Dear Marci
Dear Marci,
I’ve been using my Medicare-covered wheelchair for years. Lately, it’s been more uncomfortable and hard to steer. Will Medicare cover a new wheelchair?
– Miguel (Central Islip, NY)
Dear Miguel,
Medicare has detailed rules for how it covers the replacement of durable medical equipment. Your equipment sounds worn out, but not damaged. If this is the case, Medicare will only replace it if you’ve had it for its whole lifetime.
Medicare only pays to replace equipment before the end of its lifetime if it’s:
- Lost
- Stolen
- Or, damaged beyond repair in an accident or a natural disaster
In these cases, you’ll likely have to give proof of the damage or theft to get the replacement.
Sometimes your medical needs change, and your current DME is no longer sufficient. You could be eligible for a sooner-than-normal replacement because your medical condition or needs changed. Your provider must write a new order or prescription that explains your medical need.
Even if Medicare won’t replace your DME, know that Medicare covers repairs. Medicare covers repairs for your worn DME if it hasn’t reached the end of its lifetime. Medicare will pay for repairs up to the cost of replacement.
To find out if Medicare covers the equipment or supplies you need, or to find DME suppliers in your area:
- Call 1-800-MEDICARE.
- Visit www.medicare.gov.
You can also learn about Medicare coverage of DME by contacting your State Health Insurance Assistance Program (SHIP).
Hope this answers your question!
-Marci