Wheelchair Cost Savings

[MSspouse]

I just wanted to toss this idea out for comment. It's based on only my first experience with the Medicare/DME system but years of experience as general purpose engineer, builder, DIY, and all around cheapskate.

Our first power chair chair was bought through Medicare about 18 months ago. I wanted the power elevation option so the copay was $5800, but it probably would still have been $3000 - $4000 without it. Since then, my wife's condition changed significantly and I wanted to switch leg rest styles. The original DME was not responsive and I knew by the list price of the components that the copay might still be several hundred dollars. So, I started watching craigslist and ebay for parts. Never saw what I wanted, but I found that prices on complete used chairs are shamefully low - especially those with expensive rehab seating. I ended up buying a complete Q600 with the full TRU-Balance seating system (included the leg rests I wanted) for only $1000. It has literally only 1 mile on it. It also included a Roho Quadtro in virtually new condition.

So my question is why doesn't Medicare allow the purchase of used chairs. The savings to Medicare would be huge and the incentive for the patient is simple. NO COPAY for a used chair. To increase the supply and discourage dumping at fire sale prices they could also institute a buyback program. If you bought a new chair and you turn it in, you could get percentage of your original copay back based on the age and condition. DMEs would probably even make more by charging an inspection/reburb fee for changing batteries and customizing it for a new patient than they would on a new chair.

So what do you all think? The reason used DME has no value is that Medicare will not cover it. I'm talking about emulating the lame program where you pay overpriced rent on used items like mattresses but still have a copay and own it in 13 months. This is no copay on used equipment, no lucrative rental program for suppliers, and a reasonable one-time fee to DME to refurb/refit. Would you forgo new to get the same equipment for no cost?

[t8burst]

Although this sounds reasonable it will end up hurting people without insurance. I look at ebay all the time for used wheelchairs (don't know why I don't really need one). It is interesting to see people put out a chair "Cost 20K brand new, never used only want 15K". A week later they drop it to 10K, then 5K and eventually it sells. The reason is they didn't pay 20K for the chair, insurance (or medicare) did. The net effect of this is that if a person doesn't have insurance the price of used equipment is a lot lower because the majority of people who need the equipment can get it for free (or the co-pay cost). If medicare was allowed to buy used equipment it would drive the price up and people without coverage would suffer.

[MSspouse]

Originally Posted by t8burst

Although this sounds reasonable it will end up hurting people without insurance...

Most people who need a power chair should at least qualify for Medicare. If not, that is a problem. I think about that often, since my wife contracted MS at age 23. If she had been in college and never worked enough quarters qualify we would have been SOL.
Also, these are mostly taxpayer funded chairs. The dollars should be used to provide the maximum benefit to everyone. What about those that qualify for Medicare but can't afford the copay?
Sure it's nice for some like us to have a source of underpriced chairs but that's ultimately a selfish view. What if that change did made it financially possible for anyone that needs a real rehab chair to get one? I'm not talking about expanding scooters for old people here.

[t8burst]

Originally Posted by MSspouse

Most people who need a power chair should at least qualify for Medicare. If not, that is a problem. I think about that often, since my wife contracted MS at age 23. If she had been in college and never worked enough quarters qualify we would have been SOL.
Also, these are mostly taxpayer funded chairs. The dollars should be used to provide the maximum benefit to everyone. What about those that qualify for Medicare but can't afford the copay?
Sure it's nice for some like us to have a source of underpriced chairs but that's ultimately a selfish view. What if that change did made it financially possible for anyone that needs a real rehab chair to get one? I'm not talking about expanding scooters for old people here.

As both a tax payer as well as someone with insurance I think that your idea is sound and would save medicare and ultimately tax payers money. I was just pointing out it would hurt a segment of the population. You are probably right people who actually need chairs can get them paid for by medicare. I think ultimately I would would vote for allowing medicaid to buy used chairs. Does the most good for the most people.

[Wesley]

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