Getting a New Wheelchair: The Red Tape

For those of you that have been following my blog for a while, you might remember one I posted a couple years ago about how involved it is for me to get a new wheelchair. My chair has a lot of custom pieces to it, and it is very, very expensive (more than most cars, in fact). There are only a few companies to choose from when buying an electric wheelchair, and the one I prefer is based in Sweden. Permobil’s wheelchairs are not only state-of-the-art, but they are extremely stable and about as well-made as you can find. Although the company has an outlet in the United States (Nashville), a brand new chair has to come from across the pond. This just adds one more complication to the process, as well as some time.

The first step in applying for a wheelchair is meeting with you repair company (in my case, NuMotion), as well as the rep for the type of chair you want, and picking a model. It’s been five years since I’ve applied for a new chair, and my old one is starting to have some electrical/mechanical issues. Any time there’s an electrical problem, the writing is basically on the wall that the chair is going to start malfunctioning to a point that is unacceptable. Luckily for me, I’ve been working with the same people for so long that they already know what I’m going to want even before we meet in person. One of the only complaints I have about the last wheelchair I got (because otherwise this chair is fabulous), is that it’s huge compared to every other chair I’ve had in the past. Now, sometimes that comes in handy, but other times it’s impossible to maneuver in tight spaces and doorways, making the places I can take slightly more limited. The other, more important, problem I have with it is that it is almost impossible to get it in my car with all of my art and jewelry displays when I do my in-home art shows. This makes traveling with it extremely difficult and in some cases, not an option at all.

What I love about this big chair is that it’s extremely stable, and because it’s got an adult-size base, it has more functions than a smaller, pediatric chair. The seat can tilt and recline, and the footplate is electric. Like most of Permobil chairs, it has a seat elevator, but because it has a larger base, the elevator goes up higher than a smaller chair’s would. So there are definitely some perks to it that in certain situations, I’ve come to rely on.

But again, it’s time for a new one that will be more useful to me in the path that my business has taken. Back in March, I met with my reps and we chose a pediatric model that has an incredibly small footprint and moves well. It doesn’t have a seat recline and doesn’t elevate as high, but it does tilt and is very stable. Though there are some concessions I will make to have the smaller footprint, it will be 100% worth it with my lifestyle.

Once we chose a chair, I had to meet face to face with my orthopedic doctor for him to basically write in his notes that he saw me and that I am still disabled (imagine that) and still need an electric wheelchair for mobility. It’s kind of ridiculous, but it’s just one of those hoops you have to jump through for the insurance companies. My physical therapist had to do a lengthy seat evaluation, explaining why I needed the type of seat I did and what my physical capabilities actually are. After all of that was complete (approximately two months later), NuMotion submitted the request for the wheelchair to insurance and Louisiana Rehab Services (who, in the past, has funded whatever my insurance didn’t cover on a wheelchair) and then we just had to wait for them to respond.

A few weeks later, I received a denial letter in the mail from my insurance (Medicare/supplement). Are you ready for the reason for denial? My request for a pediatric wheelchair was denied because Medicare’s policy states that they will not approve a pediatric wheelchair for someone who will not grow. Does that make ANY sense to you? While I understand they need to put limits on what they approve, clearly I have good reason to have this particular chair. This is the problem with Medicare and insurance companies in general–it’s all about checking off boxes and not at all about making sure the individual gets what they need. The wheelchair I had approved five years ago by the same insurance cost TWICE as much as the one I’m asking for now, and because I DON’T GROW, they won’t approve it. Yet they would approve an adult-sized, more expensive one because it checks the correct box. Ridiculous, isn’t it?

I’m not a political person, but “Medicare For All” is not going to work with the system we have because currently, Medicare doesn’t even work properly for some. If it’s this bad now, imagine what would happen if we overloaded the system with even more people in need. From personal experience (not just this one) I can definitely say that there needs to be some serious reform before we try to provide even more services to more people. I’m not saying something doesn’t need to change, but what we have now is not going to work. Paying for “Medicare For All” is a completely separate issue in itself–nothing in life is actually free.

We’re working on other options to get this chair now, and honestly, it will probably all work out just fine. The denial is going to put us behind a month or two more, and it’s going to be tight as far as getting my new chair before my holiday art and jewelry shows start in the fall, but that’s okay. As exciting as it is to get a new wheelchair, I absolutely hate this part. The red tape and the hoops we have to jump through can be so frustrating at times. You’d think the process would only take a couple months, but in reality, I’ve never gotten a wheelchair in less than a year from the start of the process to delivery. I work with the best of the best in the business, and roadblocks like this still pop up every single time. It’s completely unavoidable. I’m just so thankful that I have such a great team working for me to get me the things I need to function! Thanks guys!