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Thread: New cushions

  1. #1
    Senior Member PC720's Avatar
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    New cushions

    I'm just curious I know there's a lot of you out there who are experienced. How do I go about getting a new cushion? Do I have to pay straight up out of pocket or is this something insurance helps me out with? I also have Medicare.

  2. #2
    Senior Member darty's Avatar
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    The last time I got a new cushion (your coverage may be different) I needed a prescription from my primary Doctor and had to go to ma DME who takes my insurance or Medicare and they fitted me for one then ordered it. I ended up paying 20% of the cost out of pocket.
    ^^(A)^^

  3. #3
    Super Moderator Sue Pendleton's Avatar
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    My PT had my physiatrist sign the prescription after she and the local DME expert worked out a decent back and cushion set up. Medicare paid 80% and my secondary paid the rest.
    Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, "I will try again tomorrow."

    Disclaimer: Answers, suggestions, and/or comments do not constitute medical advice expressed or implied and are based solely on my experiences as a SCI patient. Please consult your attending physician for medical advise and treatment. In the event of a medical emergency please call 911.

  4. #4
    Senior Member PC720's Avatar
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    alright thanks guys!!! cross my fingers in pray my insurance cover some of this those cushions areNt cheap!!

  5. #5
    I had to buy the cushion, then submit the paid invoice along with a prescription to my insurance (thru my employer) they then reimbursed me less my deductible. I do the same each month when I purchase my catheters except that I only have to submit a new prescription once a year.
    SCI Birthday: April 25, 1993
    T4,5,6 Incomplete
    Chair: TiLite TR3

  6. #6
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    Get a script from your Doc, turn it into your DME and have he order you one under Medicare

  7. #7
    Senior Member Oddity's Avatar
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    Last time I needed a new cushion I went to Woodrow Wilson Rehab center to their seating clinic. They said they couldn't order me one through Medicare because my chair wasn't billed through Medicare. Their Medicare billing specialist said Medicare won't reimburse for accessories on chairs they didn't initially fund, and a cushion is billed as a wheelchair accessory. I'd love to find out they were wrong!
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

    "If you only know your side of an issue, you know nothing." -John Stuart Mill, On Liberty

    "Even what those with the greatest reputation for knowing it all claim to understand and defend are but opinions..." -Heraclitus, Fragments

  8. #8
    Senior Member pfcs49's Avatar
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    Don't you just love this system?
    I'm spending my day trying to get my prescription for colostomy supplies renewed so I can continue to get them from my supplier.
    It's like going through all the bullshit to renew my handicapped parking tag-get a doctor to certify-AGAIN-that I'm paralyzed!
    When I got the colostomy, the surgeon botched it. For 12 days I lay in the hospital getting sicker and sicker, my abdomen distended until I was afraid I'd asphyxiate if I got excited. Finally my wife got a gastroenterologist to consult; on the 11th eve, he saw me and called for tests with tracers; the 12th morning they did the test; that afternoon, they did emergency surgery because they had it backwards!! My large bowel was stapled shut in my gut, and if you had blown smoke up my ass, it would have come out my ostomy.
    (And, when I had suggested on the 5th day that maybe they had transposed the bowel elements when doing the surgery, the surgical residents actually laughed and said "that's impossible!") But that's not all-after I woke up, someone came running into recovery very excited and said "he's bleeding internally; we have to open him back up!"
    So I'm trying to not deal with the dick-head and get a script from someone else. Not simple! And frustrating. You know, I really DO have that colostomy still!
    Aaahh! Life in the fast lane.

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