Medicaid Funding

Medicaid funding is available for wheelchairs and other durable medical equipment.

Medicaid is a jointly-funded, federal-state health insurance program for certain low-income and needy people. It covers approximately 36 million individuals including children, the aged, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments. It is considered a payer of last-resort.

Medicaid is federally managed through the Centers for Medicaid and Medicare Services, and in Colorado is managed by Department of Health Care Policy & Financing.

Durable medical equipment and disposable medical supplies are a benefit of the Colorado Medicaid Program for eligible clients, when ordered by a physician within the scope of the program, and determined by the Department to be medically necessary. The purpose is to enable the client to cost-effectively remain outside an institutional setting by promoting, maintaining, or restoring health; or by minimizing the effects of illness, disability, or a handicapping condition.

Items covered by Medicaid include the following, available through Peak Wheelchairs:

• Ambulation devices and accessories (canes, crutches, walkers).
• Bath and bathroom equipment.
• Bed and bedroom equipment and accessories, including specialized beds and mattress overlays.
• Manual or power wheelchairs, seating system orthosis used for wheelchair positioning.
• Oxygen and oxygen equipment in the client's own home, a nursing facility setting, moderate supervision group home, or specialized care group home (see 8.585 for additional information relating to institutional oxygen).
• Rehabilitation equipment (specialized use).
• Augmentative communication devices and communication boards.
• Replacement parts.

The Colorado Medicaid program may be utilized under the following circumstances:

• The client is eligible for Medicaid only.
• The client is eligible for both Medicare and Medicaid, and the service is denied or partially paid for by the Medicare program; or a wheelchair or wheelchair repairs are needed and provider access is not available to the dually-eligible client.
• The client is eligible for Medicaid and has insurance coverage through a third-party insurance carrier, and the service is denied or partially paid for by the insurance carrier.