For people who rely on mobility assistance, one of the most common questions is: Does Aetna cover mobility scooters? The answer depends on your Aetna plan, medical necessity, and whether your scooter qualifies as durable medical equipment (DME). Understanding the details of your coverage before making a purchase can save you time, money, and frustration.

This complete guide explains how Aetna approaches mobility scooter coverage, what criteria you’ll need to meet, and how to increase your chances of approval.

Mobility scooters are more than a convenience—they are often a medical necessity for individuals living with chronic illnesses, injuries, or disabilities that limit walking. For many, a scooter provides the freedom to move around the home, shop, attend appointments, and remain socially connected.

Without a reliable mobility aid, simple tasks like cooking, bathing, or going to the store can become overwhelming or unsafe. Access to a mobility scooter can dramatically improve quality of life, reduce fall risks, and support long-term independence.

The cost, however, can be a barrier. Depending on the model, mobility scooters range from $800 to over $3,500. Lightweight folding scooters, heavy-duty bariatric options, and long-range travel scooters are often more expensive. For people on fixed incomes, that price may be out of reach without insurance assistance.

That’s where Aetna comes in. Many Aetna plans classify mobility scooters as DME and may cover part or all of the cost if they are deemed medically necessary.

So, does Aetna cover mobility scooters? In many cases, the answer is yes—provided that the scooter is prescribed by a qualified physician and meets Aetna’s medical necessity requirements. Coverage for mobility scooters generally falls under Aetna’s durable medical equipment (DME) benefits. However, the specifics of what is covered, how much you may pay out-of-pocket, and the approval process can vary depending on your individual Aetna plan. Understanding these requirements ahead of time can help you avoid unexpected costs and delays.

1. Your Specific Plan – Aetna offers a range of plans including Medicare Advantage, employer-sponsored plans, and individual or family plans. Each plan may have different coverage rules, co-pays, deductibles, and limits for mobility scooters. For instance, a Medicare Advantage plan may cover certain types of scooters differently than an individual plan purchased through the marketplace. Knowing the exact terms of your plan is essential before requesting a scooter.

2. Medical Necessity – A mobility scooter is considered a medical device rather than a convenience item. To qualify for coverage, a physician must certify that you cannot safely walk long distances and that a cane, walker, or manual wheelchair is insufficient to meet your mobility needs. Your doctor may need to document your physical limitations, history of falls, and any other health conditions that make using a scooter medically necessary.

3. In-Network Suppliers – Aetna requires that mobility scooters be obtained through DME providers that are part of their approved network. Purchasing from an out-of-network supplier may result in reduced coverage or no reimbursement at all. Working with an in-network supplier ensures that the scooter meets both your medical requirements and Aetna’s coverage standards.

4. Prior Authorization – Many Aetna plans require prior authorization before coverage is approved. This means that you and your doctor must submit documentation—including a prescription, medical records, and sometimes a mobility evaluation form—before the scooter can be purchased or delivered. Prior authorization helps Aetna verify medical necessity and ensures that the scooter is appropriate for your condition.

Because Aetna offers different plans across the country, coverage details can vary significantly from one member to another. To confirm eligibility, limits, and any out-of-pocket costs, it is crucial to contact Aetna directly or review your plan documents before moving forward with a mobility scooter purchase.

When asking, “Does Aetna cover mobility scooters?”, the most critical factor is medical necessity. Aetna does not approve coverage for scooters simply for convenience, leisure, or general comfort. Instead, the scooter must be proven essential for maintaining your health, safety, and ability to perform daily activities. Understanding this requirement is key to a successful claim.

Aetna carefully evaluates whether a mobility scooter is truly required for your condition. If you can safely walk with a cane, use a walker, or manage with a manual wheelchair, a mobility scooter is unlikely to be covered. The purpose of coverage is to provide devices that directly support mobility, independence, and fall prevention. Proper documentation of medical necessity ensures that the insurance is used appropriately while helping members regain safety and autonomy in daily life.

Your physician plays a central role in obtaining Aetna approval. They must provide detailed documentation demonstrating that a mobility scooter is medically required. Key components of this documentation include:

• Diagnosis and Mobility Limitations: Clearly state your medical condition and how it affects your ability to walk or move safely.

• Physical Evaluations or Test Results: Evidence such as balance tests, strength assessments, or gait analysis to demonstrate unsafe walking.

