Medicaid Funding for Power Wheelchairs

Man in a power chair speaking to woman at dining room table.

Overview

Medicaid is the largest program designed to provide medical and health-related services to people with low incomes and pay for covered medical services. Medicaid may cover a power wheelchair if the patient meets eligibility and coverage requirements. Title 19 of the Social Security Act is a program that provides medical assistance for certain individuals and families with low incomes and resources. The Medicaid program is funded through a cooperative venture between the Federal and State governments. Within broad national guidelines which the Federal government provides, each of the States: 

  • establishes its own eligibility standards;
  • determines the type, amount, duration, and scope of services;
  • sets the rate of payment for services; and
  • administers its own program.
Female physician attending senior woman

Assistive technology devices, such as a motorized wheelchair, may be covered as Durable Medical Equipment (DME) under this program. 

Eligibility Requirements

 To qualify for Medicaid, an individual must meet income and resource limits, and be medically needy or fall into an eligibility category specified by your state. Anyone receiving Supplemental Security Income (SSI) benefits is automatically eligible in some states. Medicaid will only pay for a motorized wheelchair if the individual has a medical need for the specific type of electric wheelchair he or she needs. There must also be a doctor’s prescription. Power wheelchairs can be covered as DME under Medicaid; however, coverage varies from state to state. Some of these variations include: 

  • Coverage for outdoor, vocational use;
  • Coverage for skilled nursing homes;
  • Coverage for accessories (some states have age limitations for coverage);
  • Whether the power wheelchair can be purchased or rented; and
  • Some states require physical therapy reports or special forms to be completed

To apply for Medicaid, please visit your local state Medicaid agency.

16 thoughts on “Medicaid Funding for Power Wheelchairs

    1. Hi Leroy!

      Thank you for reaching out to us, Medicare covers only the “seat lift” mechanism portion of the chair. However, the specific Medicaid plan may or may not cover what Medicare does not fund. The best way to find out what exactly is covered is to contact her Medicaid plan. Please let me know if you need any additional information, always happy to help!

      Best Regards,
      Amanda

  1. Medicaid pay for electric wheelchair I can’t walk hard on my back and legs I have to stay in bed most of the time and I’m really getting tired of it everytime I try to walk my back is out. and I fall how was used to pain I can’t use it no more I have surgery from both arms I told her well repair replacement on both side and I still can’t hardly move my arms I have nerve damage in my legs and feet

    1. Hi Edward, I’ll be happy to assist you with this question! If you are receiving coverage through Medicare or Medicaid, you may qualify for coverage on a mobility device. You must have a medical need for Medicare to cover the cost of a scooter, power chair, or other mobility product. You should contact your insurance provider to get exact answers to your questions regarding coverage for your specific policy.

  2. I just need a simple scooter till surgery I pray left leg shorter than right leg from car wreck n bent hardware?

    1. Hi Cheryl!

      i’m happy you reached out to us, I’ll be glad to help point you in the right direction. To find a dealer near you please visit this link and enter in your zip code or address, you’ll see a list of authorized Pride Mobility dealers near you. https://www.pridemobility.com/find-a-dealer.asp

      We have a few scooters like the Go-Go Elite Traveller that are easy to transport and disassemble to fit into most vehicles, you can view a few of the models here: https://www.pridemobility.com/go-go-travel-mobility/models.asp

  3. Will prime west insurance cover a mobile scooter for a stroke patient. Who is Paralyzed paralyzed on one side and only can walk a Certain distance?

    1. Hi William,

      Thank you so much for reaching out to us, I will be happy to help point you in the right direction. My suggestion for the most accurate answer for your coverage and how much coverage would be to contact your insurance plan and ask them about their coverage of durable medical equipment like power wheelchairs or scooters. If you need any help or if they ask you what “code” they fall under I can help provide you with those numbers.

      I hope you have a great day!

  4. Does Medicare cover an electric lift recliner. My mother cannot get in and out of her chair consistently without assistance anynore.

    1. Hi Anthony!

      Thank you for reaching out to us here with your question. We’ll be happy to help point you in the right direction. We’ve created a few resources that will help address these questions here: https://www.pridemobility.com/medicare-funding/lift-chair-medicare-coverage.asp after you review those, please let me know if you have any additional questions and I’ll be happy to help.

      Thank you, and I hope you have a great day!

      -Amanda

  5. Hello,
    I am disabled and on SSI, and recieve m├ędicale, and medicaid. I am a fallu risk, and have a hard time getting out of my chair. I want to know how I can get funding for a Lift chair? I struggle every day getting out of my chair and to get around. PLEASE HELP ME WITH THIS REQUEST.
    Sincerly,
    Michelle Fluhrer

    1. Hi Michelle!

      Thank you so much for reaching out to us here regarding your interest in funding for a lift chair. I’ll be happy to direct you to where you can get some answers. We have put together some resources for your questions. You can review those resources here: https://www.pridemobility.com/medicare-funding/lift-chair-medicare-coverage.asp please let me know if you have any additional questions after checking those out?

      Thank you again and I hope you have a great day Michelle!

      -Amanda

  6. Friend’s husband is in long term care facility. He needs a new power chair. Facility is telling them he has to leave facility in order to get a new wheelchair. Saying he has to go to stay at his home while chair is being ordered. He’s a quad and she’s a heart transplant survivor. Both in their 70s. Also because of Covid she’s afraid to bring him home. Does he really have to leave the facility in order to replace his over 10 year old chair that is constantly in need of repair. State of Residence is Louisiana

    1. Hi Vickie!

      Thank you for reaching out to us here regarding your friends husband! I’ll be happy to help point you in the right direction. I confirmed with our in-house expert that:

      Traditional Medicare will not cover a wheelchair if the patient resides in a skilled facility but may cover a new chair only if the beneficiary is being discharged to their home.

      Other insurances and some Medical Assistance programs may cover a power chair in a skilled setting. Contact the insurer to see if they will cover a new power chair when the beneficiary resides in a long-term skilled facility.

      The number for Medicare is 1-800-MEDICARE.

      We recommend reaching out to their insurance provider(s) to see if this is something that can potentially be covered within a long-term skilled facility. Please do not hesitate to reach out if you have any additional questions or if there are any other resources we can help provide. Thank you, and I hope you have a great day!

      -Amanda

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