Paying for Wheelchair Ramps: Medicare's Benefits & Costs
For frail or disabled seniors, wheelchair ramps are essential to maintaining their independence and ability to live at home. Seniors who use a wheelchair or electric scooter benefit from the ability to get more of their activities of daily living
accomplished with less assistance. Wheelchair bound seniors with easy access to a handicap ramp will likely interact more socially, access social services more, and generally age in place more easily. Ramps also serve an important function in emergencies should medical staff need to enter and exit the senior’s home.
With so many benefits for disabled or frail seniors, our guide to wheelchair ramps takes a closer look at how to pay for wheelchair ramps, insurance benefits, the associated costs and factors affecting costs and the financial assistance options available.
Did You Know? Over 5 million Americans use a wheelchair and an additional 18 million use a cane, walker or other walking assist device.
Medicare is where most families turn first and this makes sense. The federal health insurance program is available to most adults over 65. Unfortunately, original (also called traditional) Medicare policies are strict when it comes to paying for equipment and home modifications around the senior’s home.
Original Medicare’s policy on wheelchair ramps falls under their policy for Durable Medical Equipment. As such, if the wheelchair ramp is used for a medical purpose, then the ramp is reimbursable. A ramp will have to be medically necessary as declared by a licensed physician. Therefore, it is extremely rare that original Medicare will pay for the cost of a wheelchair ramp.
On the other hand, some Medicare Advantage
(MA) plans may now cover the cost of wheelchair ramps. An announcement by CMS (Centers for Medicare and Medicaid Services) on April 2, 2018 stated MA plans could cover home and community based supplemental healthcare benefits. Prior to this announcement, services / items for the purpose of “daily maintenance” were not allowable expenses. However, with the loosely provided definition of “healthcare benefits” by CMS, some 2019 MA plans now cover healthcare items that are intended to prevent injury, compensate for a functional need, or reduce the need for emergency care. Therefore, it has been our interpretation that wheelchair ramps are an allowable supplemental healthcare benefit available with some MA plans. However, beginning in 2020, Medicare Advantage plans will be able to offer “special supplemental benefits” for persons who are chronically ill. Examples of conditions that are considered to be chronic include Alzheimer’s disease and related dementias, metastatic cancer, and rheumatoid arthritis. To qualify for these “special supplemental benefits”, which may include permanent wheelchair ramps, there has to be a “reasonable expectation” that the Medicare recipient’s current health or level of functioning will improve, or at the very least, be maintained. Therefore, with the 2020 MA plans, there should be a greater degree of flexibility with the availability of wheelchair ramps as an allowable expense.
This federal program for low-income seniors and the disabled is administered by the states and policies vary in each state. Broadly speaking, there are three ways that Medicaid program benefits are offered: 1) regular Medicaid 2) Home and Community Based Services Waivers (HCBS Waivers) and 3) nursing home benefits for long term care (which is not relevant in the context of wheelchair ramps).
Regular Medicaid operates as an entitlement program in which benefits are guaranteed for qualified individuals. For regular Medicaid, the states’ policies typically follow the original Medicare rules when it comes to paying for wheelchair ramps, meaning they only pay when medically necessary. Wheelchair ramps are not usually considered to be medically necessary equipment when looked at in the context of other medical equipment such as ventilators or oxygen tanks. While there have been some successful court cases where states have been required to provide a ramp benefit to wheelchair bound seniors, these cases are very uncommon and often require a court challenge.
Better news for Medicaid beneficiaries is the offering of HCBS Waivers. In many states, Medicaid Waivers pay for the cost of ramps, as they are considered home modifications or environmental adaptations, and help to prevent / and or delay unnecessary nursing home placements, saving the state money. One can view a state by state list of Medicaid Waivers and their benefits here
Another option are the ‘Money Follows The Person’ programs
that help the elderly who currently reside in nursing homes to move back home and in doing so will pay for some home modifications, including wheelchair ramps.
Assistance for Veterans
Similar to the Medicare supplemental insurance benefits programs for non-veterans, TRICARE for Life
for Life supplement Medicare Part B to pay the 20% co-payments that Medicare does not pay. However, this benefit only helps when Medicare first agrees to pay for the product or service which, as described earlier, Medicare is very unlikely to do in the case of wheelchair ramps.
A better option is the VA's ‘Cash and Counseling’ benefit, where qualifying veterans receive a care budget and are allowed to select the services and supplies that they require. Read more
Still another potential source of assistance for veterans are Home Improvement and Structural Alteration Grants. These are more commonly referred to by the acronym, HISA. HISA Grants are intended to help veterans make home modifications that which improve home access. A wheelchair ramp easily falls under that objective. Furthermore, the veteran’s disability need not be related to their military service to be eligible. This means veterans suffering from disabilities related to normal aging can receive HISA Grants. Learn more
Financial Assistance Options
State Based Assistance
Most states also operate their own non-Medicaid programs to support the elderly and disabled. Some of these programs are intended to help elders continue living in their homes or communities instead of in nursing homes, and some of them can assist with the cost of wheelchair ramps in order to make the home more accessible for a wheelchair bound individual. While state budgets are being tightened, these programs are still worth the time to review. See the list of state programs
to find out what your state might offer.
