Medicaid is the largest program of its kind designed to provide medical and health-related services to people with low incomes. Medicaid may cover a complex rehab power wheelchair, such as the Edge 3 Stretto™ narrow wheelchair, if the patient qualifies.
The Medicaid program is funded through a combination of the federal and state governments. The federal government provides broad national guidelines. It requires that each state establishes its own eligibility standards and determines the type, amount, duration, and scope of services. It also asks that each state sets the rate of payment for services and administers its own program.
There are eligibility requirements for Medicaid, such as meeting income and resource limits, and being medically needy or falling into an eligibility category specified by your state. Anyone receiving Supplementary Security Income (SSI) benefits is automatically eligible. Medicaid will only pay for a motorized wheelchair if the narrow wheelchair is deemed medically necessary for the individual. A doctor’s prescription written for the patient and indicating the type of motorized wheelchair he or she needs is proof that only the narrow motorized wheelchair can satisfy the patient’s medical and mobility needs.
Electric wheelchairs can be covered as Durable Medical Equipment (DME) under Medicaid, but circumstances vary from state to state since each state establishes its own eligibility standards. Variations can include but are not limited to:
- Coverage for outdoor, vocational use;
- Coverage for skilled nursing homes;
- Coverage for accessories (some states have age limitations for coverage);
- Whether the power chair can be purchased or rented; and
- Some states require physical therapy reports or special forms to be completed.
For individuals who qualify for both Medicare and Medicaid, sometimes Medicaid will pay the portion of the cost of a power chair that is not covered under Medicare.
Where to Buy a Narrow Wheelchair
It’s important to confirm that the provider you have chosen to work with accepts Medicaid before buying a narrow wheelchair. If you are unsure if your provider accepts Medicaid, we recommend contacting them directly to ask. Read more about how to use our dealer locator to find a provider near you who works with Medicaid.