Tips & Advice

Medicaid Funding for Adaptive Tricycles

April 24, 2012 by Elena Noble, MPT

Red Rifton Adaptive tricycleAs most of you undoubtedly know, for children with disabilities exercise such as cycling with a special needs tricycle can be therapeutic as well as fun. Cycling may provide a variety of health benefits unavailable through other medical interventions. For example, children with severe mobility limitations may have few, if any, other options for strengthening their cardiovascular system. In fact, cycling may be the best option for improving stamina, range of motion and coordination, and for strengthening muscles. But how often have we heard that trikes are not covered by Medicaid?

One New York-based organization heard that too many times, and now they’ve done something about it. Neighborhood Legal Services, a fabulous advocacy group in Buffalo, has put together a great primer on how to get coverage for an adaptive trike, and we’re pleased to be able to pass it on to you. Even though it’s written from a New York perspective, the basic principles should apply in every state.

For additional funding options, many of which are specifically for adaptive trikes, check our expanded funding resources listing. 

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Reply by samera musallet on May 01, 2012 at 1:51 PM
please my 7 year old girl needs a Adaptive tricycle to help her go around get her legs moving and be happy she loves the tricycle at school and i think if she has one it will help her alot please help me help her feel better and happy.thanks may God bless you.
Reply by Eileen on May 02, 2012 at 1:16 PM
I agree that all states should have medicaid pay for adaptive tricycles. Do you know if madicaid in California pays for the tricycles? Where can I find this information to share with my parents? Eileen
Reply by Elena Noble, MPT on May 03, 2012 at 1:44 PM
Hi Eileen, States Medicaid offices vary in what they’ll pay for and what they won’t. Your best bet is to call a durable medical equipment provider in your area and ask them. If you’re not sure who to call in your area call us at 800-571-8198 and we’d be happy to try to connect you with a good provider. Elena
Reply by Mary on March 15, 2014 at 5:32 PM
Medicaid denied my son an adaptable tricycle in 2007. They put it on a wish list with Children's Medical Services. It took a long time to get a stroller for him and I don't think they will pay for a tricycle, even now. My son is now an adult. He is Down's syndrome and A.S.D. It would greatly help him to have a tricycle since he no longer attends school due to seizures. Florida is one of the worst states for this kind of funding. I would like to know how I can go about getting him a one. I hope you can help me with this. Thank you for your time.
Reply by Elena on April 04, 2014 at 2:16 PM

Hi Mary,

Sorry to hear about your difficulties. You could start at our funding page for a list of alternate ideas, resources and organizations that provide help with funding adaptive equipment. We certainly hope you find a way through. Elena

Reply by JULIE on August 05, 2014 at 10:01 PM
Do you know if medicaid ( Molina ) in Washington state will cover this? If so I would love to get my 6 year old son who has down syndrome, he has low muscle tone and is just beginning to walk but I know this will help strengthen his muscles along with allowing him great enjoyment.
Reply by Elena on August 08, 2014 at 11:07 AM

Hi Julie,

I forwarded your question to an ATP in WA state and this was his reply: "No, we've never had WA Medicaid cover. Though, a good number of children with Medicaid in our state also have access to DDD funds (Department of Developmental Disabilities). This is a separate pool of money in which they are allotted each year to cover things that aren't covered by Medicaid (i.e. additional therapy, communication devices, Trikes, etc). Generally, they require a written denial from Medicaid in order to access these funds. The amount available is usually enough to cover something like a Trike."

You could also try Rifton's funding assistance page for other sources to try besides Medicaid:

Elena

Reply by Fanny on February 12, 2015 at 8:58 AM
Hi do you know if the adaptive tricycle are covered here in Chicago Illinois? My son will be 4 son and he still doesn't know how to ride a bike. And I know how badly he wants to learn because he sees his big sister ride I'm the summer and he feels left out. 😞
Reply by Elena Noble on February 23, 2015 at 10:03 AM
Hi Fanny, 

Yes, adaptive tricycles can be covered in Chicago, but it all depends on a good letter of medical necessity. See the link in the above article "how to get coverage for an adaptive trike" for good tips to writing a successful letter.

Best, Elena

Reply by Judy on March 23, 2016 at 6:28 PM
My 17 year old has CP and low muscle tone. He's used the bikes at therapy and loves them. Does Texas help with cost of these bikes. He likes to go outside but is limited to activities due his gait and muscle tone. Any information would be greatly appreciated.