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Thread: Getting what you need.

  1. #1
    Senior Member evansmom's Avatar
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    Getting what you need.

    My son Evan is a c4/5 quad. He was on Maryland medicade for 2 years. We received an emotion / wc , an fes bike that does his arms and legs and a evolution glider/ stander. They denied payment on all 3 peices of equipment. They wanted us to take a cheap knock off version of the wheelchair. I contacted my local delegate and went up the ladder until we were approved for the w/c that we wanted. Same thing happened with the bike and the stander. I have learned that if your insurance / state denies payment for any equipment that you need just keep calling, sending letters and e mails to you local government officials until someone will listen. They don;t like me I am sure of that. Last time I called them the woman asked is this Jean??? hahaha I guess they know my voice. The bottom line is be persistant and don;t give up. Evan is now on Medicare, the same thing happened. They took his transportation away. After several e mails and phone calls we got it back. Now I am fighting for his catheters. They sent us the lo fric self cath sticks and I refuse to use them. I sent them right back. We have been using the Hollister closed catheters. Evan has had 1 UTI in the last 2 years. Medicare will only pay for the closed system catheters after you have 2 doccumented UTIs within a 12 mo. period. That is BS, They are spending 5 bil. a day over in Libya but won;t pay for catheters that will prevent infections until you get 2 of them DUH.... At any rate I hope this information helps someone else who is going through the same bullcrap. EVANSMOM

  2. #2
    Quote Originally Posted by evansmom View Post
    My son Evan is a c4/5 quad. He was on Maryland medicade for 2 years. We received an emotion / wc , an fes bike that does his arms and legs and a evolution glider/ stander. They denied payment on all 3 peices of equipment. They wanted us to take a cheap knock off version of the wheelchair. I contacted my local delegate and went up the ladder until we were approved for the w/c that we wanted. Same thing happened with the bike and the stander. I have learned that if your insurance / state denies payment for any equipment that you need just keep calling, sending letters and e mails to you local government officials until someone will listen. They don;t like me I am sure of that. Last time I called them the woman asked is this Jean??? hahaha I guess they know my voice. The bottom line is be persistant and don;t give up. Evan is now on Medicare, the same thing happened. They took his transportation away. After several e mails and phone calls we got it back. Now I am fighting for his catheters. They sent us the lo fric self cath sticks and I refuse to use them. I sent them right back. We have been using the Hollister closed catheters. Evan has had 1 UTI in the last 2 years. Medicare will only pay for the closed system catheters after you have 2 doccumented UTIs within a 12 mo. period. That is BS, They are spending 5 bil. a day over in Libya but won;t pay for catheters that will prevent infections until you get 2 of them DUH.... At any rate I hope this information helps someone else who is going through the same bullcrap. EVANSMOM
    You are lucky that you have a represenative that helped you. I applaud your tenacity and persistance. Evan will do better in the long run.

    Is Evan on the REM program? There is more freedom for coverage.
    Every day I wake up is a good one

  3. #3
    Way to go Jean. That's what it takes. Ya gotta fight 'em everytime it seems. I think they do it on purpose to weed out the ones who won't stand up for what they need.

  4. #4
    Good for you!! It's so sad that we have to "fight" for what we need!

  5. #5
    Thanks for sharing your story...it helps the rest of us to know we can fight for what we need. Evan is lucky to have you.

    BTW..we live in VA. When our insurance denied the FES bike 3 times medicaid approved it.

  6. #6
    Senior Member evansmom's Avatar
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    Yes It is a shame you have to fight.

  7. #7
    Senior Member evansmom's Avatar
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    So true because most people just give up and take no for an answer.

  8. #8
    hey you...sorry I haven't called yet, been extra busy as great g-ma is back...cannot take eyes off of her, she has decided she doesn't need her walker...anyways, appreciate the post and yes, I'm still screaming (being nice was going no where)...maybe one day they'll know me by name, lol!

    This member lives near you, thought maybe you could help her or give direction...
    http://sci.rutgers.edu/forum/showthread.php?t=151703

    I directed her to this post...

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