Electric Wheelchair Medicaid Funding

What is Medicaid?

Medicaid is not federally funded. It is managed by individual states and is the largest program designed to provide health-related and medical services to people with low incomes. Medicaid pays for covered medical services.

Title 19 of the Social Security Act is a program that offers medical assistance to individuals and families with low incomes and minimal resources. Both federal and state governments fund the Medicaid program through a cooperative venture. There are several generic national guidelines which the federal government provides to each state:

• Each state sets its own eligibility standards
• Each state designates the amount, type, duration, and scope of services it provides
• Every state sets the rate of payment for services
• Every state acts as an administrator for its own program
• Assistive technology devices, such as an electric wheelchair may be covered as Durable Medical Equipment (DME) under this program.

Is a Motorized Wheelchair Medicaid-Covered?

Medicaid may cover an electric wheelchair if the patient meets eligibility and coverage requirements. Some states fully cover the cost of an electric wheelchair, while other states offer partial coverage. Eligibility will vary from one state to the next. Please speak to your local Medicaid office to learn about motorized wheelchair Medicaid eligibility. If you qualify, Medicaid may cover the cost of a Jazzy® Elite 14 motorized wheelchair or other electric wheelchairs.

Am I Eligible for a Medicaid Electric Wheelchair?

In order to qualify for Medicaid, an individual must fall into income and resource limits as set by each state. An individual must also be medically needy or fall into an eligibility category specified by your state. If you receive Supplemental Security Income (SSI) benefits, you are automatically eligible for Medicaid in some states. A motorized wheelchair if the individual has a medical need for the specific type of electric wheelchair he or she needs. A doctor’s prescription is also required for Medicaid electric wheelchair, such as the Jazzy® Select 6.

Electric wheelchairs may be covered as DME under Medicaid, yet coverage varies depending on the state you live in. however, coverage varies from state to state. Depending on how the electric wheelchair is used, states may have variations in coverage.

Possible Variations for Electric Wheelchair Medicaid Eligibility

• Coverage of an electric wheelchair for outdoor or vocational use;
• Coverage for skilled nursing homes
• Coverage for electric wheelchair accessories (some states set age limits for coverage)
• Whether the electric wheelchair can be purchased or rented
• Certain states require completion of physical therapy reports or special forms

To apply for Medicaid and to find out if you qualify for electric wheelchair Medicaid coverage, please visit your local state Medicaid agency.

Your Local Medicaid Office

• Visit the Medicaid website for your state; You can visit the Medicaid State by State directory
• Find the office location and phone number on the bottom of your state’s Medicaid website or on their Contact page
• Call your local Medicaid office to schedule an appointment; Make sure you let them know you want to apply for an electric wheelchair
• Bring photo identification, copies of your insurance policies, proof of your current income, and Medicaid status to your appointment
• Bring a letter from your physician that indicates how an electric wheelchair would benefit your medical condition
• You will need to fill out paperwork during your appointment, including an application to find out whether you are eligible for an electric wheelchair, such as the Jazzy® Elite HD Medicaid electric wheelchair.