pay for a wheelchair ramp?
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Regular Medicaid doesn&#;t pay for wheelchair ramps. Like Original Medicare, Medicaid doesn&#;t consider these to be medically necessary devices. In rare cases, Medicaid has paid for ramps, but usually only after appeals and court involvement.
Wheelchair ramps are classified as durable medical equipment (DME) under Medicaid as well. This is a federal program for low-income seniors and individuals with disabilities and is administered at the state level. So, policies will also vary by state.
There are two ways to obtain coverage for a wheelchair ramp under Medicaid: 1) regular Medicaid 2) Home and Community Based Services (HCBS) Waivers. Regular Medicaid guarantees benefits for qualified individuals. That means that a wheelchair ramp can be covered by Medicaid if it is deemed medically necessary. While possible, it is generally very difficult to get a wheelchair ramp ruled as medically necessary. The better option for Medicaid is likely going to be an HCBS Waiver.
In many states, Medicaid Waivers pay for the cost of ramps, as they are considered home modifications or environmental adaptations.
See a state by state list of Medicaid Waivers and their benefits here.
One option for Veteran assistance is to apply for coverage through TRICARE for Life to supplement Medicare Part B which would pay the remaining 20% co-payments not covered by Medicare. However, you would have to get Medicare to agree to pay for the wheelchair ramp first, which can be difficult as we mentioned earlier. The better option would be to see if you qualify for the Veteran-Directed Home and Community Based Services Program (VD-HCBS).
The VD-HCBS is designed to provide assistance for Veterans who are candidates for assisted living placements to receive the same level of care in their own home. Here is a brief overview of the qualifications:
Age: none
Health: must require &#;nursing home level care&#;
Marital Status: individuals who live alone may have an easier time going through the process, but having a spouse in the home does not make you ineligible for receiving assistance
Location: must live in a home and cannot reside in a nursing home or in an assisted living facility. There are 77 programs in 42 states and veterans are allowed to travel from the home area to participate.
Financial: there are no requirements for financial status &#;
Veteran Service Discharge: required to have had 24 months of continuous active duty and a discharge status other than Bad Conduct or Dishonorable to be eligible for VA Health Care.
The Home Improvement and Structural Alterations (HISA) Grant program can help veterans pay for wheelchair ramps. HISA allows disabled veterans to modify their homes for improved accessibility, and the disability doesn&#;t have to be related to the veteran&#;s military service.
Even though Original Medicare won&#;t pay for a wheelchair ramp, you may have access to other assistance depending on your financial circumstances and where you live. Many states have programs that offer assistance to older adults with limited mobility.
Non-Profit Assistance
The nonprofit route is a great option for non-Veterans who want to get funding for a wheelchair ramp. There is often less red tape with this route and the non-profit will do all of the heavy lifting so you don&#;t need to do much work outside of the initial application. Check out this list of national nonprofits that help with funding a wheelchair ramp:
AccessABILITY Experience
The Ability Experience (formerly Push America) charity from Phi Beta Kappa runs their own AccessABILITY program that is specifically for low-income families to help them get a wheelchair ramp. The non-profit organization supports each project with a $ grant for materials and helps to organize the volunteer labor.
Rebuilding Together&#;
Rebuilding Together helps with home modifications and safety improvements for Veterans and other individuals in need. Projects they help with include installing wheelchair ramps, handrails, outdoor lighting, and other home modifications to help a family enter and exit the home safely.
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National Directory of Home Modification Repair Resources rogram
The University of Southern California publishes a directory of programs that assist seniors with the expenses associated with the construction of a wheelchair ramp. Search the comprehensive directory by state to locate programs and resources in your area.
Centers for Independent Living
You can also search for local centers for independent living that offer support and guidance for individuals with disabilities in your area. They operate as a resource for finding local organizations that assist with the cost of a wheelchair ramp.
Some nonprofit programs also offer help for those in need of a wheelchair ramp, including:
You can find more information about assistance in your area through resources such as the federal government&#;s Eldercare Locator as well as the Centers for Independent Living.
Loans from private financial institutions may be another option for those in need of a wheelchair ramp. Some financial institutions offer eldercare loans, which may be an option for those waiting on other benefits or funds. Reverse mortgages can also be an option for older adults in need of extra funds.
For over 20 years, Lifeway Mobility has helped families navigate the Medicaid Home Modifications Funding process. The majority of our clients, from children to adults, have disabilities. About half of the Medicaid projects have entailed making bathrooms accessible and the other half have been the installation of adaptive equipment like wheelchair ramps, stairlifts, ceiling lifts, automatic door openers, and grab bars and other handholds for fall prevention. It is our goal to provide the very best solutions possible for each individual&#;s situation, and we trust you will find value in this Medicaid Home Modification Funding Guide.
Basic Medicaid services do not cover home accessibility. Thankfully, for the last 27 years, Medicaid has provided a Home and Community Based Waiver Program. This waiver program is only available to people enrolled in Medicaid and it provides an alternative to nursing home and assisted living facilities. The goal is to support Medicaid recipients and allow them to stay in their own home.
This process can take up to 6-9 months on average and can take up to one year, BEFORE the project actually begins.
This Medicaid guide does not guarantee that the client will receive funding, but it will connect the OT or family to the correct Medicaid agency that will help to start the Medicaid Home Modification Application Process.
Disabilities covered by Medicaid for home modification funding include:
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While the waivers mentioned here are specific to Colorado, the waivers in other states should be pretty similar. They may be called by another name, so it&#;s best to contact your state&#;s Medicaid Agency or look on their website for the accurate local information near you.
ADULT WAIVERS
CHILDRENS WAIVERS
Generally, children&#;s Medicaid waivers are for $10,000 every 5 years until the child turns 18 years of age at which point the child will then be transferred over to an adult waiver. Adult Medicaid waivers have a $14,000 one-time lifetime cap.
Contact us or Call (888) 714- to learn more about the Medicaid Home Modifications Funding Guide or request a free consultation.
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