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Insurance
Has anybody ever had insurance pay for durable medical equipment? How? My deductible is always outrageous. The in-patient store charges twice as much as on-line stores. And the wait time is 3 months, after I get approved! I’m trying to replace my 20 year old power chair and insurance is making me prove I need one.
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8 Replies
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Hi Christina,
I’ve got several experiences obtaining durable medical equipment (DME) for my FA son, Collin. Everything from wheelchairs to Hoyer lifts. It’s never easy but it’s doable. You just have to be relentless in your pursuits. At $12-20K costs, the insurance companies will do everything in order to avoid paying your claims – even unethical practices like saying they never received your claims. Firstly, you will need a detailed prescription from your neurologist (not your GP) that specifies a power wheelchair vs a manual wheelchair. The doctor’s office will also need to provide your specific diagnosis and treatment ICD-10 codes on the prescription. They will know what these codes are. This will streamline the insurance process. I would also ask the doctor to specify on the prescription that you are replacing a 20-year old chair. Our insurance company policy allowed an 8-year old chair to be replaced. Due to the expenses involved, almost all insurance companies require a pre-authorization before the equipment can be fitted and purchased. I recommend that you obtain your insurance plan’s summary document and confirm what they require in advance of DME purchases. While purchasing online can save some $, your wheelchair comfort and functionality is paramount. I urge you to get fitted by a wheelchair specialist OT/PT. These professionals know all the equipment, options, and possible future modifications for your current / evolving needs. They don’t always work for the DME suppliers and often can be found on the staff at rehab hospitals or the larger regional hospital groups. They also know the local suppliers who have the best fit for you. Best of luck, and let me know how it goes. Feel free to reply back if you have any other questions. -
I went to a wheelchair clinic to be evaluated by a PT who does only that. The process is very lengthy [6 months]. But my power chair is really helpful. The place that fixe my old scooter is the one that told me about the wheelchair clinic, and they helped the PT with insurance technicalities. I had never heard of a wheelchair clinic – they are all located in hospitals. And when your chair arrive, they make you practice both inside – they have a course designed with windy roads, beds, toilet and other – and outside. There is a way, as Kevin said, you just need to stay on top of it, because insurance will do anything in their power to stop the process. I had to call and create stinks.
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I’ve never heard of a wheelchair clinic either, but that’s resourceful information if my diagnosis gets to the point of me using a wheelchair (I primarily use a rollator and use a scooter on occasion). Thank you!
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I’ve never heard of a wheelchair clinic either, but that’s resourceful information if my diagnosis gets to the point of me using a wheelchair (I primarily use a rollator and use a scooter on occasion). Thank you!
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The insurance process should not be this hard or lengthy!
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I saw the “sales” guy today. PT guy on Monday then back to Cigna. My neurologist gets involved and a decision will by May. Probably $6,000. Or I can buy the same chair for $3590 thru spinlife.com and get it in 2 weeks but no insurance. Can anyone think why I should wait for insurance?
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I finally got my chair order. Delivery. . .
June 7th! Uugh!
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Hopefully it is shipped and delivered sooner!
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My chair is here! Only took 7, yes seven, months! Now we’ll see how long insurance takes. Because even though I have to pay 20% I had to pay $2300 before NuMotion would order the chair. And that better not be 20%!
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Glad it finally came! Are you enjoying it?
I’m always so shocked at how much they cost!!
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