Does Medicare Cover Adaptive Equipment? 

The field of adaptive equipment has grown with the help of technological advancements. That’s good news for people needing vehicle modifications to maintain independent transport and living in areas with limited public transportation. A modified vehicle can be a car, truck or van equipped with tailored features that enable people with motor challenges to drive safely and comfortably.

Adaptive devices can include everything from seat-back cushions for a clear view to lifts and ramps for ease of entry and exit. There are numerous features like swivel seats, pedal extensions, extra-wide or high doors, support handles, a large print for reading the dashboard, and a wheelchair carrier.

Medicare Part B durable medical equipment

If you are recovering from an illness or injury or have limited mobility due to a chronic condition, assistive devices can help you continue your daily activities at home. Durable medical equipment (DME) includes hospital beds, wheelchairs, patient lifts, commode chairs and walkers. Medicare Part B benefits defray some of the cost if you meet specific criteria.

To qualify for Part B DME benefits, your prescribing healthcare provider and equipment supplier must participate in the Medicare program. Participating providers bill Medicare directly, accept the Medicare-approved amount and bill you only to cover the Part B deductible and coinsurance. The coinsurance payment is 20% of the Medicare-approved amount.

Medicare DME criteria

Medicare Part B covers durable medical equipment needed during recovery from an illness or injury to help you navigate your home. Medicare approval hinges upon medically necessary DME prescribed for home use. The Centers for Medicare & Medicaid Services (CMS) states that Medicare will deny claims for a power-operated vehicle (POV) or power wheelchair (PWC) to be used only outside the home. 

Before Medicare pays DME benefits, your treating practitioner must conduct a face-to-face mobility evaluation. An occupational therapist (OT) or a physical therapist (PT) may perform the assessment. If you are eligible for home health services, an OT or PT can visit you at home for this face-to-face encounter.

Mobility evaluations

If you might benefit from vehicle modifications, find a driver rehabilitation specialist who can determine the appropriate adaptation and guide you on operating new features. Professional evaluators assess your ability to enter and leave the car and check your line of sight above the steering wheel. You may need extra capacity to carry cargo and an expanded parking area at home to load and unload a wheelchair.

Mindful of compatibility and transportation safety, specialists suggest adaptive equipment aligned to your needs. The American Occupational Therapy Association (AOTA) has a search tool to locate driving rehabilitation service providers in your area.

Information resources

Search for programs that offer help with the cost of vehicle modifications by contacting the Department of Vocational Rehabilitation in your state. Veterans can call the U.S. Department of Veterans Affairs. If your car is less than one year old, ask the auto manufacturer if the company offers rebates on adaptive devices.

Other sources of information include The Association for Driver Rehabilitation Specialists (ADED), National Mobility Equipment Dealers Association (NMEDA) and National Highway Traffic Safety Administration (NHTSA).