Medicaid

→ Background:  Prosthetic and orthotic devices are optional Medicaid services.  States do not have to include this category of service in their state plan.  While a majority of Medicaid programs provide at least a base level of coverage for prosthetic devices, it varies greatly.  This creates a huge disparity in the ability of amputees to access appropriate care depending on where they live. 

This is important not only to individuals looking to receive care, but also due to the fact that Medicaid is being discussed as a component of a national health care reform bill aimed at incorporating uninsured Americans into the public program by raising the income eligibility limits.  Without improvements to the state program regulations, this may leave some of the newly insured without proper coverage for prosthetic devices. 

→ Next Steps:  The ACA is currently investigating the coverage levels in each state and working to develop a multi-pronged approach in order to enhance the prosthetic coverage available through the Medicaid program. 

Click here to see where your state ranks. 

The ACA is committed to advocating for adequate coverage for prosthetic and assistive devices in state Medicaid programs.  Contact us for more information, to get involved or report an issue (state@amputee-coalition.org).