Results 1 to 9 of 9

Thread: SmartDrive Power Assist + private insurance?

  1. #1

    SmartDrive Power Assist + private insurance?

    I am trying out a SmartDrive for a couple days from a local rehab facility and I love it... and my elbows have been hurting less at the end of the day. This thing is amazing!

    Has anyone tried to get one of these devices covered through private insurance? I have Humana insurance and will be trying to get them to cover one of these and I have a feeling it won't be easy. I have received OT for elbow pain in both elbows. I apparently have bilateral lateral epicondylitis in each elbow. I have managed to get Humana to fully cover an FES bike (with the help of RTI through the various levels of appeals), so it may possible... just trying to get an idea of people's success with private insurance.

  2. #2

  3. #3
    Well it has been submitted to my insurance for pre-authorization. We shall see what happens...

  4. #4

    Denied!

    DENIED!

    It looks like we're going to be appealing the insurance decision. From what I was told, Humana only covers power assist devices if you are unable to propel yourself more than 10 feet. That strikes me as odd -- wouldn't I likely be in a power wheelchair if I couldn't push myself more than 10 feet?

    And Humana doesn't cover the stander we're trying to get because they classify it as "Transfer Equipment", which is not covered. That's 2 appeal battles we'll be fighting.

  5. #5
    Quote Originally Posted by nayr View Post
    DENIED!

    It looks like we're going to be appealing the insurance decision. From what I was told, Humana only covers power assist devices if you are unable to propel yourself more than 10 feet. That strikes me as odd -- wouldn't I likely be in a power wheelchair if I couldn't push myself more than 10 feet?

    And Humana doesn't cover the stander we're trying to get because they classify it as "Transfer Equipment", which is not covered. That's 2 appeal battles we'll be fighting.
    I have a friend, a para, who's just back from rotator cuff surgery on both shoulders. He got a SmartDrive paid for in full by his insurance, no arm twisting involved. Don't give up!

  6. #6
    Quote Originally Posted by stephen212 View Post
    I see what it says about hills, but I thought I read somewhere else that medicare limited power add ons to indoor need uses only.
    I have had periodic paralysis all my life. I lost my ability to walk in 2011 beginning with a spinal block, which was used for a hip fracture caused by periodic paralysis.

  7. #7
    The appeal for the smart drive was DENIED. I am not at all happy with Humana's decision. The person who wrote the order is the wheelchair clinic guy at the rehab facility I go to for this stuff. He is a Physical Therapist. He wrote the order and had it signed by my rehab doc. Humana says that the diagnosis and prognosis of the cause/source of my elbow pain is beyond the scope of practice of a physical therapist. I now need to see my rehab doc, get HIM to do the eval and write up (including his diagnosis and prognosis), and then I need to file another appeal. What a pain in the butt for something that could really help ease the pain I endure each day.

    I don't understand how it is relatively easy to get approved by insurnace to have occupational therapy (which didn't help anything) for thousands of dollars, but they are so resistant to pay for a device that would directly address the cause of my pain long-term.

  8. #8
    Insurance isn't in the business of preventative care, nor do they have any common sense for understanding what various healthcare professionals actually do.

    Yup, appeal again.

  9. #9
    Quote Originally Posted by -scott- View Post
    Insurance isn't in the business of preventative care, nor do they have any common sense for understanding what various healthcare professionals actually do.

    Yup, appeal again.
    I have absolutely no love for ANY insurance company and wholeheartedly agree that they do not "have any common sense for understanding what various healthcare professionals actually do." Some, however, do offer cash credits for activities such as gym memberships in addition to "free" (i.e., no co-payment) annual physical and GYN checkups in the name of "prevention."

Similar Threads

  1. SmartDrive Power Assist Device from MAX Mobility
    By SCI_OTR in forum Equipment
    Replies: 454
    Last Post: 10-14-2015, 06:49 PM
  2. Power Assist Devices?
    By wheeliegirl in forum Equipment
    Replies: 21
    Last Post: 03-17-2013, 04:58 PM
  3. Replies: 10
    Last Post: 10-16-2012, 03:14 AM
  4. Electrical Handcycle Power Assist - POWER POD
    By stephen212 in forum Equipment
    Replies: 6
    Last Post: 03-09-2012, 08:23 PM
  5. Used Power Assist ?
    By erikferret in forum Equipment & Services
    Replies: 6
    Last Post: 04-03-2009, 08:11 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •