Are Walkers Covered by Medicare? Unveiling the Truth Behind Mobility Aid Benefits

Are Walkers Covered by Medicare?

Medicare includes walkers as part of the durable medical equipment benefits provided under Part B.

The need for walkers arises for various reasons, including shortness of breath, arthritic or other pain, fear of falling or a history of falls, or difficulty walking while carrying objects.

If walking without support is challenging, a walker may be necessary.

The usage of walkers and other walking assistance devices is on the rise.

Owning a walker can enhance independence, improve the quality of life, and decrease the likelihood of falls or injuries.

Categorized as durable medical equipment (DME), walkers are prescribed by doctors for home use.

If you have Medicare Part B coverage and your doctor deems a walker medically necessary, Medicare will contribute to the cost.

To qualify for Medicare, individuals must be aged 65 or older, have worked and paid Medicare taxes for at least 10 years (or their spouse has), and be a U.S. citizen or permanent resident.

In this blog post, we will discuss whether or not Medicare pays for walkers.

Are Walkers Covered by Medicare? An image of an elderly individual using a walker for support
An image of an elderly individual using a walker for support. PHOTO: Freepik

 

How Often Will Medicare Pay For A Walker?

Typically, Medicare offers coverage for walkers once every five years.

Should your walker require replacement parts or repairs before the five-year mark, Medicare will usually cover these expenses when serviced by an approved technician.

If the cost of repairs exceeds that of a new walker, Medicare may opt for a new walker before the five-year period elapses.

Additionally, Medicare generally provides coverage for lost, stolen, or irreparably damaged walkers.

For short-term mobility needs, Medicare may mandate a rental, while for long-term requirements, it may recommend equipment purchase.

In certain situations, Medicare might afford you the flexibility to choose between buying or renting your Durable Medical Equipment (DME).

Will Medicare Pay For A Walker?

Walkers are classified as medical apparatus.

Insurance firms refer to these healthcare items as “Durable Medical Equipment” (DME).

Original Medicare Part B provides coverage for DME.

As a recipient, you bear the responsibility of covering the Part B deductible, which amounts to $226 in 2023.

After meeting the deductible, Medicare will contribute 80% towards the approved cost of a walker, while the remaining 20% becomes your responsibility.

Medicare can assist with covering the costs of your walker if you fulfill the specified criteria:

  1. You must have a doctor approved by Medicare to verify your particular condition and furnish documentation affirming the essential need for a walker to assist in your daily activities.
  2. A doctor must recommend a suitable walker type.
  3. You must acquire your walking aid from a medical equipment provider that accepts Medicare.

Does Only Medicare Part B Of The Federal Medicare Program Cover Walkers For Seniors?

The Medicare program administered by the federal government comprises various segments, each addressing distinct medical expenses.

Part B specifically addresses durable medical equipment, including items like walkers and wheelchairs, designed for individuals aged 65 and older.

Nevertheless, eligibility for walker coverage under Medicare is not automatic.

A physician must prescribe the walker as medically necessary for the individual’s condition.

Furthermore, approval from Medicare for the specific make and model of the walker may be necessary before reimbursement.

It’s important to acknowledge that depending on the individual’s plan, copayments or deductibles may still apply.

Notably, Medicare Part A primarily deals with inpatient hospital stays, while Part D focuses on prescription drugs, excluding coverage for walkers.

In summary, walker coverage for seniors falls under Medicare Part B, contingent on specific conditions and prerequisites.

How Much Do Walkers Cost Without Medicare?

The price of a walker can vary significantly depending on the desired type and features.

A basic model, devoid of additional accessories, may be priced at approximately $50 to $100.

On the other hand, more advanced options equipped with extra support or adjustable features can range from $150 to $250 or even higher.

It’s crucial to note that Medicare typically does not cover walker costs, so individuals should inquire with their insurance provider about potential coverage options.

Exploring rental possibilities is also advisable, as medical supply companies or pharmacies often offer reasonably priced rentals.

Ultimately, selecting a walker that aligns with the individual’s needs and budget is paramount.

Seeking guidance from a medical professional can aid in determining the most suitable option for safe and comfortable mobility.

Do Medicare Supplement Insurance Plans Provide Walkers For Seniors?

As individuals age, many seniors may find the need for walking aids like canes or walkers.

However, the expenses associated with these mobility aids can be substantial, and conventional Medicare plans may not include coverage for them.

This is where Medicare supplement insurance plans play a crucial role.

These supplementary plans offer coverage for the expenses related to walking aids, including walkers.

