When my grandma first needed a wheelchair to get around her apartment last year, I spent more hours on hold with insurance representatives than I’d care to admit. Every time I asked if her basic manual wheelchair would be covered, I got a different answer—sometimes a confirmation, sometimes a denial, sometimes a vague line about “medical necessity” that felt like a moving target. That frustration is exactly why I started my assistive living devices supply business three years ago. I saw too many families like mine scrambling to figure out insurance coverage, and too many older adults or people with disabilities being forced to skip out on devices that would make their daily lives safer and more independent. Today, I want to pull back the curtain on a question we get every single week from customers and their caregivers: do insurance companies actually cover the cost of assistive living devices? Assistive Living Devices
First, it’s important to note that there’s no one-size-fits-all answer here. Coverage rules change based on the type of insurance you have, the specific device, and how your doctor frames its need. Let’s break down the most common insurance types people rely on, because that’s where the biggest differences show up. For Medicare, which is the federal health insurance program for people 65 and older, or those with certain disabilities, coverage falls into two parts that matter most for assistive devices. Medicare Part B, which covers outpatient medical services, does cover durable medical equipment (DME)—that’s the official term for things like wheelchairs, walkers, hospital beds, oxygen concentrators, and even grab bars for bathrooms. But there are strict rules. The device has to be medically necessary, meaning a doctor has to prescribe it to treat or manage a specific health condition. For example, if your doctor writes that a wheelchair is needed because you have mobility issues from arthritis or a recent knee replacement, that usually counts. If you just want a wheelchair to make weekend trips easier without a doctor’s note, that won’t be covered. Also, Part B typically covers 80% of the Medicare-approved amount for the device, and you’re responsible for the remaining 20%, plus any deductible you’ve already met for the year. One big catch here: not all DME suppliers accept Medicare assignment. That means if you go to a supplier that doesn’t, they might charge you more than the Medicare-approved rate, and you’ll have to pay that difference, which can add up fast. That’s why so many of our customers come to us after being overcharged by suppliers who don’t work with their insurance.
Medicare Advantage plans, which are private alternatives to Original Medicare, often have different rules. Some may cover more items than Original Medicare—like certain types of seating cushions for wheelchairs that help with pressure sores, which are a big concern for people who use wheelchairs full-time. But they might also require you to use in-network suppliers, so you can’t just walk into any store. We work closely with most major Medicare Advantage plans, so we can help customers confirm if a device is covered before they order, which saves them weeks of waiting and frustration.
Private health insurance, the kind you get through your employer or purchase on the Affordable Care Act marketplace, is even more variable than Medicare. Some plans have robust coverage for assistive devices, while others limit it to only devices deemed “medically necessary” and exclude items that are considered “comfort” or “personal use.” For example, a power wheelchair is much more likely to be covered if you have a condition that makes walking long distances painful or impossible, like multiple sclerosis or advanced Parkinson’s, than if you just need it for grocery shopping. But some plans won’t cover power wheelchairs at all, sticking only to manual ones. That’s where a lot of the confusion comes in. A caregiver might call one insurance rep who says a power wheelchair is covered, another who says it’s not, and end up giving up. Our team takes the time to help customers gather the right documentation—doctor’s notes, proof of medical need, even photos of their current mobility challenges—to submit to insurance for prior authorization. Prior authorization is a step most people miss: you can’t just order a device and file a claim afterward. You have to get approval from your insurance first, and if you skip that step, your claim will almost certainly be denied.
Then there’s Medicaid, the joint federal and state program for low-income individuals and families. Medicaid rules vary by state, which means coverage for assistive devices can look very different depending on where you live. Some states cover a wide range of DME, including specialized items like adaptive bikes or communication devices for people with speech disabilities, while others have more limited lists of covered devices. A lot of our customers who are on Medicaid have found that working with a supplier who knows their state’s specific Medicaid guidelines makes all the difference. For example, in my home state, Medicaid will cover a hospital bed if a doctor says it’s needed to prevent bedsores or manage a chronic respiratory condition, but they won’t cover over-the-bed tables unless the doctor specifically prescribes one for post-surgery care. We keep our team updated on every state’s Medicaid changes, so we can guide customers through what’s actually covered.
