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Thread: Insurance And Power Chair Coverage Questions

  1. #1

    Question Insurance And Power Chair Coverage Questions

    The service technician said that I'm due for a new power chair when he came out to my house to look at my five year old drive motors that were going bad on my Quickie S-525. It had been five years since they were last replaced. I've had my power chair for seven years.

    I'm not on Medicaid/Medicare, as I just have private insurance coverage as my main insurance coverage. They paid for my power chair in full, and I didn't have to pay anything out-of-pocket for it. I got my power chair in 2001 and it was upgraded with all of the latest features on the Quickie model power chairs today (VSI controller, bigger motors, and bigger drive wheels) in January of 2005.

    My question is, does the insurance company pay attention to when the chair was first purchased in order to pay for a new one? I know I'm way past the five year deadline to when they would be able to pay for a new power chair again. The service technician did say that he could replace my motors. But, now that I found out that I can get a new power chair. I'll probably be pushing for that more than the new motors.


  2. #2
    Only you can find out for sure, but calling your insurance company and asking.

    Private insurance can be quite different in their coverage. When I was with United Health Care, they would buy me(80%/20%, no deductible) a new chair every 5 years. I use a manual chair, but I think the guidelines are the same for a power chair. However I need a Rx from my Dr, and a statement of need(justification) from the DME for the configuration and options recommended.

    I'm currently with Blue Cross Blue Shield, and they have no time limits and if the cost is under $5k, no requirement for a Rx or written justification. They also pay at an 80%/20% rate, but after I've met my deductible. Over $5k the Rx and justification are needed, but still no time limits.

    I don't know about Oregon, but in Iowa your chair will be tax exempt if you have an Rx, so that might be something worth checking out.

    Good Luck...


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