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Thread: Have Any Of You Had Trouble With Medicare Funding Your Second Power Chair?

  1. #1

    Have Any Of You Had Trouble With Medicare Funding Your Second Power Chair?

    I'm getting ready to receive my second power chair. However Medicare is taking their own sweet time in reviewing the documentation. They've been at it since August, and from what I've heard. They're at the end to making their final decision. I'm getting anxious each week because I'm getting what's supposed to be a really cool power chair, and I can't wait for it to get to me once it gets ordered. But, my disability is a complicated one to understand, and I'm worried that Medicare may deny my new power chair.

    Has anyone else had problems with Medicare funding their second power chairs?
    Samantha

  2. #2
    I believe there are some new guidelines as to what they will and will not cover and what is required for documentation. Provided what you want is within the eligible guidelines and your seating team provides the appropriate documentation, including everyone from the therapist to the physician, you should feel comfortable that you will get covered. Unless you have a secondary Medigap insurance you will be on the hook for the 20% or whatever the percentage is that is not covered by Medicare.

    Having started your process in August it is not even a month or so, so I would be more patient. Some people wait a very long time for approval. You just don't want to have to wait inordinately because of something that was needlessly omitted, improperly documented, or was clearly not on the eligible list of covered DME.

    I am also in the process of starting my evaluation for my second power chair. My first one, a Permobil C 300, was mechanically reliable, though very painful to sit in. So far, we are going to stick with Permobil, though the new models accept three aftermarket backs.

    My wheelchair clinic seems to only push Permobil so I don't know if anything out there that suits my purposes better, such as Invacare. Any choice I make must be covered by Medicare.

    What were you using and what are you going to get for your second chair?

  3. #3
    It is interesting how variable the 10 regional administration offices for Medicare/Medicaid seem to be. My durable medical equipment supplier told me that the San Francisco regional office, number 9 (Arizona, California, Hawaii, and Pacific Territories) rarely considers Permobil chairs, while regional offices in the eastern part of the country rarely consider anything else. I don't know from any personal experience if this is true, but it was an interesting observation.

    All the best,
    GJ

  4. #4
    Quote Originally Posted by 50surgeries2012 View Post

    Has anyone else had problems with Medicare funding their second power chairs?
    I personally gave up years ago on getting Medicare funding for a wheelchair. For one thing, they only want something that can be used indoors, and I like to go outdoors sometimes. I also like a chair that is comfortable and smooth riding outdoors, and it seemed nearly impossible to explain that I would pay for the difference between what Medicare would fund (typically a low-end chair with poor shocks) and what I wanted (which was a chair with good shocks, suitable for outdoor use).

    Strangely enough, Medicare partly funded a powerchair for me over a decade ago, when I was actually a bit more functional. But the new one seemed nearly impossible to fund (I wound up paying out of pocket for a used chair).

    However, I have heard of many people who have managed to get wheelchairs through Medicare, so I believe it can be done..
    Last edited by xsfxsf; 09-27-2016 at 05:23 AM.

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