Kid Wheelchair Funding and Medicaid

As the largest program that is designed to give health-related and medical services, Medicaid assists many individuals with low incomes. If your kid has a mobility impairment or struggles with health issues, your state’s Medicaid program may help! Get more information on what services Medicaid offers and how your child may qualify for a kid wheelchair.

What is Medicaid?

Although it is funded through cooperative efforts of the federal and state governments, your state administers its own Medicaid program, staying within broad national guidelines set by the federal government. Your state also establishes its own eligibility standards and determines the type of services it provides, the scope of services, the amount of services it offers, and how long the services are offered. Each state also sets the rate of payment for services received.

Kids Wheelchairs and Medicaid Requirements

To qualify for Medicaid, a child’s parents must meet income and resource limits. He or she must be medically needy or fall into a state-specified eligibility category. Any kid receiving Supplementary Security Income (SSI) automatically qualifies.

Medicaid will only cover a kids wheelchair if the child has a medical need for the specific wheelchair. A written doctor’s prescription is also required that specifies the type of kid wheelchair needed. Wheelchairs for children can be covered as Durable Medical Equipment (DME) under state Medicaid programs. Circumstances for coverage vary from one state to another. Some of the variations include:

  • Coverage for outdoor, vocational use
  • Coverage for skilled nursing homes
  • Kid wheelchair accessory coverage; some states have age limitations for coverage
  • Whether the wheelchair for disabled child can be purchased or rented
  • Some states require completion of special forms or physical therapy reports

If your son or daughter qualifies for both Medicare and Medicaid, sometimes Medicaid covers the portion of the cost of a wheelchair for disabled child that is not covered by Medicare.

Power Elevated Seating on a Kid Wheelchair

Edge 3 Stretto with iLevel

Medicaid may also cover the cost of power adjustable seat height on wheelchairs for children. Medicaid considers funding power adjustable seat height on a case-by-case basis. It must be demonstrated that elevated seating is essential for transfers, reach, access, safety, communication and/or supports identified educational and vocational goals. iLevel® power adjustable seat height can improve daily functionality and quality of life for your kid by allowing operation of the power chair with the seat elevated up to 12 inches, while driving up to 3.5 mph. Click to learn more about iLevel technology on wheelchairs for children.

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