• Daily Living Impact: Notes explaining how your mobility issues affect activities of daily living (ADLs), including bathing, dressing, cooking, and navigating your home.

• Prescription or Certificate of Medical Necessity (CMN): A formal prescription stating that a mobility scooter is required because other aids are insufficient.

The more detailed and comprehensive your doctor’s documentation, the stronger your case for Aetna coverage. Missing or vague information may lead to delays or denials, so thorough preparation is essential.

To approve a mobility scooter, Aetna generally reviews the following criteria:

1. Inability to Walk Safely Without Support: You must demonstrate that walking independently is unsafe or impossible for long distances.

2. Difficulty Performing Activities of Daily Living (ADLs): Your condition should interfere with essential tasks such as bathing, dressing, cooking, or moving between rooms.

3. Ability to Operate a Scooter Safely: Aetna evaluates whether you have the necessary strength, coordination, and cognitive function to safely operate the device.

4. Home Accessibility: The scooter must be practical for your living environment, including hallway widths, doorways, and obstacle-free spaces.

If these requirements are not met, Aetna may deny the claim. For example, if documentation shows general weakness but fails to explain why a cane or walker is insufficient, approval is unlikely. Similarly, if your home cannot safely accommodate a scooter, Aetna may not cover the device.

When working with your physician, request that they clearly explain why other mobility aids are inadequate and why a scooter is medically necessary. Providing specific examples—such as “patient cannot walk more than 20 feet without resting, has a history of falls, and cannot safely use a walker due to balance issues”—significantly improves the likelihood of coverage approval.

If you believe you may qualify for coverage, the process of obtaining a mobility scooter through Aetna involves several important steps. Following them carefully can help ensure approval, avoid delays, and minimize out-of-pocket costs.

The first step is to make an appointment with an Aetna-affiliated physician or specialist. During this visit, your doctor will evaluate your mobility limitations, medical history, and daily challenges. They may ask questions about:

• How far you can safely walk

• Your history of falls or injuries

• Your experience using other mobility aids like canes, walkers, or manual wheelchairs

• The impact of mobility limitations on daily activities such as bathing, cooking, or moving around your home

This evaluation allows your doctor to determine if a mobility scooter is medically necessary for your specific condition.

If your doctor determines a mobility scooter is required, they will provide a prescription or CMN. This document is a critical part of your approval process, as it formally outlines:

• Your diagnosis and physical limitations

• Why a cane, walker, or manual wheelchair is insufficient

• How the scooter will support your safety, mobility, and independence

A strong, detailed CMN increases the likelihood that Aetna will approve coverage.

Next, your prescription and supporting medical records must be submitted to Aetna for review. This package may include:

• Progress notes from your doctor

• Test results, such as balance or strength assessments

• Documentation showing how mobility issues affect your ability to perform activities of daily living (ADLs)

Providing complete and thorough documentation helps Aetna assess medical necessity accurately and reduces the risk of delays or denials.

Most Aetna plans require prior authorization before a mobility scooter can be purchased or delivered. This step ensures that the scooter meets medical necessity standards and comes from an in-network supplier. Without prior authorization, even a valid prescription may not guarantee coverage.

Once approval is granted, Aetna will direct you to an approved in-network DME supplier. Working with an in-network provider is essential because:

• It ensures the scooter meets Aetna’s coverage requirements

• You are more likely to receive full or partial coverage rather than paying out-of-pocket

• The supplier can help match you with a scooter that meets your mobility needs and plan guidelines

Purchasing a scooter from an out-of-network provider may result in reduced or denied coverage.

After all approvals are completed, your scooter will be delivered. Depending on your Aetna plan, the device may be provided as:

• A rental, with ongoing monthly coverage for the duration you need it

• A permanent purchase, allowing you to keep the scooter long-term

Your DME supplier will typically provide delivery, setup, and instructions for safe use and maintenance to ensure you can operate the scooter confidently and safely.

So, does Aetna cover mobility scooters? Yes—but approval depends on medical necessity, proper documentation, and using in-network providers.

The key steps are:

• Get a strong prescription from your doctor

• Prove that lesser aids are not sufficient

• Follow Aetna’s prior authorization process

• Work only with approved DME suppliers

By following these steps, you can improve your chances of approval and minimize out-of-pocket costs. At the end of the day, Aetna’s coverage of mobility scooters can help you regain independence, stay safe, and remain active at home and in your community.