Getting a seat cushion for a wheelchair is not just about comfort. It also helps with pressure relief, skin protection, positioning and more stability while seated.
Whatever the reason, the question often comes up “does Medicare cover seat cushions?”. We answer this question below. And you’ll also find information about seat cushion costs as well as other general info about them.
Does Medicare Cover Seat Cushions?
Yes, Medicare will cover seat cushions. Although only under certain conditions. Let’s take a closer look at these conditions here.
The first condition applies to the type of wheelchair you have. You must have a manual or power wheelchair with a sling/solid seat/back. For those who have a POV or power wheelchair with a captain’s chair seat, coverage for a cushion will likely be denied.
If you have an eligible wheelchair, then a general use seat cushion and a general use back cushion can be covered.
If you are enrolled in any program with Medicare Part B, it will pay for 80% of the cost. You will pay for the remaining 20%.
Also, the cushion(s) need to be considered medically necessary. This generally requires a prescription from your Medicare-approved doctor for the cushion.
The order/prescription must specify what type of seat cushion(s) you require and meet the criteria for that seat cushion.
For Medicare to cover for skin protectant cushion, you must have a pressure ulcer or have suffered from one. Medicare will also cover skin protectant cushion if you suffer from conditions such as:
- Spinal cord injury or disease
- Quadriplegia or paraplegia
- Cerebral palsy
- Post-polio paralysis
- Alzheimer’s disease
- Parkinson’s disease
- Childhood cerebral degeneration
- Multiple sclerosis
- Amyotrophic lateral sclerosis
- Spina bifida
Medicare will cover positioning seat and back cushions if you have significant asymmetry in posture caused by:
- Lower limb monoplegia
- Hemiplegia caused by stroke or traumatic brain injury
- Torsion dystonias
- Muscular dystrophy
- Spinocerebellar disease.
Where Can Wheelchair Seat Cushions Be Purchased?
You can purchase cushions from Medicare-approved manufacturers, retailers, and pharmacies.
Wheelchairs And Types of Seat Cushions
A wheelchair seat cushion, similar to a household seat cushion, provides padding and relief from pressure. They are great for people who have to spend long periods in their wheelchairs.
There are two main types – skin protection varieties and positioning seat or back cushions.
Skin protection cushions are great for people who are having trouble adjusting their positions in their seats. It’s also useful for those who may suffer or already have suffered from pressure ulcers.
On the other hand, positioning seat or back cushions are for people who need support for offset postural asymmetries caused by paralysis of the limbs or similar conditions.
Seat cushions are typically made from a few different types of materials. Foam cushions which are low maintenance and low cost. Gel cushions which are ideal for pressure relief and the best positioning. And also air cushions which are low maintenance and also provide fantastic pressure relief.
How Much Does A Wheelchair Seat Cushion Cost?
Wheelchair seat cushions have a wide range of prices. They can cost anywhere from around $20 to over $380. The prices vary so much due to the cushion’s quality and features.
Custom made positioning seat and back, and skin protectant cushions can cost as high as $250.
Note: Medicare coverage changes all the time. Always be sure to double check with your health care provider and/or Medicare insurance provider about what is and isn’t covered by your plan.
Additional Info on Medicare Coverage
This article is part of our series on “What does Medicare cover?”
Also, please check out other articles in this series including: Does Medicare Cover Rollators?