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Thread: Medicare coverage for wheelchair

  1. #1
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    Medicare coverage for wheelchair

    I am running into a problem with my DME. They are telling me that Medicare will not pay for any repairs to my chair because it was purchased 4 years ago when I had private insurance. Has anyone had this problem, and what was the solution? They are absolutely no help at all.

  2. #2
    We were told that medicare would repair my husband's wheelchair even though it was purchased with private insurance. We opted to get a new chair from medicare instead.

  3. #3
    My chair was purchased thru private ins and was also repaired by Medicare, unfortunately when it came time for a new chair Medicare kept saying I received a new one when in fact it was only repaired. I am still trying to sort it out, going on a year now. I finally had to repair the one I have otherwise I would have no chair at all. The saga contunues...

  4. #4
    Senior Member rdf's Avatar
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    This sounds the safest way to go. Just have them buy you a new one, and don't get stuck like Chrl did a couple years from now with Medicare claiming the repairs on an old one constitutes buying a new chair.
    Quote Originally Posted by ginamarie View Post
    We were told that medicare would repair my husband's wheelchair even though it was purchased with private insurance. We opted to get a new chair from medicare instead.
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    Quote Originally Posted by rdf View Post
    This sounds the safest way to go. Just have them buy you a new one, and don't get stuck like Chrl did a couple years from now with Medicare claiming the repairs on an old one constitutes buying a new chair.
    So should I ask for one now or wait for the five year mark? I think I can get by until then (Nov. 2010). I have heard that the five year mark is the magic number but medicare never purchased this one from the start. I feel stupified and unsure where to go to get the answers.

  6. #6
    Senior Member rdf's Avatar
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    I'm not sure. I think since they haven't purchased you a chair to date, they will buy you one now. You might ask ginamarie how the process went for her. But I'm almost certain that they'll purchase you a chair if they haven't in the past, even if private insurance bought your last one within the past 5 years.The people who seem to know the best are the DMEs' billing people. You might call up Sportaid or Allegro or another supplier and ask them. Good luck. I remember seeing on Spinlife.com's website that they list a lot of their chairs as Medicare eligible, meaning I think that they will handle the Medicare billing process, etc. Surely they will know.
    Quote Originally Posted by Mateo View Post
    So should I ask for one now or wait for the five year mark? I think I can get by until then (Nov. 2010). I have heard that the five year mark is the magic number but medicare never purchased this one from the start. I feel stupified and unsure where to go to get the answers.
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  7. #7
    Quote Originally Posted by Mateo View Post
    So should I ask for one now or wait for the five year mark? I think I can get by until then (Nov. 2010). I have heard that the five year mark is the magic number but medicare never purchased this one from the start. I feel stupified and unsure where to go to get the answers.

    If Medicare has never bought you a chair you can get one now....I was in same situation....

  8. #8
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    I got my chair through private insurance about 4 years ago. Now I have Medicare.
    I just went to Magee rehab for a seating eval to get a new cushion. The chair needs some repairs, too.
    The DME and therapist suggested just ordering a new chair.
    They said if I had repairs paid by Medicare, I'd have to wait another 5 years for a new chair.
    So they wrote me up for a new chair.
    Rich

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    Got a ? for you guys and gals. I'm in the great bankrupt state of CA and got hurt in 2004. Then Medi-Cal bought me a TiLite ZRA with E-Motion wheels on it that of course didn't arrive til mid 2005 and then the charger for the wheels broke and was fixed in 2006 and since 2007 the chair has been getting denied now that I have Medicare and MediCal.

  10. #10
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    now it's been 5 years since 2005 and I was told since MediCal bought the chair that Medicare won't replace it. Unless I get an Rx for a damn power chair...oh hell NO! The whole point of having a power assist chair was to not need a huge bulky power chair. Anyway since Medi-Cal paid like 8k for the chair and emotions shouldn't medicare fix it at least since medi-cal is now broke as a joke??? I know the 5 year rule would be in tact too and I do not need a new chair just the new wheels which are now the newer better M15s ...I had the crappy old model. Any of you care to chime in? I had to purchase a manual chair myself since it was an entire year after my injury that MediCal bought me the chair w/ the emotions on it. It'd be nice to have the emotions but I do not feel like paying cash for them since I use a different chair on a daily basis now.

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