Medicaid Funding for Power Wheelchairs

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.

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.

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Published by Pride Mobility

Welcome to Pride Mobility! We are a leading manufacturer of mobility products, including power chairs, scooters, lift chairs, and more. Our goal is to help people with mobility challenges live their best lives by providing innovative, high-quality, and reliable products that enhance their independence and comfort. Our company was founded in 1986 with a mission to improve the quality of life for people with mobility limitations. Since then, we have grown to become a global leader in the industry, with a wide range of products designed to meet the unique needs of individuals with varying levels of mobility. At Pride Mobility, we are committed to delivering exceptional customer service and support. Our team of knowledgeable and experienced professionals is dedicated to helping our customers find the right products to meet their specific needs, and we are always here to answer any questions or concerns. We take pride in our products and stand behind them with a comprehensive warranty and service program. Whether you are looking for a power chair to help you navigate your home or a scooter to explore the outdoors, you can trust Pride Mobility to provide the quality, comfort, and reliability you deserve. Thank you for choosing Pride Mobility as your partner in mobility. We look forward to helping you live your best life! View more posts

65 thoughts on “ Medicaid Funding for Power Wheelchairs ”

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

I’m on state medicaid was in a car wreck left me unable to do things one are is bad and both legs bad I had 32 broken bones can I qualify for power chair

Hi Shirley! The best way to verify if you qualify for a power mobility scooter or an electric wheelchair is to speak with your primary care physician. They will be able to help you with your questions and detail out with your insurance any copays/etc.

I am looking for a light weight mobility scooter for my mother. She had a couple strokes and a bunch of seizures. The left side of her body doesn’t work well. She can barley walk. How would I go about getting her a mobility scooter.

Hi Patricia, we’re not familiar with the ibot brand but we do have several power wheelchairs that have billing codes associated with them. Here are a few: https://www.pridemobility.com/jazzy-power-chairs/models.asp many of the seats come in a variety of sizes as well. To determine what your insurance will fund the best thing to do is contact them and ask them what your coverage and copay if applicable would be. Then you can speak to a mobility dealer who can help you. You can find one here: http://www.pridemobility.com/find-a-dealer.asp

Most insurance offers you a healthcare coordinator. Call and ask for to speak to yours. They will help you with all your needs and strides you wish to achieve. Most offer medical rides to appointments as well as get your doctor on board with your needs and requests. Yes your combined insurance pays for chairs in full once you qualify. Not necessarily this brand but it might be it depends what your needs are and the steps you take to get it. Your doc needs to be on board, as well as your insurance.
I started the process of getting mine thru my healthcare coordinator.
Hope this help answer some questions

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

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.

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

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

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?

Hi Sasa! Thank you for your inquiry! My suggestion would be to contact your insurance policy to determine exact coverage. After that you can work with a provider to obtain your equipment. To find an authorized retailer please visit: https://www.pridemobility.com/find-a-dealer.asp

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!

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

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

Hello,
I am disabled and on SSI, and recieve médicale, 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

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

I have Medicaid and will turn 60 next month am disabled and draw SSI I am basically in a chair most days thankfully I have just a small apartment but I need a lift chair as it is difficult to get up and down on my own

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

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

Hi I’m on Medicare and Medicaid pays what Medicare doesn’t my doctor put me in for scooter I’m also on ssdi will I be able to pick the scooter I want or do Medicare/ Medicaid choose I need an outdoor one and indoor

Hi Rose! Typically when your doctor is prescribing you a new mobility scooter they will fall into categories based on your diagnosis, thankfully within those categories you’ll have some great options to work with. If you happen to know what billing code they are using I can send you the options that fall within that category for you to look at. I hope that helps and I hope you have a wonderful day! If you’d like to speak with one of our friendly representatives you can call us directly at 800-800-4258 or send us an email at info@pridemobility.com

Hi Vergis! I hope you are having a great day so far, here is some information on how you can obtain funding for an electric chair if you qualify: https://experience.pridemobility.com/electric-wheelchairs/faqs-for-electric-wheelchairs/will-medicare-pay-for-an-electric-wheelchair/ Please feel free to contact us directly at info@pridemobility.com if you have any additional questions. I hope this helps and thank you for visiting our blog.

