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Thread: Medicare and purchasing cushions

  1. #1
    Senior Member Cowboys_Place's Avatar
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    Medicare and purchasing cushions

    Does anyone know Medicare's policy on purchasing a wheelchair cushion? The provider I go through is telling me Medicare will only purchase a cushion once every five years unless I have some kind of medical change.
    How do they expect a cushion to last that long..!!??

    I currently use a supracor stimulate contoured cushion. However like a dummy I made some modifications to it by trimming some of the front off it so it wouldn't rub the back of my legs. Now my legs are spread further apart causing my feet to rest on their outer edge which in turn caused sores.

    Thanks for your time
    Courage is being scared to death but saddling up anyway. .(John Wayne)

  2. #2
    Senior Member Oddity's Avatar
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    In addition to the time requirement, I was told, earlier this year, by the funding/billing specialist (and the seating OT), at Woodrow Wilson Rehab Center, that Medicare won't reimburse a cushion to be used on a chair they didn't also fund. I was told they classify cushions as 'accessories' and won't fund any accessories for self-payed (or other insurance) chairs. The folks at WWRC were prepared to advocate my need for a new chair so I could also get the cushion I needed. Crazy. I just bought the cushion myself.

  3. #3
    From Medicareinteractive.org:

    "If your equipment is worn out, Medicare will only replace it if you have had the item in your possession for its whole lifetime. An item?s lifetime depends on the type of equipment. An item?s lifetime is
    never less than five years from the date that you began using the equipment in the context of DME replacement. Note that this five-year time frame differs from the three-year minimum lifetime requirement that most medical equipment and items must meet in order to fall under Medicare?s definition of DME. The item must also be so worn down from day-to-day use that it can no longer be fixed. Keep in mind that Medicare will repair worn out equipment up to the cost of replacement before the end of its lifetime."

  4. #4
    Senior Member Cowboys_Place's Avatar
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    So obviously whoever is making the decisions/guidelines doesn't have their a** sitting on a wheelchair cushion every day. Thanks for the quick replies, take care.
    Courage is being scared to death but saddling up anyway. .(John Wayne)

  5. #5
    They key words you used are "Some sort of medical change". I think you have that.

  6. #6
    Senior Member Cowboys_Place's Avatar
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    Does anyone happen to know what I can use to keep my legs from sliding apart so much, I tried a belt however it left marks on my legs.
    Courage is being scared to death but saddling up anyway. .(John Wayne)

  7. #7
    Cowboy, I used to make these out of wide (2-3") elastic and Velcro for my mother. She used them under her dresses. Using stretchy material make much less marks on her legs.

    (KLD)

  8. #8
    Your wheelchair manufacturer may have a knee abductor accessory similar to these: http://www.therafin.com/kneepad.htm

    Some cushion manufacturers make wedges that fit under the cushion that help deal with knee abduction.

    Body Point makes a universal stretch neoprene strap covered with nylon fabric and a velcro closure. It is pricey, but you may find a cheaper similar alternative if you search the internet. Whatever you use, be careful when strapping you knees together that you don't strap so tight that you create pressure on the insides of your knees.

    All the best,
    GJ
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    Last edited by gjnl; 12-02-2016 at 01:08 PM.

  9. #9
    I agree, the Body Point strap is excellent. It's made very well, excellent craftsmanship. (Kind of unusual to see such good craftsmanship these days). I think the one I use is called their "Universal" strap.

  10. #10
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    dumb question when and how often should cushion get replaced how do u know I have j extreme

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