Lupine just got a lovely new electric, folding wheelchair. Even better, insurance covered most of the cost!
Lupine chose a KD SmartChair. The SmartChair is (tragically) not covered by Medicare or Medicaid at this time. But it is (happily) sometimes reimbursed by private insurance.
Lupine took some smart steps to get the right documentation so that insurance would cover the reimbursement. For the $2,000 chair, she paid $800 and insurance paid $1,200.
Lupine wanted to help others who may be looking for a share, so she was kind enough to share her story, along with a copy of her doctor’s letter that got the insurance reimbursement.
Lupine’s Story
My chair is on its way! I am SO excited! I can’t wait to use it in the house and maybe accomplish something or big dreams of going outside, down the way a bit! Thank you to all the folks that contributed such helpful advice to this blog!
My doctor had warned me this could take multiple appeals to get approved. But it did not. The process only took 14 weeks. There are a couple of things I think helped make this a relatively quick process.
Learning the Policies
🌷 I read and used all the steps recommended on this page: How to get an Electric Wheelchair or Scooter Through Insurance and had excellent results.
🌷 I also called my insurance company and asked if my policy covered a scooter or electric wheelchair. My company (Aetna) will only pay for an electric wheelchair, so I specifically looked for a chair that both met my needs for within my home, and would also be usable outdoors.
Choosing a Chair
🌷 I compared a lot of different chairs.
🌷 One of the main things I wanted was portability for when I go to appointments. I chose a KDSmartChair because it was easily transportable in a regular vehicle (with the assistance of a helper for lifting).
Assessments
🌷 Next, I made an appointment with a physical therapist to evaluate my need for a chair for home use. The physical therapist did a home visit to examine my home and my response to walking the distances involved in necessary activities and wrote a letter for me. To ensure the letter had all of the details in it, I drafted a letter and let the Physical Therapist review, modify and insert the data. (The therapist was very happy to not have to spend time writing a letter from scratch!) Using the post above as a guide, the letter focused on safety, feeding and toileting.
🌷 Next I visited my doctor. I showed my doctor the post in the link above and emphasized the key things she needed to include in my chart note.
🌷 My doctor input these into my note while I was in my appointment with her. Then I requested a copy of my chart notes from the doctor’s office.
🌷 Here is copy of the Doctor’s Chart Notes and Physical Therapist’s Letter.
Insurance Authorization
🌷 Next I followed my insurance companies instructions for pre-authorization.
🌷 If you chose a wheelchair supplier that is on your insurance companies list of approved suppliers, then you might not have to take as many steps.
🌷 In my case, the wheelchair I selected was not from an approved Durable Medical Equipment Supplier, so I needed to take extra steps. I sent the insurance company:
- Doctor’s chart note
- Physical Therapist’s letter
- Information about the chair off the company’s website
- Company’s tax identification number
- Price quote from the wheelchair company
🌷 After that, I was notified that I got the pre-authorization approving the purchase.
🌷 Before going forward, I decided to verify their percentage of coverage. This is not required, but I was imagining them only reimbursing $50 so I wanted to check! I submitted the authorization to the insurance company’s claims department to see exactly how much they’d pay toward the chair. It turned out they agreed to pay 60% of the cost.
🌷 Once I received the claim information, I placed the order.
I LOVE IT!!
Update: My chair arrived, and I love it! It has changed my life!!
My chair has really has changed everything for me! The way my house is laid out, I was really struggling to coordinate remembering anything. I am just able to take care of myself better.
I am shocked to realize how much I was denying myself food, water, and even postponing bathroom trips. I am now able on some days to help now with laundry.
In the past, sometimes I was so tired I couldn’t make it to the bathroom to brush my teeth. Now I’m much more consistent with that, which makes me feel so much better psychologically. I don’t want to lose my choppers!
Learn More
How Do I Know If I Need a Wheelchair? (For People with ME or CFS)
Thanks for Reading
🌸 This page is part of the free online guide: How to Be Poor in America
🌸 Art on this page by Robin Mead and Elizabeth D’Angelo.
🌸 Page Updated: 10/1/19
🌸 To get daily updates on helpful disability services, and low income programs, follow us on Facebook: The Sleepy Girl Guide.
🌸 Please comment below with stories, ideas, questions or suggestions. Please let us know if any links on this page stop working. Please share this page with others by pressing one of these magic little buttons:
How to Get On 