Does Medicare Pay for a Walker for Seniors?
Summary: Medicare generally covers walkers as part of “durable medical equipment.” To get full coverage, you may need a Medicare Supplement plan.
A walker may be essential for you if you struggle to walk without support. In fact, nearly 25% of adults over 65 use some kind of mobility device, according to the American Physical Therapy Association.
Most people understand that Medicare covers a broad range of healthcare services and supplies. However, you might not know that Medicare Part B could also help pay for durable medical equipment, often referred to as a DME. This coverage may include such take-home equipment as walkers for seniors, wheelchairs, crutches, and other mobility aids.
When does Medicare pay for walkers for seniors?
You can get Medicare Part B to help pay for walkers for seniors and other DMEs under certain circumstances. Medicare might cover walkers for seniors and other durable medical equipment if:
- Your doctor wrote a prescription
- Medicare deems the equipment medically necessary
Are walkers for seniors medically necessary?
The term “medically necessary” refers to things a doctor prescribes because you need them to treat or diagnose a health issue.
- One National Institute of Health study found that 24 percent of people over 65 relied on at least one kind of mobility device. Devices included in the study included walkers, wheelchairs, and canes.
- Almost 10 percent of people over 65 used more than one kind of mobility device within the same time period. For instance, an elderly person might use a cane around the house but rely on a walker for longer trips.
Doctors might prescribe canes or wheelchairs for seniors with pain or balance problems to help them move around with a reduced risk of falling. Helping older patients remain somewhat active and decreasing their risk of injuring themselves in a fall could satisfy the requirements to establish medical necessity. Typically, the doctor’s prescription will have to include a description of the item that you need and exactly how it can improve your health or prevent a medical risk.
When does Medicare cover walkers for seniors?
In some cases, your doctor, nurse practitioner, or another qualified provider may supply walkers for seniors. For example, a nurse in the hospital might offer you one to use and take home with you. In those cases, according to Medicare, they will cover the equipment. This is true even if the entity who supplied you with your walker isn’t contracted to supply durable medical equipment.
In other cases, you may need to fill your prescription for a walker with a contract supplier if you live in an area that participates in Medicare’s competitive bidding program for DMEs. Your provider may offer suggestions for local providers that have contracted with Medicare to sell walkers for seniors. If not, you can check with suppliers before you buy. You also have the option to contact Medicare or your private insurer for help.
If you live in a competitive bidding area and don’t purchase your walker from a contract supplier, you could risk having your claim denied. Even if Medicare accepts your claim, you may have to pay more if the seller charges more than Medicare allows.
How Medicare helps pay for walkers for seniors
Medicare Part B of Medicare generally pays 80-percent of the approved cost amount after you have satisfied your yearly Part B deductible. Then you will pay 20 percent of the approved price.
Medicare will pay this portion of walkers for seniors if you need to rent or purchase the equipment. In some cases, you may have the option to choose between buying and renting. In other cases, the decision may depend upon the temporary, long-term, or permanent nature of your medical issue.
Paying for walkers for seniors with Medicare Supplements and Medicare Advantage plans
Medicare Supplement insurance plans may help pay some or all of your portion for walkers. They may make you acquire your equipment from contracted suppliers and at Medicare-approved cost amounts.
There are up to 10 Medicare Supplement insurance plans available, labeled A, B, C, D, F, G, K, L, M, and N. All these plans pay for Medicare Part P coinsurance for walkers at least 50%. Most Medicare Supplement insurance plans pay the Medicare Part B coinsurance for walkers 100%.
Note that the high-deductible version of Plan F has its own deductible that must be satisfied first.
You will need to review your Medicare Advantage plan to understand how it will cover durable medical equipment such as walkers for seniors. These plans vary, so they may have you pay a copay or some percentage of the cost.
Is coverage for walkers for seniors, other kinds of durable medical equipment, or another health issue very important to you? Enter your ZIP Code on this page to find a Medicare Supplement plan that can help cover your coinsurance for walkers for seniors.