It is essential to recognize that the extent of coverage can vary among different plans and may be contingent on medical necessity.

Before finalizing a purchase decision, it is advisable to verify with your insurance provider regarding the specific walking aids covered by your Medicare supplement plan.

By opting for a Medicare supplement insurance plan, elderly individuals can enjoy the assurance of financial assistance for essential walking aids, providing them with peace of mind.

Will Medicare Pay For Rollators?

Yes, Medicare Part B generally includes coverage for medically necessary walkers, such as rollators.

To avail of this coverage, it’s essential to consult with a doctor and obtain a prescription for a rollator before Medicare contributes to the expenses.

Individuals with Original Medicare, are responsible for paying 20% of the approved amount for either renting or purchasing a rollator, along with the application of the Part B deductible.

For those enrolled in a Medicare Advantage Plan, it’s crucial to review the plan details to determine any associated costs for renting or purchasing a rollator.

When deciding between renting and buying a rollator, consider the duration of your need, especially if it’s temporary, such as post-surgery recovery, where renting may be a more practical choice.

Certain types of walkers, like lightweight ones, can be purchased without a prescription.

Some rollators feature a built-in seat, providing a convenient option for taking breaks during outings.

Additionally, seats can often be added to most rollators.

It’s important to note that if opting for a rollator with a seat, assistance may be required when getting in and out of the seat.

When Won’t Medicare Cover Walkers?

Medicare provides coverage for Durable Medical Equipment (DME) prescribed by your doctor for home use.

However, coverage does not extend to items primarily used outside the home, for recreational purposes, or under specific circumstances.

Living in a hospital or nursing home, even if covered by Medicare, does not qualify as a “home.

Consequently, items like a walker may not be covered, unless you reside in a long-term care facility.

To benefit from Medicare coverage for a walker, it must be obtained from a Medicare-approved supplier.

Choosing a non-approved supplier or one without a supplier number will result in Medicare not covering the claim, leaving you responsible for the full out-of-pocket cost.

Additionally, walkers are not covered if they are deemed unnecessary from a medical perspective or if prescribed by a doctor who does not accept Medicare.

How To Get A Walker Covered By Medicare

Are Walkers Covered by Medicare? An infographic on how to get a walker covered by Medicare
An infographic on how to get a walker covered by Medicare.

 

To obtain a walker through Medicare, adhere to the following steps:

  • Review Your Plan

Examine the specifics of your policy to assess your qualification for Durable Medical Equipment (DME) coverage through Medicare and determine the potential out-of-pocket expenses.

The amount you are responsible for will differ based on whether you are enrolled in Original Medicare, Medicare Advantage, or Medigap coverage.

  • Consult With A Medicare-Approved Doctor

To be eligible for Durable Medical Equipment (DME) coverage, you need a prescription from a Medicare-accepting physician affirming the medical necessity of a walker for managing your condition.

  • Find A Walker Supplier Who Accepts Medicare Assignment

After obtaining a prescription, you have the option to acquire a walker from any supplier approved by Medicare.

Your choices may be constrained based on your location, as you might be restricted to models offered by the supplier holding Medicare’s regional competitive bidding contract.

  • Purchase or Rent Your Walker

After identifying a walker that meets your medical requirements, acquire or lease a suitable model based on the recovery timeline specified in your prescription.

Ensure you cover your portion of expenses not covered by Medicare.

How Much Does A Walker Cost With Medicare?

Typically, you’ll start by settling your Medicare Part B deductible, which stands at $240 in 2024.

Subsequently, you cover 20% of the Medicare-approved amount, with Medicare handling the remaining 80%.

(The Medicare-approved amount is what your healthcare provider can receive.)

The actual amount you pay may fluctuate based on the provider.

For Part B coverage, you’re required to remit a monthly premium, serving as your medical insurance coverage.

Medicare will directly bill you for your Part B premium.

The expenses can also hinge on whether you’re renting or purchasing equipment.

Medicare may cover the rental cost or opt to buy the equipment on your behalf.

In certain situations, the choice between renting and buying depends on the temporary or long-term/permanent nature of your need for a walker.

Consult your doctor and DME supplier to ascertain whether your walker will be purchased or rented.

To determine the specific cost of your walker, engage in a conversation with your doctor.

Are Other Walking Aids Covered By Medicare?

If the walking assistance device is deemed medically essential, prescribed by a doctor enrolled in Medicare, and obtained from a supplier approved by Medicare, it qualifies as durable medical equipment eligible for Part B coverage.

After meeting your deductible, Medicare will cover 80%, with the remaining 20% being your responsibility.

