TSA screening is built around a traveler who can stand unassisted, walk through a scanner, and lift a bag onto a belt. Plenty of people cannot do all three, and the rules for them are real, specific, and poorly publicized.
If you are 75 or older, use a wheelchair or walker, have a joint replacement or a pacemaker, or are helping an aging parent get to a flight, this guide covers what actually happens at the checkpoint and what you can arrange in advance.
The 75 and Older Rule
TSA applies modified screening procedures to passengers aged 75 and older. In practice this means two things:
- You may leave your shoes on.
- You may leave a light jacket on.
That is the core of it, and it applies in the standard lane without any application, enrollment, or fee. You do not need to prove your age in advance, though an officer may ask to see your ID to confirm it.
Two important limits. First, this is a modification, not an exemption. If something alarms during screening, an officer can still ask for whatever is needed to resolve it. Second, modified screening does not shorten your line. You wait in the same queue as everyone else. If line length is the problem rather than the screening itself, TSA PreCheck is the thing that helps, and it extends the same shoe and jacket allowance to a dedicated, usually much shorter lane.
Children 12 and under receive comparable modified screening, which is covered in our family travel guide.
Wheelchairs, Scooters, Walkers, and Canes
You are never required to stand up or leave your wheelchair or scooter. This is the single most important thing to know, and it is the point travelers most often get wrong. If you cannot stand or walk through the screening equipment, you will be screened seated.
Here is how it works in practice.
If you can walk a short distance without assistance, you may be asked whether you are able to walk through the metal detector or body scanner. This is optional. Your mobility device is then screened separately, and you can request that it stay within your sight throughout.
If you cannot stand or walk, you remain seated and receive a pat-down instead. An officer of the same gender conducts it. They will inspect the areas they cannot otherwise clear, including under and behind you as far as is reasonable while you remain seated, and they will run explosive trace detection swabs over your hands and over the wheelchair or scooter itself. The swab is a small cloth pad; it is painless and takes seconds.
Walkers, canes, crutches, and rollators go through the X-ray machine if they physically fit. If a device does not fit, or you need it to remain with you, it will be inspected by hand and swabbed instead. You can ask for a chair or a place to sit during this.
Casts, braces, prosthetics, and support garments are never required to be removed. They will be visually inspected and swabbed.
Our guide to body scanners and pat-downs covers the general procedure, including your right to request a private screening room and to have a companion or witness present. Both of those rights apply here and are worth using if a seated pat-down feels exposed in a public checkpoint.
Joint Replacements, Pacemakers, and Implants
Hip and knee replacements will almost always alarm a walk-through metal detector. Millimeter-wave body scanners, which most large airports now use, do not alarm on internal metal the same way, but they will flag the area on the generic outline they display. Either way, the resolution is a targeted pat-down of that specific area, not a full-body search. It usually adds a minute or two.
Pacemakers and implanted cardiac devices are generally considered safe for both walk-through metal detectors and millimeter-wave scanners. That said, some cardiologists advise patients to avoid metal detectors as a precaution. If yours has, you can simply tell the officer and request a pat-down instead. You do not need to justify the request or produce a doctor’s note.
Insulin pumps, continuous glucose monitors, ostomy pouches, and catheters can all stay on your body. Some manufacturers advise against sending pumps and monitors through X-ray or body scanners, in which case you should tell the officer before screening begins and request alternate screening. Expect a pat-down of the area plus a hand swab. For anything you are carrying rather than wearing, our flying with medication guide covers liquid medication, syringes, and quantity rules, all of which are exempt from the 3-1-1 limits.
The TSA Notification Card is a printable card you can download from TSA’s website and hand to an officer. It describes a medical condition or disability discreetly so you do not have to explain it out loud in a crowded line. It does not exempt you from any screening. It is purely a communication tool, and it is genuinely useful for travelers with conditions that are hard to explain quickly or who find the interaction stressful.
TSA Cares: The Thing Almost Nobody Uses
TSA runs a helpline specifically for travelers who need assistance getting through screening. It is called TSA Cares, and it is the most underused resource at the airport.
