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Thread: Insurance coverage on new chair

  1. #1

    Insurance coverage on new chair

    I am fighting to get a new chair through my insurance. They have approved to fund a Quickie Ti, but they have decided that it is not important to fund side guards, tires or wheels....because of course they arnt needed or anything. I am asking for Spinergy's, so I wouldnt be surprised if it was just that part denied, but all the other things denied is telling me that the insurance company is just screwing with me.

    How many people have actually gotten Spinergies paid for? I swore people were able to make that happen recently.

  2. #2

    Huh?

    They won't pay for side guards or wheels...that's a joke. A total crock sledr. Not only did mine pay for my Ti and Spinergies, I just got approved for $600 for a spare Spinergy incase of a flat. Who is filling out your forms? Your Dr. should be, I always tell my Dr. exactly what to say.

    Also, your name is familiar, if you live where I think you do,(not showing in profile) get ahold of the seating clinic @ GF, tell them about this crap and I'm sure they'll write up a form for the Insurance Co. What Co. are they? I have had (well my hubby's plan) Sunlife, Rwam, and Manulife, and never a problem with chairs ever.

  3. #3
    Senior Member
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    Back when I had Blue Cross they pay for my power wheelchair which was close to being $45,000. For a piece of junk what a waste of money. They should at least let me help design what the wheelchair would look like. Trying to get something smaller and not head control. But since I have Medicare it will be quite difficult in my opinion.

  4. #4
    my ins has paid for 3 pair of spinergys in 4.5 years along w/ new chairs. its all how its submitted. my doc writes a seperate letter of med necessity for the spinergys
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  5. #5
    Senior Member wheeliecoach's Avatar
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    I just had my Spinergys paid for...my doctor wrote that I have shoulder issues and a lightweight wheel would help to not damage it any further (although we all know with overuse it is going to happen). He also said that a lightweight wheel (and a lightweight chair) would make me more independent since I will be able to transfer it in and out of the car myself.

    It is all in the wording. Have a conversation with your doctor telling him what you would like and why. He can put the medical justification around it. As far as the other stuff...that is plain ridiculous...I have never had an insurance company tell me that those would not be paid for.

  6. #6
    Wouldn't it depend on your insurance? Isn't some insurance better than others?
    Aerodynamically, the bumble bee shouldn't be able to fly, but the bumble bee doesn't know that, so it goes on flying anyways--Mary Kay Ash

  7. #7
    Senior Member
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    Quote Originally Posted by november
    Wouldn't it depend on your insurance? Isn't some insurance better than others?

    Yes some insurance are better than others. My insurance when I got hurt spent over $500,000 on my sorry ass. Looking over the invoices that says this is not a bill I was astonished on what they paid everywhere I went.

  8. #8
    honestly guys, ins doesnt want to pay for anything. u have to be very aggressive.....everyone thinks its amazing that i get my ins to cover a new ultralight every 1-1.5 years, its not......its all about staying on their asses.
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  9. #9
    Senior Member
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    I actually just got my insurance to pay for a Ti-lite ZRA with spinergys. My other chair is only 3 yrs old but I had a medical necessity letter written by the therapist. It does also depend on insurance but im pretty sure that you need wheels for you chair to move though. Good luck.

    JJ

  10. #10
    Senior Member Andy's Avatar
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    My first chair was a TiLite TRA loaded up with every goofy gizmo you could get on one of those including Spinergies, all paid for 100%. The letter was written by a PT on staff at the rehab place I was at. No problems getting it approved. I think it all depends on how the letter is written, crappy letter, crappy result. If I recall, I was pretty impressed how much labored details were included in that letter when I read a copy of it.

    My second chair I just bought the basic TR online from Spinlife as I didnt want to deal with that process and waiting, then pilfered all the good parts off my first to build what I wanted after some chair experience. Seemed more worthwhile to do it that way than dealing with DME clowns and insurance approvals.

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