• Assigned vs. non-assigned claims: Assigned means no out of pocket, non-assigned means you pay up-front (reimbursement for purchase). More on Medicare Assignment and Non-Assignment.
• Capped-Rental: Paid as a monthly rental and not as a reimbursable purchase. More on Medicare Capped Rentals.
• Compression Hose: At this time Compression Hose are not covered by Medicare.
• Diabetic Shoes and inserts: In order for Medicare to cover Diabetic Shoes they must be fit to your feet by a local foot specialist. You cannot bill Medicare for shoes sold over the Internet. More on Diabetic Shoes Medicare Coverage.
• Hospital Beds, Adjustable Beds: Hospital Beds are Capped-Rentals, Adjustable beds are not covered. See your local store for rentals. More on Medicare and Hospital Beds.
• Lift Chairs: The lift-mechanism is covered, about $280 reimbursement. Files as non-assigned claim, meaning you pay up front. See your local store if you want Medicare to cover Lift Chair. More on Medicare Coverage of Lift Chairs.
• Patient Lifts: Patient Lifts are a capped-rental item. See your local store for rentals. More on Medicare Coverage of Patient Lifts and Hoyer Lifts.
• Manual Wheelchairs: Capped-rental. All manual wheelchairs are covered by Medicare as rental only. See your local store if you want Medicare to cover a mnual Wheelchair. More on Medicare Coverage of Wheelchairs.
• Oxygen Concentrators, Nebulizers, CPAP:Capped Rental items. For products such as Oxygen Concentrators, CPAP, Nebulizer and related supplies are covered as a capped-rental. Visit a local supplier that rents these products and bills Medicare. More on Medicare Coverage of Respiratory Products.
• Power Wheelchairs: Power wheelchairs purchased over the Internet cannot be files as a non-assignment claim. More on Medicare Coverage of Power Wheelchairs.
• Power Scooters (POVs): Power scooters purchased over the Internet cannot be files as a non-assignment claim. More on Medicare Coverage of Power Scooters.
• Walkers and Rollators: Visit a local supplier if you want Medicare to cover your walker or rollator. More on Medicare Coverage of Ambulatory Aids.

A In most cases a Doctor's written prescription (Rx) is all that is required, or Dispensing Order written by the treating physician. Some items require a Detailed Written Order (DWO) prior to delivery or a Certificate of Medical Necessity (CMN). You can view or Download Medicare Forms here.

• A description of the item
• The beneficiary's full name
• The date of order; and
• Physician's signature and date

A "Assigned" means the supplier accepts the Medicare-approved fee for the equipment. Medicare pays for 80% of the approved fee. The beneficiary is responsible for the remaining 20%. "Non-assigned" means the beneficiary pays the supplier in full for the equipment and the supplier submits the claim to Medicare. If the item is covered, Medicare reimburses the beneficiary 80% of the approved fee.

• manual wheelchairs (capped rental)
• power wheelchairs
• some positioning devices
• walkers , rollators
• scooters
• seat-lift mechanisms for lift-chairs
• mattress over-lays (capped rental)
• hospital beds, semi-electric type only (capped rental)
• patient lifts (capped rental)
• oxygen equipment (capped rental)
• artificial limbs
• orthotics, splints

A Equipment not covered by Medicare includes; adaptive daily living aids such as: ramps, automobile lifts, reachers, sock-aids, utensils, transfer benches, shower chairs, raised toilet seats, adjustable based beds , pulse oximeter and grab bars. Basically, Medicare stops at the bathroom door. For more detailed information regarding coverage, call 1-800-MEDICARE.

A Home medical equipment must be appropriate for use in the home. Your "home" is your house, assisted living facility, apartment, a relative's home, or a group home in which you live. However, certain facility's are NOT CONSIDERED YOUR HOME: a hospital, skilled nursing facility, or nursing facility.

A In almost all cases, manual wheelchairs are covered by Medicare as a "Capped Rental." This means that Medicare pays approx. 80% of the monthly rental and you are responsible for the remaining 20% or this may be covered by secondary insurance. You must use a local dealer that rents chairs and bills Medicare for the monthly rental fees. Some Ultra-lightweight wheelchairs have a K0005 Billing code and can be billed as a purchase.

All manual wheelchairs on our website are for purchase only. Medicare does not reimburse for the purchase of a wheelchair.

See all manual wheelchairs

A Medicare will allow a walker or rollator every 5 years. They cover 80% of the allowed amount set by Medicare. If you have a supplement insurance that covers the 20%, reimbursement is usually about $125.00. Regardless of whether your rollator cost $150 or $350, the reimbursement amount is basically the same, unless qualifying for heavy-duty or Bariatric walker. Rollators are coded as walkers with appropriate accessories (wheels, seat, hand brakes). Visit a local supplier that bills Medicare if you want Medicare assistance with walkers and rollators.

Q What should the doctor's prescriptions say for a Rollator?

A Walker with 4 wheels, seat, and handbrakes.

See all Walkers and Rollators

A Medicare coverage for a bed is limited to a Semi-Electric Hospital Bed and all hospital beds are covered as a capped rental only. Medicare does not cover Adjustable Beds. See next FAQ answer for coverage details.

