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Thread: Insurance coverage for a shower chair

  1. #1
    Senior Member johnc1's Avatar
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    Insurance coverage for a shower chair

    Has anyone had any luck getting their insurance to cover the cost of a shower/commode chair. I'm currently covered with BCBS of IL and I turned in all the documentation needed for a new one. I just received my second denial saying the new chair is for comfort and convenience. The DME told me this happens all the time, BCBS just does not pay for these chairs. How can this be?

  2. #2
    Senior Member ~Lin's Avatar
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    What I've read/heard is that most insurances follow medicare, who's coverage stops at the bathroom door. Are your justifications for a shower chair, or for a commode chair that can be used in the bedroom? I've heard of people getting them approved if its a shower commode combo chair and the justification is for use as a commode in the bedroom.
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  3. #3
    Quote Originally Posted by johnc1 View Post
    Has anyone had any luck getting their insurance to cover the cost of a shower/commode chair. I'm currently covered with BCBS of IL and I turned in all the documentation needed for a new one. I just received my second denial saying the new chair is for comfort and convenience. The DME told me this happens all the time, BCBS just does not pay for these chairs. How can this be?
    Don't know if you have the patience to contact BCBS and ask for a supervisor to discuss your need for the shower/commode chair. I once did this when BCBS approved coverage for a wheelchair, then during fabrication and shipping (took a few months in those days), I reached qualification date for Medicare and BCBS said they would not cover the chair, telling me to have Medicare cover it. Knowing that would take months more, I called BCBS and spoke to a supervisor for about a half hour about how they had approved the chair in writing, and he finally got worn down (like I was) and agreed to cover it.
    I just wish someone would push things like this as good quality shower chairs are a necessity, like a wheelchair.

  4. #4
    I fought this fight and lost and lost again. I tried every avenue I could think of. The bottom line is that insurance considers showering a luxury not a necessity. And they don't cover nice-to-haves just needs. According to them, you can get clean by sponge bathing so it isn't needed. After 5 years I gave up the fight.

    Good luck and let us know if you figure out how to win this battle!

  5. #5
    Here is Aetna's policy. It gives you some idea of what you are up against.

    http://www.aetna.com/cpb/medical/data/400_499/0429.html

    My DME says Medicare will cover a commode chair only when the person is confined to the bedroom.
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  6. #6
    Senior Member goldnucs's Avatar
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    Yeah, I'd like to see the dummies at MC go a week without pooping and showring and see how they like it!
    Rick Goldstein
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  7. #7
    Medicare's position is that a commode chair is an item that they rent for 13 months and then you own it. Of course that means you get a frame, a seat, a bucket and plastic bags, not a commode/shower chair that most quads and paras would need.

    Here is the Medicare statement about Commode Chairs:
    http://www.medicare.gov/coverage/commode-chairs.html

    All the best,
    GJ

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