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Thread: wheelchair

  1. #1
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    wheelchair

    ok my j2 back 18 years has give it up I am on phone with united health they are telling me I need a new chair that unoted health/medicare will not pay for a replacement back

    is that true

  2. #2
    Quote Originally Posted by vjls View Post
    ok my j2 back 18 years has give it up I am on phone with united health they are telling me I need a new chair that unoted health/medicare will not pay for a replacement back

    is that true
    Medicare will pay for a replacement chair every five years. When the chair needs replacement parts, Medicare will only pay for the part(s) if Medicare is the registered purchaser of the chair on your behalf. When a chair starts needing new parts, Medicare makes a determination if it is more cost effective to replace the part(s) on the chair, especially when a chair is over 5 years old, or to replace the entire chair. So it isn't surprising that United Health is telling you that you need a new chair.

    If the j2 back is 18 years old, I assume the chair is pretty old too.
    Last edited by gjnl; 01-07-2019 at 04:41 PM.

  3. #3
    i too needed a new back 6 years after i got my chair the DME said medicare wouldn't pay for 1 because the chair was too old. i just got a new chair worked out great for me. as this new chair fits me better and is lighter than the old one.
    T6 Incomplete due to a Spinal cord infarction July 2009

  4. #4
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    Quote Originally Posted by Smashms View Post
    i too needed a new back 6 years after i got my chair the DME said medicare wouldn't pay for 1 because the chair was too old. i just got a new chair worked out great for me. as this new chair fits me better and is lighter than the old one.

    I refuse to deal with numotion here that said I talk to united health got to get scrip for back I will pay out of pocket subbmitte anget 60%

  5. #5
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    Quote Originally Posted by gjnl View Post
    Medicare will pay for a replacement chair every five years. When the chair needs replacement parts, Medicare will only pay for the part(s) if Medicare is the registered purchaser of the chair on your behalf. When a chair starts needing new parts, Medicare makes a determination if it is more cost effective to replace the part(s) on the chair, especially when a chair is over 5 years old, or to replace the entire chair. So it isn't surprising that United Health is telling you that you need a new chair.

    If the j2 back is 18 years old, I assume the chair is pretty old too.
    the frame cracked on both side is 2014 I think ti lite replace fram the wheels are the same ones I got 18 years ago have solid tires

  6. #6
    Quote Originally Posted by vjls View Post
    the frame cracked on both side is 2014 I think ti lite replace fram the wheels are the same ones I got 18 years ago have solid tires
    18 years, that's so long. What chair is it? Must have held up pretty good.

    My current chair is 7 years old and I'm pretty happy with it, but super ready to replace it because all kinds of things are wearing out (bar that supports footplate, both brakes don't work right any longer, back is loose, seat sling sags, lost the axle to one caster-currently replaced with generic bolt from home depot, footplate adjustment screws are too dirty or oxidized to be loosened and it's scratched and scraped to hell). I can only imagine what your chair has been through being a decade older than mine!

  7. #7
    as i said before my last chair was 6 years old with i don't know how many bearings and such replaced last straw was it needed a new back, my new chair is still using my old spynergy wheels with new tires and tubes. but i fear they will need to be replaced soon as well.
    T6 Incomplete due to a Spinal cord infarction July 2009

  8. #8
    Quote Originally Posted by gjnl View Post
    Medicare will pay for a replacement chair every five years. When the chair needs replacement parts, Medicare will only pay for the part(s) if Medicare is the registered purchaser of the chair on your behalf. When a chair starts needing new parts, Medicare makes a determination if it is more cost effective to replace the part(s) on the chair, especially when a chair is over 5 years old, or to replace the entire chair. So it isn't surprising that United Health is telling you that you need a new chair.

    If the j2 back is 18 years old, I assume the chair is pretty old too.
    Past experience with Medicare before all this competitive bidding, so might not be correct now.
    Powerchair less than 3 years old with many electrical and seating problems. DME said cost repair was not worth difference than replace. DME handled back/forth with Medicare about age of chair and costs.
    Surgeon wrote up justification letter/Rx on changes in seating plus impact on Activities of Daily Living vs old broken chair seating.
    Granted DME had to resubmitted paperwork to Medicare, the billing was for Group 3 without seating system on first go around. DME said was their mess up and not Medicare.
    New chair and seating was covered.
    DME said anytime cost repair vs cost of new chair and/or patient condition changes that Medicare would purchase new chair if old chair was not upgradeable due to cost vs new.

  9. #9
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    Quote Originally Posted by funklab View Post
    18 years, that's so long. What chair is it? Must have held up pretty good.

    My current chair is 7 years old and I'm pretty happy with it, but super ready to replace it because all kinds of things are wearing out (bar that supports footplate, both brakes don't work right any longer, back is loose, seat sling sags, lost the axle to one caster-currently replaced with generic bolt from home depot, footplate adjustment screws are too dirty or oxidized to be loosened and it's scratched and scraped to hell). I can only imagine what your chair has been through being a decade older than mine!
    its a ti lite the frame was replace in 2014 or thereabout as frame on botth sides cracked but I have replaced cshion every 3 years never replace bak but fixing too today casters replaced I don/t know how many times

    frog legs 3 or 4 times and brakes 3 times I am a quad and I go a lot foot plate fine I put solid tires on my wheels years ago mybe 14 or more still on using the same ones the wheels are the orginals

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