Other walking aids Medicare will cover include:

  1. Canes.
  2. Crutches.
  3. Powered/electric wheelchairs.

In certain instances, Medicare may cover only one mobility aid.

If you require two, such as a walker and a wheelchair, it is advisable to consult with your doctor and/or contact Medicare to clarify your coverage for both durable medical equipment (DME).

Will my Medicare Advantage or Medicare Supplement plan cover a walker?

If you’re enrolled in a Medicare Advantage (MA) plan, it is required to provide coverage for the same services as Original Medicare.

The distinction lies in the varying costs associated with the chosen plan.

To ascertain whether your MA plan includes coverage for Durable Medical Equipment (DME), reaching out to your plan is essential.

Inquire about the specifics of what is covered, what isn’t, and the corresponding expenses, including potential copayments or a percentage of the total cost.

For Medicare supplement plans, there is potential assistance in covering some or all of the expenses for a walker.

However, it may be necessary to obtain the walker from a supplier contracted with Medicare.

Most Medicare supplement plans cover at least 50% of the walker’s cost, with some offering full coverage.

Keep in mind that there might be a deductible that must be satisfied first.

To gain clarity on your coverage and associated costs, it’s advisable to contact your plan directly.

Durable Medical Equipment (DME) Under Medicare Coverage

Durable medical equipment (DME) refers to medical apparatus that delivers therapeutic advantages to patients requiring such treatment.

It finds application in diverse environments such as in-patient and out-patient facilities, homes, or skilled nursing care facilities.

The extent of Medicare coverage for DME depends on the specific equipment and the environment of its usage.

Some common examples of Durable Medical Equipment (DME) that Medicare might cover comprise:

Are Walkers Covered by Medicare? An infographic on common examples of Durable Medical Equipment (DME) that Medicare might cover
An infographic on common examples of Durable Medical Equipment (DME) that Medicare might cover.

 

  1. Wheelchairs and scooters.
  2. Walkers and crutches.
  3. Hospital beds.
  4. Stair Lifts and ramps.
  5. Oxygen equipment and supplies.
  6. Respiratory equipment and supplies.
  7. Medical nutrition products.
  8. Hearing aids.

Medicare’s coverage for Durable Medical Equipment (DME) may also encompass specific services associated with the utilization of the equipment, including maintenance and repairs.

What Kind Of Walker Does Medicare Cover?

Medicare encompasses various walkers, including:

  • Standard Walkers

These devices come equipped with four legs, demanding users to lift them with each step, and are most effective when used over short distances by individuals experiencing moderate balance and stability challenges.

  • Rollator Walkers

Individuals lacking the upper body strength needed for traditional walkers find advantages in these wheeled alternatives.

Referred to as upright walkers or rollators, they often feature resting chairs, detachable baskets, and adjustable handlebars.

  • Hemi Walkers

These compact walkers enable individuals to rely on one side of their body for support, making them particularly well-suited for those recovering from strokes or dealing with limb amputations.

 

To qualify for Medicare coverage, the prescription from your doctor must specify the precise type of walker required and detail how its use will contribute to the enhancement of your health.

Frequently Asked Questions (FAQs)

  • What types of walkers are covered by Medicare?

For 2024, Medicare Part B includes coverage for standard, rollator, and upright walkers, with an 80% coverage rate once you fulfill the $226 deductible.

Your expenses might vary if you possess supplementary insurance plans like Medigap or Medicare Advantage.

  • Does Medicare pay for a walker for knee replacement?

Medicare provides coverage for medically necessary durable medical equipment (DME) prescribed for home use.

Following knee surgery, these devices may be termed assistive devices, and they will be utilized during outpatient physical therapy sessions for supervised walking or gait training.

  • What is the difference between a walker and a rollator?

Rollators are equipped with wheels on each leg, typically three or four, depending on the specific model.

In contrast, walkers lack wheels altogether or have them only on the front two legs.

  • Will Medicare pay for a platform walker?

Yes, Medicare provides coverage for walkers, as well as other types of durable medical equipment (DME) and transportation options.

Final Thoughts

Medicare Part B covers walkers, including standard and specialized types, for individuals aged 65 and older who meet specific criteria and have a doctor’s prescription.

Coverage includes 80% of the approved cost after the Part B deductible, with the individual responsible for the remaining 20%.

Replacement parts, repairs, and early replacements may be covered.

It’s important to get the walker from a Medicare-approved supplier.

Other walking aids like canes, crutches, and powered wheelchairs may also be covered.

Beneficiaries should be aware of coverage terms and associated costs for mobility assistance.

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