Why Wheelchair Selection Matters
A wheelchair isn’t just a mobility device — it’s a patient’s independence. The wrong chair leads to pressure sores, poor posture, falls, and ultimately, readmissions. The right one keeps patients mobile, comfortable, and out of the hospital.
As a provider, your recommendation carries weight. Here’s how to make it count.
Manual vs. Power: When to Recommend Each
Manual Wheelchairs
Best for patients who:
- Have sufficient upper body strength
- Need a chair primarily for longer distances
- Live in spaces that accommodate a standard-width chair
- Want a lightweight, portable option
Common types: Standard folding, lightweight, ultra-lightweight, transport chairs
Power Wheelchairs
Best for patients who:
- Cannot self-propel a manual chair
- Have progressive conditions (MS, ALS, muscular dystrophy)
- Need to travel longer distances regularly
- Require powered tilt, recline, or elevation features
Important: Medicare requires a face-to-face examination and a detailed assessment before covering a power wheelchair. The documentation burden is higher, but the clinical benefit for qualifying patients is substantial.
Sizing: The Details That Matter
Incorrect sizing is the most common wheelchair-related problem we see. Key measurements:
- Seat width — Add 1-2 inches to the widest point of the patient’s hips. Too narrow causes skin breakdown; too wide reduces stability.
- Seat depth — Measure from the back of the buttocks to the popliteal fossa (behind the knee), then subtract 1-2 inches. This prevents pressure on the back of the knees.
- Seat height — The patient’s feet should rest flat on the footrests with knees at approximately 90 degrees.
- Back height — Depends on the patient’s trunk support needs. Higher backs for less trunk control.
- Armrest height — Elbows should rest comfortably at approximately 90 degrees.
Insurance Coverage Considerations
Medicare
- Covers manual wheelchairs under Part B when medically necessary
- Power wheelchairs require additional documentation (specialty evaluation, home assessment)
- Replacement typically covered every 5 years
Medicaid
- Coverage varies significantly by state
- Many states require prior authorization
- Some states limit brand or model options
Private Insurance
- Most plans cover wheelchairs as DME
- Pre-authorization is almost always required
- Coverage percentages vary widely
Accessories and Add-Ons
Don’t forget the components that make a wheelchair functional:
- Cushions — Essential for pressure relief, especially for patients who sit for extended periods
- Positioning belts — For patients with limited trunk control
- Anti-tip devices — Recommended for patients at fall risk
- Elevating leg rests — For patients with edema or circulation issues
Ordering Through BG Clear
We stock a full range of manual and power wheelchairs from leading manufacturers. Our team can help with:
- Sizing guidance based on patient measurements
- Insurance verification and pre-authorization support
- Delivery coordination directly to the patient’s home
- Ongoing maintenance and replacement parts
Need help selecting the right chair? Talk to a specialist — we’ll match your patient with the right equipment.