Does Medicare Cover Walkers?
Find out what coverage Medicare offers for walkers and other mobility aids.
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Joining Medicare is a great way to get health care coverage as you age. However, the federal health care program won’t cover all your medical costs.
We often get asked at PolicyScout if Medicare will cover mobility devices like walkers. The short answer is yes, but there may be complications depending on the reason you’re getting it.
Read on to learn how Medicare coverage works and determine if you can get your walker covered.
What Is Medicare?
The federal Medicare program is medical insurance for seniors over 65, disabled individuals, and people who suffer from ESRD (End-Stage Renal Disease) and ALS (Lou Gehrig’s).
You can get two main types of Medicare cover: Original Medicare and Medicare Advantage.
Original Medicare is the government-run health program that covers Medicare Part A and Medicare Part B costs.
Medicare Advantage is the new name for Medicare Part C. These are health plans that fall under the Medicare program that private health insurance companies offer to eligible people.
There are also Medicare Supplement Insurance Plans and Prescription Drug Plans, which you can enroll in if you have Original Medicare.
Overview of the Medicare Parts
Medicare is split into different parts to help enrollees manage and pay for health care expenses.
Medicare Part A is coverage for in-hospital care, treatment, and services.
Medicare Part B relates to outpatient or general medical care that enrollees receive.
Medicare Part C is the old name for Medicare Advantage, which are private health plans that offer the same level of care as Original Medicare.
Medicare Part D relates to prescription drug coverage.
Does Medicare Pay For Walkers?
Depending on the type of Medicare coverage you have, you may be able to get your walker covered as durable medical equipment (DME).
DME is defined by the Centers for Medicare and Medicaid Services (CMS) as equipment that:
Has a covered medical purpose.
Can be used repeatedly.
Reduces the symptoms or causes of a covered condition.
Another consideration is the term ‘medically necessary’. Medicare will look at why you want to get a walker before covering the cost. If it’s for a medically approved purpose or reason, then your durable medical equipment will be covered by Medicare.
Getting a walker or any piece of durable medical equipment approved by Medicare will typically go like this:
You’ll consult with your primary care physician, who’ll refer you to a specialist.
The specialist will then examine you and recommend that you need a walker.
They will submit their recommendation to the CMS and they will decide whether or not to cover you.
If you’re approved, you’ll be able to get a walker, and the durable medical equipment manufacturer or Medicare approved supplier will send the bill to Medicare for reimbursement.
Will Medicare Pay the Whole Cost of Getting a Walker?
If you apply for a walker through Medicare, Part B will cover the costs. With Part B expenses, Medicare will cover 80% of the approved amount of your device, and you’ll need to cover the remaining 20% as a coinsurance amount.
Before this happens, you’ll also need to pay your annual Part B deductible (In 2022, this was $233). A deductible is a set amount that enrollees must pay before their Medicare cover starts for the year. If you haven’t paid your deductible, Medicare won’t cover you for any costs.
What Is an Approved Amount?
All covered expenses under Medicare are paid at the CMS's rate. This is known as the approved amount or assignment and is applied to all services, tests, and items that you claim.
If you use a doctor's services or buy DME above Medicare-approved rates, the CMS will only cover their approved amount, and you’ll need to cover the difference.
For example, if the Medicare-approved rate for a walker is $500, and you buy a device that costs $550, they will only pay 80% of their approved amount ($400).
You will need to pay the remaining 20% ($100) and cover the difference between the agreed amount and what you were charged ($50).
Remember that if your doctor or DME manufacturer accepts Medicare assignment, they can charge a maximum of 15% more than the Medicare-approved amount.
If you’re worried about covering your coinsurance amount, you can look at Medicare Supplement Insurance Plans. These are private health plans that people with Original Medicare can join, which help pay for out-of-pocket costs.
Either way, be aware that there will be costs if Medicare covers your DME. Make sure that you’ve kept your premiums up to date and paid your deductible so that you don’t run into any surprises when you apply for your walker.
If you’re interested in learning more about Medicare Supplement Plans and how they can help you save on out-of-pocket costs, reach out to a licensed insurance agent today on 1-888-912-2132.
What about Medicare Advantage?
If you’re a Medicare Advantage member, you’ll get the same coverage level as someone with Original Medicare. This is known as equivalent cover, and all private health plans that offer Medicare Advantage are required by law to provide their members the same coverage.
Medicare Advantage Plans usually offer their members additional benefits on top of the minimum coverage requirements. This is part of the reason that millions of Americans have joined Medicare Advantage.
Depending on your plan, you may be able to get a walker covered by your Medicare Advantage without having to go to a specialist. Your plan might also cover different types of walkers and give you more choice in choosing the style and design of your walker.
What Types of Walkers are There?
Different walkers can improve your overall quality of life depending on your mobility issues.
Here’s an overview of the different types of walkers:
The standard walker
A standard walker has four rubber-tipped legs that provide stability to the person using it. With this type of walker, a person must pick up the device with each step.
Two-wheel walkers
Two-wheel walkers are similar to standard walkers, except that they have two wheels at the front of the device. With this type of walker, a person can slide the walker without having to lift it, and it is a good choice for someone who needs a bit of weight-bearing help.
Three-wheel walkers and four-wheel walkers
As the name suggest, four-wheel walkers allow a person to slide the device and don’t require that a person lifts their walker at all to move forward. Three-wheel walkers also enable the user to roll their walker but they are more maneuverable than four-wheel walkers.
These walkers are ideal for people who require balance support but don’t need to lean on their devices when moving.
Depending on your symptoms and mobility needs, Medicare will cover all types of walkers. It’s best to speak to your physician or a mobility specialist beforehand to ensure you’re getting the right kind of walker for your situation.
Other Considerations When Getting a Walker
Besides the sort of walker you get, there are other considerations you should keep in mind. Apart from making sure that your walker is adjusted to fit your height and proportions, here are some added features you can look into:
Selecting a grip
Changing the grip on your walker can improve comfort and your ability to use the device. Most walkers will come with a standard plastic grip. Other options include memory foam grips and cushioned grips, but they may cost more money to install.
Walker accessories
Depending on your needs, you may need to buy additional accessories for your walker to improve your overall mobility and quality of life.
For example, a tray accessory can help if you want to use your walker to eat or drink while you’re out and about.
Ask your doctor for their recommendations on what accessories you’ll need to get the most out of your walker. In some cases, Medicare may cover these additional features, but you should contact the CMS to make sure beforehand.
Where Can I Learn More about Medicare?
If you’re considering getting your walker covered through Medicare, be sure to speak to your doctor to understand what will be covered and what you’ll need to pay.
Medicare coverage can be challenging to navigate, so we’ve created articles to help you know what you can claim as a Medicare beneficiary. Here are some of our top picks:
Does Medicare Cover CPAP Machines
Does Medicare Pay for Lift Chairs
Does Medicare Cover Acupuncture
Does Medicare Cover Wheelchairs
Does Medicare Cover Preexisting Conditions
If you’d like to speak to an agent about Medicare coverage and how Medicare Advantage can help, reach out today on 1-888-912-2132 or send an email to help@policyscout.com.