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Thread: natural fit hand rims through medicare/medicaid ?

  1. #1
    Senior Member NW-Will's Avatar
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    natural fit hand rims through medicare/medicaid ?

    I met with my PT and the supplier to discuss the chair I'm trying to get.
    Previously I have always had natural fit push rims, and never a thought or issue about insurance and natural fit rims.

    I'm being told I can't have natural fit rims with my new chair! because that would be unbundling!!

    Has anyone else had this experience ?

    Better still ... the supplier tells me, once I receive the chair, I can't go to them and buy natural fits from them, cash and fit them myself.. "The whole dog and pony show about how it is fraud!"

    I would have to go buy them somewhere else.

    Does this sound a little beyond crazy?

    I was going to add this to my other thread but figured not as many folks would read it etc.

    http://sci.rutgers.edu/forum/showthread.php?261501-New-Manual-chair-through-Medicare-Medicaid-understanding-available-options-for-2018

  2. #2
    Seems like you have Original Medicare.

  3. #3
    Senior Member Oddity's Avatar
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    Sounds to me like this is another artifact of you being a Dual Enrollee, with both Medicaid and Medicare. I dunno about unbundling, unless you're trying to add them after the fact using the "wheelchair accessory" HCPCS code, but I thought they were an option on the order form you could just add in the 'bundle'; however, since you're Dual Enrolled, they are indeed bound by certain Medicaid restrictions on charging you out of pocket overages (even on an ABN), since 'Caid is means tested, and supposed to be 100% coverage, or nothing (in most instances), with no OOP costs to you. Dual Eligibility is tricky, and I'm not 100% up on the rules, but seems to me that's what you're bumping up against here.
    "I have great faith in fools; self-confidence my friends call it." - Edgar Allen Poe

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  4. #4
    Im pretty sure I have a fairly lightly used 24 inch pair you can have gratis, if u pay for shipping. I need to look first tho. Let me know

  5. #5
    good luck my DME company had a slightly used set i paid $100 bucks for. they are out there however you will have to pay for them and they happily put them on for me. i use Monroe wheelchair. it also helps that i am friends with both of the guys that sold me the chair.
    T6 Incomplete due to a Spinal cord infarction July 2009

  6. #6
    Senior Member NW-Will's Avatar
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    Hey thanks for the offer.
    Someone out there will definitely take those.
    I'm after a pair of 26" natural fits otherwise I'd totally take you up on your offer.


    Quote Originally Posted by Podkane View Post
    Im pretty sure I have a fairly lightly used 24 inch pair you can have gratis, if u pay for shipping. I need to look first tho. Let me know

  7. #7
    Senior Member NW-Will's Avatar
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    Yeah I'll figure it out.... I was just surprised how it is a total NO NO with insurance.

    Quote Originally Posted by Smashms View Post
    good luck my DME company had a slightly used set i paid $100 bucks for. they are out there however you will have to pay for them and they happily put them on for me. i use Monroe wheelchair. it also helps that i am friends with both of the guys that sold me the chair.

  8. #8
    Hey no worries. Sorry couldn't help you out. So if anyone wants these let me know. They are just gathering dust in my garage.

  9. #9
    did you find a taker?

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