I have medicaid I had knee surgery in 2018 and plantar fasciitis so it hard for me to get out of chair because they are so low. Do I qualify for a power lift chair.

Hi Jean! I hope you are doing well, this is a great question! Typically a scooter or power chair is covered by various types of insurance based on several factors that can include condition – related symptoms. To ensure that you get answers for your coverage I would suggest speaking with your primary care physician and your insurance company directly. If they need to know what billing codes our scooters fall under I can send those to you if you would like to send me an email at amoy@pridemobility.com I hope this helps, and I hope you have a wonderful day!

Iam currently receiveing medicaid an fidelis care at home an a fall risk I was told they only pay for the mechanism for lift chair is this true. I am unable to stand or walk distances

Hi Kim! I hope you are doing well – thank you for coming to our blog! I think this page will help answer that and a few other questions you might have around funding. There are also some reference guides that will help you step by step along the way. Please let me know if you have any additional questions, or if you’d like to talk to one of our friendly support representatives in more detail: https://www.pridemobility.com/medicare-funding/lift-chair-medicare-coverage.asp -Amanda

Hello i have a question i recieve medicaid and my doctor wrote a perscription for a power chair since i do have many issues with my back legs and some with my arms as well and i can’t walk very much i have very bad knees . But i have not been able to find someone that accepts medicaid so tht i can get a power chair. Thanks in advance and please help.

Hi Mary! I’m so sorry for the late reply, I’ll be more than happy to help you find someone. If you want to please send me your zipcode to my email address and I can do some research for you, my email is amoy@pridemobility.com I hope you are having a happy and safe holiday season! Sincerely,
Amanda

My daughter has Spinal Muscular Atrophy. She is three years old and can not walk, but she has wonderful eye hand coordination and could use an electric wheel chair. She is covered by Medicaid. Would she eligible to receive one. Her doctor said he will write a prescription.

Hi Leigh! Thank you for visiting our blog, I will be happy to help guide you toward an answer for your daughter. That’s great that she has that kind of hand-eye coordination, it helps with using a joystick to maneuver a power wheelchair for sure! I would see what her doctor says regarding her needs for a mobility device, and the next step you can take is to speak with an authorized dealer who accepts her type of insurance/coverage. You can find one by visiting our locator here https://www.pridemobility.com/find-a-dealer.asp If you have any questions on the options for your daughter I’ll be happy to help, feel free to email me directly at amoy@pridemobility.com I hope you and your family have a safe and happy holiday season! Sincerely,
Amanda

Hi, I’m paralyzed and my power chair was supplied thru my medicaidand Medicare paying 80% of the cost. But my question to you is, how do I find out what company or whom billed my Medicare/Medicaid for my power chair ? Or should I say, what company billed my medicaid/Medicare for my power chair and where that company may be located ? And will either Medicaid/Medicare send me a copy of the billing statement invoice on my power chair so I know how much my medicaid/Medicare was billed ?

Hi Judy! We recommend contacting your medicare plan and seeing if they can give you that information. They may be able to assist you further. Thank you for reaching out!

I have a hard time walking with my back and now I have to carry oxygen with me am I eligible for a scooter?

Hi Nancy! We recommend speaking with your primary healthcare physician, they may be able to let you know if you qualify for a scooter. After you speak with your doctor, you can start your search by visiting this link and finding a dealer: https://www.pridemobility.com/find-a-dealer.asp We hope you have a wonderful day!

I’m am total disabled can only stand for about five mins, i cant walk no more than ten mins. I have a manual wheelchair but i cant push myself in it and sometimes i have to push myself. I have server osteoarthritis in my arms and back and legs, So needless to say i cant get around in a wheelchair or out of a wheelchair. so im trying t find out how i would go about getting a motorized wheelchair. i have Wellcare Medicaid.