Does Medicare Cover Walkers?
Yes, Medicare will cover a walker if your doctor prescribes one as a medical necessity. Walkers fall under Medicare’s durable medical equipment (DME) classification, which includes other assistive tools and devices such as canes, hospital beds, nebulizers, oxygen supplies and much more.
If your walker qualifies as medically necessary DME and your doctor accepts Medicare assignment, Medicare Part B will cover 80% of your walker after you meet your $226 annual deductible. After that, you can expect to pay the remaining 20% out-of-pocket. Individuals with supplementary insurance such as Medigap or a Medicare Advantage plan with comprehensive DME benefits would owe even less.
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Are Walkers Considered Durable Medical Equipment?
Medicare considers durable medical supplies, supplies that can withstand repeated use and help you complete basic activities of daily living as durable medical equipment. Common examples of DME include:
- Blood testing strips
- Hospital beds
- Assistive canes
- Mobility scooters
All these items help people with limited capabilities get through the day and participate in their lives without human assistance. Walkers qualify as DME because they physically empower people with compromised mobility, shortness of breath, arthritis, a history of falling, and recent injuries and traumas. Because Medicare covers medically necessary DME, it must also include any walker prescribed as such by a doctor.
How Does Medicare Coverage of Walkers Work?
To secure a walker through Medicare, you must first schedule a doctor’s visit to verify you meet the eligibility requirements.
To qualify for a Medicare-covered walker, you must check the following three boxes:
- You have a medical condition requiring a walker for care: Medicare considers any item needed to diagnose or treat an illness, condition, disease, or its symptoms as a medical necessity.
- You receive a prescription from a doctor: Just as you would need a doctor to greenlight a course of pain medication or antibiotics, you will need them to write you a prescription for a walker or any other DME to attain Medicare eligibility.
- Your doctor and walker supplier must accept Medicare: Not every working doctor or business selling walkers will accept Medicare. Research all available avenues before shopping for Medicare-covered DME.
What Is a Medical Necessity?
For any medical procedure, prescription, or DME to qualify as a medical necessity under Medicare, your doctors must affirm no other viable alternatives exist to properly diagnose, treat, or manage a persistent or unignorable condition.
In the context of walkers, medical necessity usually applies to people who cannot walk independently without falling, walk and carry objects simultaneously, or walk without pain, discomfort, or risk of injury.
What Kind Of Walker Does Medicare Cover?
Some of the walkers covered by Medicare include:
- Standard walkers: These models have four legs, require users to pick them up with every step, and work best in short distances for people with moderate balance and stability issues.
- Rollator walkers: These wheeled walkers benefit individuals without the upper body strength required to lift conventional walkers. Some rollators, known as upright walkers, come with resting chairs, detachable baskets, and adjustable handlebars.
- Hemi walkers: These half-sized walkers allow users to lean on one side of the body for support, best suited for stroke patients or amputees.
Your doctor’s prescription must describe the exact walker needed, and how it will improve your health for any specifically requested model to qualify for Medicare coverage.
How Does Medigap Cover Walkers?
Medicare Supplement, or Medigap, is additional insurance you can purchase from a private company to fill in cost-sharing “gaps” in your Medicare coverage. After Medicare Part B covers 80% of the price of DME, Medigap would cover at least 50% of your remaining coinsurance. Most Medigap plans, however, absorb 100% of the remaining costs.
Insurers sell ten different Medigap policies, labeled A through N, all of which would include some coverage for medically necessary walkers. Furthermore, Medigap Plan C and Plan F would also cover your $226 Part B deductible, typically due before DME can qualify for Medicare coverage.
How Does Medicare Advantage Cover Walkers?
Because Medicare Advantage plans must legally offer all the same benefits as Original Medicare, they must cover walkers as DME. However, since private companies oversee these policies and set distinct price structures, your coverage details will vary depending on who insures you.
Medicare Advantage members must contact their insurer to verify DME coverage terms and the percentage of final costs they would have to pay out of pocket. Conversely, Original Medicare members know what to expect, as Part B always charges a 20% coinsurance and the same annual deductible for DME.
Rentals Vs. Purchases
Depending on your situation, Medicare will either pay to purchase your walker or fund a rental model. Suppose you recently broke a bone; Medicare would likely only cover a rental walker as a temporary medical necessity. Conversely, people with chronic or steadily declining conditions, such as arthritis, or softening reflexes often qualify for permanent walkers.
In exceptional cases where doctors cannot accurately pinpoint a recovery timeline, such as with someone who recently suffered a stroke, Medicare may allow members to choose between a rental or permanent walker. Regardless of how you attain one, your walker would still qualify for 80% coverage as DME under Medicare Part B.