See all Adjustable Beds

A Medicare covers hospital beds as a Capped Rental item. This means that you must use a vendor in your local area that rents equipment and bills Medicare for the monthly fees. Your local dealer will install and maintain this "capped rental" equipment. Medicare does not consider a full-electric hospital bed, Adjustable Bed, or other Luxury beds to be medically necessary. Medicare coverage is for a Semi-electric twin-size hospital bed.

See all Hospital Beds

A Over-Bed Tables an Bedside Tables are not classified as a medical necessity and are not covered.

See all Bedside Bed Tables

A Oxygen Concentrators, CPAP and other respiratory products such as Nebulizers are Capped Rentals thru Medicare.

Q If you purchase a Portable Oxygen Concentrators will Medicare reimburse me?

A No. Medicare does not allow for, or provide, coverage for both a home oxygen concentrator and additional Portable Oxygen Concentrator. For these products you should seek a local dealer that rents equipment and bills Medicare.

See all Respiratory products.

A Transfer boards may be considered medically necessary for patients with medical conditions that limit their ability to transfer from wheelchair to bed, chair, or toilet. For Medicare coverage of these products visit a local supplier. See all Transfer Boards.

A Patient Lifts are reimbursed as a capped rental item. This means that you must visit a local dealer/retailer that rents such equipment and bills Medicare for the monthly fees. Medicare reimburses 80% of rental for up to 13 months. This capped-rental coverage is for a standard hydraulic-manual lift and sling. Power Lifts and Standing Lifts are not covered. For Medicare coverage of these products visit a local supplier.

Q Are Stand-up Patient Lifts covered by Medicare?

A No. Patient Lift coverage is for a Manual/Hydraulic Patient Lift only. Visit a local supplier to rent a Patient Lift.

See Patient Lift Catalog

A Medicare may pay for a motorized wheelchair. Although it is not guaranteed that you will qualify or be reimbursed by Medicare, whether you personally lay out the price for one, or are looking for Medicare to purchase one for you, we can give you some guidelines to follow and the basic criteria that must be met in order for Medicare to either reimburse or authorize payment for a motorized unit. A power wheelchair is covered when all of the following criteria are met:

• The patient's condition is such that without the use of a wheelchair the patient
  would otherwise be bed or chair confined.
• The patient's condition is such that a wheelchair is medically necessary and the
  patient is unable to operate a wheelchair manually.
• The patient is capable of safely operating the controls for the power wheelchair.

See all Power Wheelchairs.

Medicare: Step by Step Consumer Guide to Medicare Coverage for Power Mobility Device

A A power operated vehicle (POV) is covered when all of the following criteria are met:

• The patient's condition is such that a wheelchair is required for the patient to get around in the home.
• The patient is unable to operate a manual wheelchair.
• The patient is capable of safely operating the controls for the POV.
• The patient can transfer safely in and out of the POV and has adequate trunk stability to be able to safely ride in the POV.

Read more about requirements for Power Mobility Devices (PMDs) in this Note to Physicians on Scooters & Power Chairs.See all Power Scooters

A For Medicare coverage of these products visit a local supplier. Only the seat lift mechanism on a Lift Chair could be considered medically necessary if all of the following coverage criteria are met:

• The patient must have severe arthritis of the hip or knee or have a severe neuromuscular disease.
• The seat lift mechanism must be a part of the physician's course of treatment and be prescribed to effect improvement, or arrest or retard deterioration in the patient's condition.
• The patient must be completely incapable of standing up from a regular armchair or any chair in their home. (The fact that a patient has difficulty or is even incapable of getting up from a chair, particularly a low chair, is not sufficient justification for a seat lift mechanism. Almost all patients who are capable of ambulating can get out of an ordinary chair if the seat height is appropriate and the chair has arms.)
• Once standing, the patient must have the ability to ambulate (walk).

A Medicare does reimburse for, or authorize the coverage of Diabetic shoes, if the shoes are fitted to your feet by a local Pedorthist or trained fitter. Most cases involve "heat molding" the shoe or insert to your feet such that the foot condition is treated properly. Even with this personal fitting, the shoes must be prescribed by a qualified physician treating a foot condition resulting from Diabetes. In addition, the person fitting and providing the shoes must be approved by Medicare and must be a Medicare provider in order to properly bill for the product. Medicare will cover 1 pair of shoes and 3 pairs of inserts per calendar year. Patients seeking Medicare coverage of shoes are usually diagnosed with peripheral neuropathy.See all Diabetic Shoes and Footwear

A Medicare does not reimburse nor authorize the purchase of mobility lifts or ramps for a wheelchair or scooter at this time. Such items are typically not considered a medical necessity because they can also be used by persons without a medical condition. See all Wheelchair and Scooter Ramps

A After you have met your deductible, you're still responsible for paying directly, or through supplemental insurance, at least 20 percent of the Medicare approved amount. This co-payment may not be dropped by the supplier except in hardship situations and only on a case-by-case basis. A supplier who routinely drops the co-payment may be violating federal law.