Saturday, February 9, 2008

Wheelchairs and Scooters Not Covered by Medicare and Insurance?

As many PWDs know, Medicare and Medicaid require that wheelchair or scooter use be in the home and do not consider leaving the home a medical necessity, but a luxury. Nevermind that many PWDs can get around their homes, but participating in life activities outside the home, which requires more than a few steps, is impossible without mobility equipment.

Now insurance companies have adopted this new "standard," but they go even further, denying medical equipment for use outside the home, even for work, stating that "employment is not a medical necessity." Through private insurance funded by an employer. Of course, this kind of decision makes employment inaccessible to people with disabilities; let's see if someone can file an ADA suit based on that. Medicare/Medicaid assumes people aren't employed, but where is the logic in private insurers of employees adopting these regulations? Plus, you know, someone somewhere, sometime, might consider doing something because it's right to let people out of their homes since they can be. Not only should people be employed if they can and want to be, but many people requiring mobility equipment may not be disabled enough for government benefits. Too disabled to work without a wheelchair/scooter, not disabled enough to go on disability.

Watch what the government does first. People shouldn't shrug off this issue because it doesn't apply to them. Any unfair rules will soon be featured at an insurance company near you as their new standard. And with an aging population, many who don't need wheelchairs now will.

I once read that users of mobility equipment actually save insurance companies money once they have wheelchairs/scooters since they are no longer having accidents and falls, further damaging themselves, or increasing their pain levels, all of which require a lot of treatment. Even an expensive scooter is far less than a surgery or an ER visits. or two, or ongoing pain and medical management.

For me? Yes, I will be using the scooter in the home and have. Especially if the insurance company asks. If I qualify as disabled enough for them. I can push myself to pain that incapacitates me later; an independent insurance assigned doctor would only see the intial pushing, not the incapacitation.

What can you do? Write your senator and representative and let them know that the Medicare and Medicaid laws need to change, and that insurance companies should be required to pay for mobility equipment that will allow people to participate in normal life activities.


Anonymous said...

Durable Medical Equipment (DME) scams by unscrupulous providers have skyrocketed over the past few years, hence we see a crackdown of the entire system, and not the lawbreakers. See recent articles in the Miami Herald where the Feds finally arrested several providers for fraud.

However, the "overall" approach of the Feds fix to DME problems leaves many needy people needy. I am confined to a wheelchair fulltime, and have been for more than forty years. I have used very few services from the Fed, but have seen the system abused by those that want "convenience," while those of us that truly need help are lumped in with the crooks.

So sad, but I say scrap the entire DME program, clean out the crooks, wannabes, and the lazes. Then maybe we can once again create a program that will address the needs of the truly needy.

FridaWrites said...

Yes, insurance scamming is terrible and raises the costs for everyone. The price people with disabilities are paying is even higher, in terms of being unable to get needed equipment and health services.

I'm not sure what the solution is--more documentation by physicians?