Does Medicare Cover Walkers?
Daily activities like walking, opening doors, and reading sometimes require extra help from a person or device as we age. There are many mobility aids and other assistive devices that can help you maintain your independence and quality of life. And, new advancements are made all the time, helping older adults age better!
Walkers are one of the most common mobility aids. According to the NIH, around 24% of people over 65 use a walker or similar mobility device, and nearly 9% use multiple devices.
With more people using mobility aids than ever before, many wonder if Medicare covers walkers and other aids. The short answer is, yes! Explore more details below.
What is an assistive device?
Assistive devices help you stay independent by making daily activities easier. These tools can help with walking, communicating, seeing, hearing, and other daily activities we use to move around and stay connected.
Here are some examples of assistive devices that specifically help with mobility:
Walkers
Crutches
Scooters
Wheelchairs
Other categories include:
Communication devices: Hearing aids, cochlear implants, sign language interpreters, speech-generating devices
Vision aids: Magnifying glasses, braille readers, screen readers, closed captioning devices
Daily living aids: Adaptive utensils, button hooks, sock aids, reachers
Computer and technology aids: Voice recognition software, alternative keyboards, mouse alternatives, screen magnifiers
Does Medicare cover walkers?
If you have Original Medicare, Medicare Part B generally covers mobility aids like walkers when they meet specific requirements. Medicare Advantage plans (Part C) cover the same types of medical equipment, though costs and approved suppliers may vary by plan.
To get Medicare coverage for medical devices, your equipment must:
Be prescribed as medically necessary by a Medicare-enrolled physician or qualified provider
Be suitable for use in the home
Be obtained from a Medicare-approved supplier
Be durable enough to last at least three years
Be used for a medical purpose, not just to improve general quality of life
For more expensive equipment like power wheelchairs or scooters, Medicare has additional requirements for eligibility, prior authorization, and delivery.
Is a prescription necessary for Medicare to cover a walker?
Medicare Part B covers walkers, but you'll need both a prescription and an authorized medical equipment supplier to get coverage.
Many basic walkers and mobility aids are available online and in stores for under $30. For these less expensive items, you might prefer paying out-of-pocket rather than going through Medicare's requirements.
If you're staying in a skilled nursing facility or rehab center under Medicare Part A, your health care provider may supply mobility aids and other medical equipment needed during your stay.
What kind of walkers does Medicare cover?
Several types of walkers are covered by Medicare:
Standard walker: A basic walker with four legs and no wheels provides stable support.
Two-wheeled walker: Adding two wheels to the front legs of a standard walker makes it easier to move.
Rollator: A walker with four wheels, handlebars, and a built-in seat for resting make for a natural gait when walking. Hand brakes on the rollators prevent the device from moving while trying to stand.
Knee walker: Individuals with lower leg injuries can rest the injured leg on a padded cushion while propelling themselves forward with the other leg.
Hemi walker: A hemi walker has a design that offers support on only one side for those who need support but have limited use of one arm or hand.
Medicare will pay for the type of equipment your doctor or other healthcare professional deems necessary, based on a face-to-face evaluation of your needs.
For example, your doctor might evaluate your condition and determine that a rollator will serve you better than a walker. Your doctor may also suggest a hemi walker if you depend on one side to get up from a bed or chair.
How much does Medicare pay?
Medicare covers 80% of the Medicare-approved amount for durable medical equipment (including walkers) after the Part B deductible has been met. The remaining 20%, known as coinsurance, is what you owe. Medicare Supplement Insurance (Medigap) often covers this coinsurance and potentially the deductible.
There are no fixed dollar limits set by Medicare for the amount it will reimburse. Instead, coverage is limited to what is deemed medically necessary by a Medicare-approved provider. For instance, if a beneficiary requests a $500 premium rollator, Medicare will only cover it if the physician provides a justified medical reason for the premium features. Without sufficient medical justification, the request for a more costly option may be denied.
How can you file a complaint if your request for durable medical equipment is turned down
Medicare might deny coverage for your walker or other medical equipment even when you have a prescription and use an approved supplier.
Common reasons for denial include:
Medicare doesn't consider the equipment medically necessary
The equipment isn't covered under your Medicare Advantage plan
Your supplier isn't in your Medicare Advantage plan's network
There are mistakes on the claim form
To appeal a rejection, you or the supplier must submit an appeal form along with any additional or corrected information that supports the claim. This might include:
Detailed and accurate medical documentation that substantiates the medical necessity and relevance of the requested equipment.
Confirmation that diagnoses are supported thoroughly by medical evidence.
Proper use of Healthcare Common Procedure Coding System (HCPCS) codes and any necessary modifiers that reflect special conditions or circumstances.
For issues that do not relate directly to coverage or payment decisions, such as service quality or safety concerns, you can file a complaint with Medicare by calling us at (855) 900-2427.
Will Medicare cover replacement or multiple devices?
Here are a few things to keep in mind when it comes to whether medicare will cover a replacement walker or multiple devices:
Durable medical equipment is supposed to last for a certain length of time—usually 5 years. Medicare is unlikely to approve a new walker or other piece of equipment due to wear and tear alone.
Your doctor may feel that you need both a walker and a wheelchair but must convince Medicare that you need both devices. Medicare usually approves one piece of equipment at a time for a health condition and tends to pay for the most basic item to meet the need.
To request new equipment, you must go through the same process of getting an assessment of your condition and a prescription from your doctor to prove medical necessity. Then, you must get your new device from an approved vendor that will accept the Medicare-approved amount.
Medicare will cover replacements in special circumstances such as natural disasters, theft, or loss—with the appropriate proof.
If you want a new model or a different color walker, Medicare won’t pay for a new one.
Medicare periodically updates its guidelines and its list of new durable medical equipment it will cover.
Have more questions about what Medicare does and doesn’t cover when it comes to assistive devices? Speak with one of our independent Medicare Advisors, who are eager to help you understand your coverage and how to get the most out of Medicare. Get in touch by calling us at (855) 900-2427 or picking a time to chat.