaining amount not covered by Medicare, which may be supplemented by additional insurance.

To qualify, your doctor must certify that a mobility scooter is medically necessary for you to complete daily activities safely. Medicare’s goal is to ensure that those who need mobility assistance can move around their homes, reach essentials, and stay safe.

Medicare Eligibility Requirements for Mobility Scooters

Not everyone qualifies for a Medicare-covered mobility scooter. Here are the main criteria that must be met:

1. Medical Necessity: Your doctor must determine and document that a scooter is medically necessary for you to safely complete daily tasks and that a cane or walker is insufficient to meet your mobility needs.
2. Inability to Walk: Medicare requires that you have a mobility limitation that prevents you from walking within your home, even with a walker or cane.
3. Physician’s Order: You must have a written prescription from your doctor specifying that a mobility scooter is necessary.
4. Ability to Safely Operate the Scooter: Medicare needs assurance that you are physically able to control and operate a mobility scooter, or that someone in your household can help you use it safely.
5. In-Home Use Requirement: The scooter must be needed primarily for moving around inside your home. Medicare does not cover scooters solely for outdoor or recreational use.

Steps to Get a Mobility Scooter Covered by Medicare

To increase your chances of Medicare approval, follow these steps:

1. Consult with Your Doctor

Speak with your doctor about your mobility needs and discuss whether a mobility scooter is necessary. If your doctor agrees, they’ll complete the necessary paperwork to document your mobility limitations and explain why a scooter is required.

2. Obtain a Written Prescription

Your doctor will need to provide a prescription for a mobility scooter, outlining why it is essential for daily tasks. This prescription is a critical piece of Medicare’s approval process.

3. Work with a Medicare-Approved Supplier

Medicare only covers scooters from approved suppliers. Make sure the provider you choose accepts Medicare and is authorized to provide DME. Working with a Medicare-approved supplier will ensure that Medicare’s portion of the cost is billed directly to Medicare, reducing your out-of-pocket costs.

4. Submit a Prior Authorization Request (if necessary)

Some Medicare suppliers may require prior authorization before delivering the scooter. This approval process helps ensure that all paperwork is complete and that Medicare’s requirements are met, reducing the risk of unexpected costs later.

5. Pay the Deductible and Co-Pay

Once Medicare approves the scooter, you’ll need to cover any remaining costs, including the Part B deductible and the 20% co-pay. If you have supplemental insurance (Medigap), it may help cover these remaining expenses.

Types of Mobility Scooters Covered by Medicare

Medicare generally covers different types of mobility scooters as long as they meet the requirements. Here are some of the common categories:

1. Three-Wheel Scooters:
   Three-wheel scooters are compact and have a smaller turning radius, making them ideal for indoor use in tight spaces. They are usually lightweight, portable, and easy to maneuver, which may be ideal for use around the home.

2. Four-Wheel Scooters:
   Four-wheel scooters are more stable and suitable for both indoor and outdoor use. They are sturdier than three-wheel models, but they may be bulkier and less maneuverable in tight spaces.

3. Heavy-Duty Scooters:
   Designed to accommodate higher weight capacities and rugged terrains, heavy-duty scooters offer greater durability but are typically larger and require more storage space. Medicare will cover these if you need the additional support and stability.

4. Compact or Travel Scooters:
   Travel scooters are lightweight, easy to transport, and can be folded or disassembled for storage. While Medicare may cover these, they may not be suitable for people who need higher weight capacities or more stability.

How to Choose the Right Mobility Scooter

Selecting a mobility scooter that suits your lifestyle and physical needs is essential. Consider the following factors to make an informed choice:

1. Indoor vs. Outdoor Use

If you need a scooter primarily for home use, a three-wheel or lightweight model is ideal. However, if you plan to use it outdoors, consider a four-wheel or heavy-duty scooter for extra stability and support on rough terrain.

2. Portability

If you travel frequently or need to transport the scooter in a car, look for a portable model that can be disassembled or folded. Keep in mind that smaller, portable scooters may have lower weight capacities.

3. Weight Capacity

Most scooters have weight limits, usually ranging from 250 to 400 pounds. Be sure to choose one that meets your specific needs, especially if you’re considering a compact model.

4. Battery Life

Battery life affects how far you can travel on a single charge. If you anticipate needing longer trips, opt for a model with extended battery life.

5. Budget

While Medicare covers 80% of the cost, you may still have out-of-pocket expenses. Research the co-pay amount and check with your supplemental insurance if you have it, as some plans may cover the remaining 20%.

Real-World Examples of Medicare-Approved Mobility Scooters

Here are a few examples of mobility scooters commonly covered by Medicare to help you understand the options:

Drive Medical Scout Compact Travel Power Scooter

• Type: Three-wheel scooter
• Weight Capacity: 300 lbs
• Battery Range: Up to 9 miles per charge
• Features: Adjustable armrests, padded seat, and lightweight design for easy portability

Best For: Individuals who need a scooter for indoor use and shorter trips. The compact design makes it ideal for small spaces and easy transport.

Pride Mobility Go-Go Elite Traveler 4-Wheel Scooter

• Type: Four-wheel scooter
• Weight Capacity: 300 lbs
• Battery Range: Up to 10 miles per charge
• Features: Easy disassembly for transport, increased stability with four wheels, and adjustable tiller

Best For: Those who need a reliable scooter for indoor and outdoor use, with a focus on stability and portability. Ideal for navigating both small indoor spaces and moderate outdoor terrain.

Golden Technologies Companion Scooter

• Type: Heavy-duty, four-wheel scooter
• Weight Capacity: 400 lbs
• Battery Range: Up to 18 miles per charge
• Features: Full suspension, high ground clearance, extra stability, and a powerful motor

Best For: Individuals who require a high weight capacity and plan to use their scooter outdoors or on uneven terrain. This model offers the strength and range needed for long trips.

EV Rider Transport Plus Foldable Mobility Scooter

• Type: Compact travel scooter
• Weight Capacity: 250 lbs
• Battery Range: Up to 15 miles per charge
• Features: Lightweight, foldable, fits into most car trunks

Best For: Active individuals who need a highly portable scooter that’s easy to transport. The foldable design makes it ideal for travel, but it may not be suitable for heavy-duty use.

Other Financial Assistance Options for Mobility Scooters

If you don’t qualify for Medicare coverage or need additional financial assistance, there are other options:

• Medicaid: Some states offer Medicaid coverage for mobility scooters. Contact your state’s Medicaid office to find out if you qualify.
• Veterans Affairs (VA): Veterans may be eligible for mobility scooters through the VA if the scooter is deemed medically necessary.
• Private Insurance: Check with your private health insurance provider to see if they offer any benefits for mobility aids.
• Charitable Organizations: Certain nonprofit organizations, such as the National Council on Aging or the Muscular Dystrophy Association, may offer financial assistance or resources to help cover the cost of mobility devices.

Conclusion

Mobility scooters offer a lifeline to people with limited mobility, enabling them to navigate their daily lives safely and independently. With Medicare’s potential coverage, these scooters can be more affordable, providing a valuable resource to improve quality of life. By understanding Medicare’s criteria, consulting your doctor, and working with an approved supplier, you can maximize your chances of securing financial assistance for a mobility scooter that meets your specific needs. Whether you’re looking for a portable model or a heavy-duty option, choosing the right scooter will make all the difference in your day-to-day mobility and independence.