Child Wheelchair Medicaid Coverage

Is your child living with a serious medical condition, such as cerebral palsy or spina bifida? If you believe that a wheelchair for child with cerebral palsy or other medical condition is the solution but aren’t sure how to pay for it, you do have options available to you. If you’ve heard of Medicaid, then you know that it is the largest program that gives medical and health-related services to people who have low incomes. If your child has a medical condition that affects his or her mobility, he or she may qualify for coverage through your state’s Medicaid program. Read on to obtain additional information on child wheelchair Medicaid eligibility requirements and how wheelchair technology can enhance your child’s life!

Understanding Medicaid Programs

Funded through cooperative efforts between state and federal governments, each state administers its own Medicaid program, while staying within general national guidelines enforced by the federal government. Each state sets its own standards for eligibility and decides what type of services are offered. Individual states determine the scope of services, the amount of services offered and for how long. In addition, each state is responsible for setting the rate of payment for services received by Medicaid recipients.

Child Wheelchair and Medicaid Eligibility

For your child to qualify for Medicaid, your family must meet resource and income limits. Your child must have a medical need or fall into a specified eligibility category that is specified by your state. Any child that receives Supplementary Security Income (SSI) automatically qualifies for Medicaid services.

For Medicaid to cover the cost of a power chair, the child must have a medical need for the specific wheelchair. A written prescription from a doctor is required and the prescription must specify the type of child power wheelchair he or she needs.  A child power wheelchair may be covered as Durable Medical Equipment (DME) under Medicaid, although circumstances do vary from one state to the next. These variations can include coverage for outdoor or vocational use; coverage for skilled nursing homes; Wheelchair accessory coverage, as some states have age limits for coverage; whether the wheelchair for child with cerebral palsy (for example) can be rented or purchased. In addition, some states require physical therapy reports or forms to be completed. 

Edge 3 Stretto Wheelchair

It’s important to understand that if your daughter or son qualifies for both Medicaid and Medicare, Medicaid may cover the portion of the cost of a child power wheelchair that is not covered by Medicare.

Medicaid Funding for Edge 3 Stretto™

If your daughter or son qualifies for a child power wheelchair, why not consider the narrowest power chair in America? The Edge 3 Stretto™ has a narrower width for exceptional maneuvering in tight spaces. With an overall width of 20.75 inches with 12.5-inch drive wheels, the Stretto is perfect for navigating cramped living quarters, narrow school hallways and small spaces on the playground. Equipped with independent SRS (Smooth Ride Suspension), the Edge 3 Stretto provides a smoother, more comfortable ride with increased shock absorption. The power chair also comes standard with a USB charger port and front and rear fender lights. Most importantly, the Stretto is available with optional iLevel® technology, that raises the child power wheelchair’s seat up to 12 inches, while driving up to 3.5 mph.

Medicaid may cover the cost of a power adjustable seat height on a child wheelchair, such as iLevel, on a case-by-case basis. It must be shown that iLevel is essential for your child’s daily living activities, such as transferring, reaching and accessing, as well as safety, communication and/or supports educational goals.

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