How Does Competitive Bidding Affect Walkers?
Under Medicare’s Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding program, companies submit bids for exclusive Medicare sales contracts in proposed areas. Medicare then uses these bids to determine the amount it will pay for DME and other items in that region.
If you live in a DMEPOS zone and need a walker, you will likely have to secure an off-the-shelf model from Medicare’s regional contract supplier. However, if your prescription explicitly requests a particular brand of walker, Medicare must find a way to secure one for you or work out an appropriate alternative with your doctor.
How Much Do Walkers Cost With Medicare?
What you pay for a Medicare-approved walker will vary widely depending on its classification, brand, whether you purchase or rent it, and what levels of coverage you have. The chart below shows the national average cost for standard, non-wheeled walkers:
Cost of Walker
Cost of Walker With Original Medicare
$13 if you have already fulfilled your annual Part B deductible. $65 if not.
Cost of Walker with Medigap
$0 under most plans.
Cost of Walker with Medicare Advantage
Depends on your policy but should fall close to the Original Medicare pricing.
The cheapest standard walkers start around $30, while high-end models can cost up to $110. Prices swing even more widely when shopping for rollators, three-wheeled, or hemi walkers.
How To Get A Walker Covered By Medicare
Follow these steps to secure a walker through Medicare:
- Review your plan: Review your policy details to determine your eligibility for DME under Medicare and how much you would personally owe out-of-pocket. Your share of expenses will vary depending on whether you have Original Medicare, Medicare Advantage, or Medigap.
- Consult with a Medicare-approved doctor: To qualify for DME coverage, a doctor who accepts Medicare must write you a prescription stating that a walker is medically necessary to manage your condition.
- Find a walker supplier who accepts Medicare assignment: Once you have a prescription, you can pick up a walker at any Medicare-approved supplier. Depending on your location, you may be limited to models from the supplier who owns Medicare’s regional competitive bidding contract.
- Purchase or rent your walker: Once you find a walker that fulfills your medical necessity, buy or rent a model according to the recovery timeline stated on your prescription. Pay your share of non-Medicare covered costs.
Consider Getting a Medicare-Covered Walker If…
- Less body strain
- Coverage ensured if prescribed
- Potentially expensive
- Must be Medicare-approved
- Limited providers
- Out-of-pocket fees
Consider getting a Medicare-covered walker if you have Original Medicare Part B or equivalent benefits through Medicare Advantage. Remember that your doctor must prescribe a walker as medically necessary to manage an existing condition. Candidates might include seniors with arthritis, trauma from a stroke, declining balance and reflexes, or injuries that inhibit their ability to move independently.
If you simply want a walker to help with day-to-day activities but have no medical precedent in justifying one, you will not qualify for Medicare coverage. Patients with severe conditions such as muscular dystrophy, ALS, or amputations may want to forego a walker and consult their doctors about Medicare-covered wheelchairs or powered scooters.
Some benefits of securing a Medicare-covered walker include:
- Safety: A walker will help you feel safer while moving around alone and allow you to stay out for extended periods.
- Support: Walkers will give you extra support and the ability to rest standing up if you get tired mid-activity.
- Less body strain: Walkers put less stress on bodies already suffering from deteriorative conditions.
- Coverage ensured if prescribed: Because Medicare classifies walkers as DME, members have guaranteed coverage for any model explicitly prescribed by their doctor as a medical necessity.
- Affordable: Standard walkers cost very little, especially after considering Medicare cost-sharing and supplemental insurance coverage.
While receiving a walker through Medicare provides many benefits, consider the following drawbacks:
- Potentially expensive: If you need a rollator, three-wheeled, hemi, or any other specialized walker, you could pay two to three times more than for a traditional model.
- Must be Medicare-approved: You can only secure a walker through doctors and suppliers accepting Medicare assignment.
- Limited providers: If you live in an area participating in Medicare’s competitive bidding program, you can typically only secure models through your region’s designated contract supplier.
- Out-of-pocket fees: Before Medicare coverage kicks in, you must meet your annual $226 Part B deductible, which costs more than most walkers on the market.
Putting It All Together
If you have recently suffered a debilitating injury or have had to endure an ongoing degenerative condition, consult a Medicare agent to see how you might qualify for a walker under your plan. Medicare typically covers any medically necessary assistive device as durable medical equipment under Medicare Part B.
Once you understand your coverage limits, visit a doctor who accepts Medicare assignment and secure a prescription justifying your medical necessity. Locate a Medicare-approved supplier and purchase or rent a model that suits your condition. Getting the right walker will help you return to daily life assured of your safety and ability to move without failing, experiencing pain, or exacerbating preexisting issues.