Purchasing a new cushion via Medicare on a non-Medicare purchased wheelchair

[zillazangel]

Chad has a Permobil C500 and Jay Stimulite cushion that was purchased by his BCBS insurance through his employer about 6 years ago. In the meantime, he retired due to medical disability. Thus, in Aug of last year, he rolled over to Medicare and now BCBS is his secondary insurance. He needs a new cushion for his wheelchair. I have heard that if Medicare did not purchase the chair (which they did not, BCBS did, 6 years ago), that they will not pay for any repairs to the chair. Is this true? Will we be able to purchase a cushion for his chair through Medicare?

[SCIfor55yrs.]

You should try but you are at the mercy of the bureaucrats. They may make you jump through a lot of hoops to get the cushion paid for. Because the chair is not in their computer, it does not exist. To get a wheelchair and related support you will likely have to go through the evaluation process like a newbie. That was my experience.

[ChrissyOT]

My experience with medicare (in Missouri, doing home health) is that you need a script from your doc for the cushion and a documented history of pressure sores for any type of high-end cushion. that you got the chair paid for elsewhere should not matter, as long as someone (such an an OT) documents that that's the chair you have.

I can't comment on the chair repair issue, that's never come up for me.

Does Chad have a Jay cushion, or a Stimulite cushion? Those are two different brands. Supracor makes Stimulite cushions.

[randomryan007]

To get a cushion covered you will need a script for a doctor. Thats all you need i went o medicare and before i was on private insurance all i had to do is get a script and i was good to go.