Now, let’s talk about what usually doesn’t get covered, because that’s another big point of confusion. Insurance almost never covers items that are considered “general comfort” rather than medical necessity. That means things like decorative grab bars that don’t have a medical need, standard walking canes if a manual wheelchair would be more appropriate, or luxury power wheelchairs with custom paint or extra features that aren’t clinically necessary. Some plans also don’t cover devices if they’re not deemed “cost-effective”—if an insurance company decides that a cheaper manual walker would work just as well as a power wheelchair, they’ll often deny coverage for the more expensive option. That’s why we work with doctors to make sure they frame the medical need clearly, and sometimes provide data on how a specific device improves a patient’s quality of life, which can help overturn denials.
I want to share a real story from a customer we had last year to put this in perspective. Mr. Torres, 72, had recently had a stroke that left him unable to walk more than a few steps without losing his balance. His primary care doctor prescribed a power wheelchair, but when we submitted the prior authorization to his private insurance, they denied it, saying a manual wheelchair would be sufficient. We worked with his neurologist to provide a letter detailing that Mr. Torres had a history of falls, and a manual wheelchair would leave him stranded if he couldn’t propel it long distances. We also included photos of his home: narrow doorways, a small bathroom where a manual wheelchair wouldn’t fit, and his need to go to physical therapy three times a week. We appealed the denial, and three weeks later, the insurance approved 80% of the power wheelchair cost, and Mr. Torres was able to get back to visiting his grandkids and attending his weekly church service. That’s the kind of outcome we’re in this business for.
Of course, there are common mistakes that lead to coverage denials that we see all the time. One of the biggest is not confirming that your supplier is in-network or accepts your insurance. If you go to a big box store that doesn’t work with your plan, your claim will likely be denied, and you’ll be stuck paying the full cost. Another mistake is not getting prior authorization. A lot of customers wait until they have their device, then try to file a claim, which is almost always rejected. And a third mistake is not providing enough detail about your medical need. A doctor’s note that just says “needs a wheelchair” isn’t enough—insurance needs to know why, how it affects your daily life, and why a less expensive device won’t work. That’s where our team steps in: we help gather all that documentation, submit prior authorizations, and handle appeals when claims are denied.
Now, let’s talk about what families can do to increase their chances of getting coverage. First, start with your insurance plan’s website or customer service line, and ask for a list of covered DME suppliers in your network. If you’re working with a supplier, ask them to check your plan’s coverage before you order—most reputable assistive living device suppliers will do this for free, and they’ll know the specific rules for your device and plan. Second, make sure your doctor is involved early. Don’t wait until you’re ready to buy a device to ask for a prescription. A doctor who understands how insurance works can help write a strong letter of medical necessity that addresses all the points insurance looks for. Third, keep all your documentation: receipts, doctor’s notes, insurance correspondence, and photos or videos of how you use the device. If your claim is denied, you’ll need all of this to appeal. And don’t be afraid to appeal—many denials are overturned when you provide additional information.
At the end of the day, the goal of insurance coverage for assistive living devices is to help people maintain independence, avoid falls, and manage chronic conditions without going broke. But the system is complicated, and it’s not designed to be easy for families to navigate alone. That’s why we’re here: we’re not just a supplier of wheelchairs, walkers, and adaptive devices. We’re a resource, to help you understand your insurance, get the coverage you’re entitled to, and find the right device for your needs.
If you’re struggling to figure out if your assistive living device will be covered, or if you need help navigating the insurance process, our team is ready to work with you. We’ve helped hundreds of customers get the devices they need without the stress of insurance runaround, and we’re here to guide you every step of the way.
Steel Furniture References
Centers for Medicare & Medicaid Services. (2024). Durable Medical Equipment (DME) Coverage.
U.S. Department of Labor. (2023). Private Health Insurance Coverage of Durable Medical Equipment.
National Council on Aging. (2022). Navigating Insurance Coverage for Assistive Technology.
American Academy of Family Physicians. (2023). Medical Necessity for Durable Medical Equipment.
Jiangsu Hangjia Marine Decoration Co., Ltd.
As one of the most professional assistive living devices manufacturers and suppliers in China, we’re featured by quality products and low price. Please rest assured to buy customized assistive living devices made in China here from our factory. Contact us for pricelist and quotation.
Address: No.256, Gongnong North Road, Nantong City, Jiangsu Province, China
E-mail: 13962916076@163.com
WebSite: https://www.hangjiaindustry.com/