Call 855-787-2227 at least 72 hours before your flight. You can request a Passenger Support Specialist, a trained officer who meets you at the checkpoint and walks you through screening personally. They can help with communication, explain each step in advance, and smooth out the parts of the process that tend to go badly for travelers with mobility, cognitive, or medical needs.
This service is free, it works at most major airports, and it makes a substantial difference. If you are helping an aging parent fly, particularly someone with dementia, anxiety, or a condition that makes an unexpected pat-down distressing, this is the call to make.
Separately, if a family member needs help getting to or from the gate but is not flying, ask the airline for a gate pass at the ticket counter. A non-traveling companion with a gate pass clears security with you and can stay until boarding. Our full guide to getting a gate pass and going through security without a ticket covers what ID you need and why requests get denied.
Practical Tips for an Easier Checkpoint
Ask the airline for wheelchair assistance when you book, not at the airport. It is free, and requesting it in advance means someone is actually assigned to you.
Fly midday, midweek. Checkpoints are calmest between roughly 10 a.m. and 2 p.m. on Tuesdays and Wednesdays. A slower checkpoint means officers are less rushed, which matters more when screening takes extra steps. See the busiest days and times for the full pattern.
Build in extra time. Seated screening and device inspection typically add 10 to 20 minutes. Use our arrival time guide as a baseline and add to it.
Wear slip-on shoes anyway. Even with the 75-and-older allowance, an alarm can mean removing them, and struggling with laces while seated is worth avoiding. Our what to wear guide covers what triggers scanner alarms in the first place.
Consider PreCheck for the lane, not the shoes. For a traveler who already gets modified screening, PreCheck’s real value is a shorter queue and less time standing.
Frequently Asked Questions
Do seniors have to take off their shoes at TSA?
No. Since July 2025 nobody removes their shoes in standard screening, at any age, and passengers 75 and older may also leave a light jacket on. This applies automatically with no enrollment or fee. An officer may still ask you to remove footwear if something alarms and needs to be resolved.
Do you have to get out of a wheelchair for TSA screening?
No. You are never required to stand up or leave your wheelchair or scooter. If you cannot walk through the screening equipment, you will be screened while seated with a pat-down and an explosive trace detection swab of your hands and the device.
Will a hip or knee replacement set off airport security?
A hip or knee replacement will typically alarm a walk-through metal detector. Millimeter-wave body scanners do not alarm on internal metal the same way but will flag the area. In both cases the result is a short, targeted pat-down of that area, usually adding a minute or two.
Is a body scanner safe with a pacemaker?
Millimeter-wave body scanners are generally considered safe for pacemakers and implanted cardiac devices. If your cardiologist has advised avoiding metal detectors, tell the officer and request a pat-down instead. You do not need a doctor’s note to make that request.
What is TSA Cares and how do I use it?
TSA Cares is a free helpline for travelers who need screening assistance. Call 855-787-2227 at least 72 hours before your flight to request a Passenger Support Specialist, a trained officer who meets you at the checkpoint and guides you through screening in person.
Can someone help my elderly parent through security if they are not flying?
Yes. Ask the airline at the ticket counter for a gate pass. A non-traveling companion with a gate pass goes through security with the traveler and can stay with them until boarding. Request it in advance when possible, since policies vary slightly by airline. See how gate passes work.
Does the TSA Notification Card get you through security faster?
No. The card discreetly communicates a medical condition or disability to an officer so you do not have to explain it aloud. It does not exempt you from screening or speed up the line, but it makes the interaction easier and less stressful.
The Bottom Line
The accommodations exist and they are more generous than most travelers realize. Passengers 75 and older keep their shoes and jacket on. Nobody has to leave a wheelchair. Medical devices stay on the body. Braces and prosthetics are never removed. The catch is that almost none of this is signposted at the checkpoint, so you have to know to ask. If the trip involves real difficulty, call TSA Cares 72 hours ahead and let a support specialist handle it.
Check Your Airport’s Busiest Hours Before You Fly
Extra screening time matters a lot more when the line is already long. Look up your airport on Airport TSA Times to see when its checkpoints are busiest, from TSA’s hourly counts at 73 US airports, so you can pick a calm window and give yourself the buffer that seated screening and device inspection require.