Wheelchair Ramps and Medicaid/Medicare: Understanding Accessibility and Health Insurance

For seniors who wish to remain in their homes, wheelchair ramps are an essential tool for aging in place and maintaining their independence at home.

Seniors with mobility issues who use wheelchairs or scooters can implement ramps throughout their home to easily and safely navigate their own spaces. In addition, if emergency staff ever need to enter or exit the home, these ramps make it easier for that to happen.

Outfitting a home with a variety of wheelchair ramps to ensure greater accessibility costs money, though, and seniors on a fixed income may find it difficult to make the investment.

The most common methods used for supporting these payments for seniors who can’t purchase the equipment outright are funding through Medicare and Medicaid.

Medicare

Medicare is a federal health insurance program geared toward most adults over age 65. While it may be an avenue for seniors to explore to outfit their home with accessibility equipment, there are some strict policies regarding paying for that equipment and other home modifications.

Under Medicare, wheelchair ramps are considered Durable Medical Equipment, meaning the ramps are reimbursable under Medicare if used for medical purposes. A senior would need to have a physician declare the use of the ramp medically necessary.

Certain Medicare Advantage plans can also cover the cost of wheelchair ramps. An announcement in 2018 stated MA plans could be used to cover certain home supplemental healthcare benefits. This could be interpreted to include items intended to prevent injury or reduce need for emergency care. A wheelchair ramp is one such example of this sort of equipment.

MA plans are also able to provide special supplemental benefits to people with chronic illnesses. Certain chronic illnesses can result in the use of a wheelchair or scooter, which would mean wheelchair ramps would apply for coverage under those stipulations.

Medicaid

Medicaid is a federal program for low-income seniors and disabled individuals that is administered by each individual state, which means policies for Medicaid distributions vary from state to state.

These benefits are offered in several ways:

• Standard Medicaid
• Home and Community Based Services (HCBS) Waivers
• Nursing home benefits for long-term care

States’ policies for standard Medicaid will typically follow original Medicare rules for covering the purchase and installation of wheelchair ramps, which means coverage will only occur when it is medically necessary.

There are a number of states that allow HCBS waivers to pay for the cost of ramps, as they are classified as home modifications or environmental adaptations designed to prevent or delay unnecessary emergency are or nursing home placement (which saves the state a significant amount of money).

There are a variety of other options for potentially getting funding for the purchase of wheelchair ramps for a residential setting. There are various financial assistance programs including veterans’ assistance, elder care loans, certain state-based assistance plans, and a variety of nonprofit organizations and programs that specialize in helping seniors age in place and improve home accessibility.

But this is the information you need to be aware of if you are looking into using Medicare or Medicaid as the main avenue through which you pay for wheelchair ramps for your home.

There are certainly plenty of options for assistance, so be sure to look into your qualification for them before making your purchase!