Elder Care Loans
Financial institutions have recently developed elder care loans. These loans can be used to finance the cost of a wheelchair ramp while an individual is awaiting the fulfillment of other benefits, for example, a veteran’s pension, with which the loan can be paid back in full in a lump sum. For more information about elder care loans, their costs and uses for making home modifications like building a wheelchair ramp, click here
Another type of loan is a reverse mortgage. These are best for individuals who plan to age in place or stay in their home for several years. Available to elders older than 62 who own their home, a reverse mortgage does not have to be paid until the homeowner leaves the house or passes. For more about reverse mortgages, see this page
Non-Profit Assistance Programs
There are several national and affiliated non-profit organizations that assist the elderly with the cost and the construction of wheelchair ramps. We take a look at some of the most important ones in our survey below.
Habitat for Humanity
Habitat for Humanity is an international non-profit organization that runs volunteer driven home construction projects for needy families domestically and throughout the world. Besides the home construction projects, Habitat for Humanity also has a program called “A Brush with Kindness,” which runs exterior improvement projects for qualifying individuals and families. Several of A Brush With Kindness projects have organized volunteers and donations to support the construction of wheelchair ramps for seniors.
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. Fraternity brothers and their families operate this community service to give back to the local areas where they live. The non-profit organization supports each project with a $1000 grant for materials and helps to organize the volunteer labor.
Rebuilding Together is another non-profit organization that helps with home modifications and safety improvements for veterans and other needy individuals including seniors. Past projects have included the installation of wheelchair ramps, handrails, outdoor lighting, and other improvements to help the resident enter and exit their home safely. Learn more
National Directory of Home Modification Repair Resources Program
Housed within the University of Southern California, this team publishes a directory of many programs that assist seniors with the expenses associated with the construction of a wheelchair ramp. Search this comprehensive directory
by state to locate programs and resources in your area.
Similar to the Peace Corps, the National Service operates Senior Corps RSVP, which is a volunteer service program for individuals aged 55 and up. Their volunteer projects have included home renovations and wheelchair ramps. Learn more about Senior Corps on the National Service site
Centers for Independent Living
Local centers for independent living offer support and guidance for disabled people in their geographic service area. They are an information source on local resources that can help you to find organizations that assist with the cost of a wheelchair ramp. The centers also serve as a good resource to help connect with religious organizations, high school woodworking classes, or even union training programs that run projects to help seniors and the disabled in the area. To find centers for independent living in the area in which you reside, click here
Costs of Wheelchair Ramps
The cost of a wheelchair ramp typically ranges between $1,000 and $2,800. This price encompasses both the materials and labor required. There are several factors which affect overall cost.
- Local Costs - One can expect to pay twice as much for labor in densely populated urban areas where contractors are busier and perhaps 10% - 20% more for materials.
- Ramp Materials - Aluminum modular ramps are easier to assemble and maintain but require accurate measurements when ordering. Wooden ramps require maintenance as they weather, but have lower materials costs.
- Stair Height - The change in height of the stairs determines the necessary length of the ramp and, therefore, the costs as well.
- Intended Use - Powered wheelchairs are significantly heavier than push wheelchairs. The more weight that the ramp is required to support, the more it will cost.
How to Determine Ramp Length
Ramps that are built too steeply are difficult and possibly dangerous to use. It is recommended that ramps rise no more than 1 inch over no less than 12 inches of run. To estimate the length of the ramp needed, measure the height in inches and change the inches to feet. Don’t forget to allow for the landing pads at both the top and bottom of the ramp that are large enough for a wheelchair and a person who may be needed to push. Additional landing pads, or flat surfaces, might be necessary for especially long ramps to allow a rest. Read the ADA Specifications here.
Wheelchair Ramp Rentals
In most areas of the country it is possible to find companies that offer wheelchair ramp rentals. These services almost always include the installation (and removal) of the ramps. Some situations that might make a rental ramp more attractive than purchasing a permanent one include when there is a short-term need such as during physical rehabilitation or for end-of-life situations. Seniors who rent their home or are unsure how long they will live in the house may also consider renting one a better option. Another advantage to consider of rental or temporary ramps is that they are less likely to require any building permits or fees. One should always check with the city or local authorities to make sure of the local building codes.
Alternative to Ramps
Space or the physical limitations of the caregivers might make a wheelchair or scooter lift, or elevator, preferable to a ramp. However, these electric devices are more expensive than simple ramps. Prices without installation costs for a wheelchair lift run from $2000 to over $5000 for the more fully featured models. So, they are not cheap. Learn more about platform lifts and how to pay for them
Sometimes a ramp is not necessary if the individual can walk with the assistance of a walker or a cane. In cases such as these, a set of low rise stairs might be better.