Wheelchairs/Power Operated Vehicles - (0030)

Cigna covers medically necessary manual wheelchairs, specialized/manual strollers, power wheelchairs, POV/scooters, push‑rim power assist devices and essential accessories but excludes many leisure/outdoor‑only enhancements and specific items (e.g., certain batteries, standing systems, transport/rollabout chairs, stair‑climbing/gyroscopic systems, dual‑mode chargers, robotic arms). Coverage requires documentation that a mobility limitation significantly impairs MRADLs in the home with failure of less‑supportive aids, device‑specific medical necessity per HCPCS criteria, formal face‑to‑face physician evaluation (often supplemented by a specialty PT/OT/LCMP evaluation with no supplier financial relationship), and supplier/ATP/RTS documentation and staffing requirements (Medicare face‑to‑face within 6 months when applicable).

"A standard manual wheelchair (HCPCS code K0001) is considered medically necessary when ALL of the following criteria are met: - The individual would otherwise be confined to a bed or chair. The ind..."