If you have trouble walking and your doctor has prescribed a walking aid, your insurance will likely pay for part of the bill. Here’s an overview of what’s covered and how to best use the coverage available to you.
If You Have Original Medicare
Medicare Part B covers doctor-prescribed walking aids deemed medically necessary for use in your home.1 Walking aids may be prescribed temporarily, such as crutches, to help recover from a broken leg. They may also be prescribed for a permanent condition, such as a wheelchair for a patient with a spinal injury or advanced Multiple Sclerosis.
Durable Medical Equipment
Walking aids fall under the category of durable medical devices. They include crutches, canes, walkers, wheelchairs, scooters, and motorized wheelchairs.
To buy or rent durable medical equipment (DME), Medicare recipients must use a DME supplier. That company must have enrolled with Medicare and agreed to Medicare’s reimbursement rates. Your prescribing doctor must also have done the same. Your doctor can help you find a nearby supplier and determine if buying or renting makes sense.2
How Much Does It Cost?
With Medicare Part B, you’ll be responsible for the 20% co-pay and any Part B deductible that is still applicable. (The Part B deductible for 2020 is $198.3) For equipment such as motorized scooters, pre-approval may be necessary. Some Medicare Supplement Insurance plans, also known as Medigap, will help cover the copay. Check with your Medigap insurer to find out if your policy offers this coverage.
If you have Medicare Advantage
If you purchased a Medicare Advantage, or Medigap, plan, you’ll receive the same coverage for walking aids as provided by Medicare Part B. Still, many Medigap plans, which are sold by private insurers, include additional coverage beyond Medicare Part B.
Check with your insurer to see how much out-of-pocket costs to rent or buy a walking aid. And be careful which supplier you use. Most Medicare Advantage plans require you to rent or purchase equipment through an in-network provider.
Watch Out For Medicare Fraud
One final note on Medicare coverage: The durable medical equipment category is rife with Medicare fraud.4 Always make sure to have a doctor’s prescription and use a Medicare-approved supplier (or supplier approved by your Medicare Advantage plan) to avoid scams.
If You Have Private Insurance
Private insurers also offer coverage for prescribed walking aids. But depending on your plan, to qualify you may need more than a doctor’s prescription. You may also need an assessment from your healthcare provider.
You may also need to use a DME supplier that accepts your insurance. Keep in mind, however, that you can still be turned down for coverage if you don’t have the proper prescription or assessment.
As with Medicare, private insurers offer coverage only under certain conditions. Mobility limitations must prohibit you from achieving daily activities such as dressing or bathing. You must also be able to use mobility aid safely.5
Whenever a mobility aid is prescribed, call your insurer before buying to check how your coverage works.