Buying a bicycle, car, truck, or any other form of transportation is exciting. The ability to get you where you want to go is often taken for granted until it breaks down or becomes hard to use. For most transportation vehicles you’re free to shop around, try out different makes and models, and buy the one that fits your needs. However, buying a new wheelchair is unfortunately different. If you’ve never bought a custom wheelchair or needed one to get you everywhere you want to go, you’re probably wondering, what’s the big deal! You go into a Medical Equipment Store and try out a few different wheelchairs to see which one fits your needs the best, then order the perfect color and in a day or two have your new wheelchair.
If I could have it my way, it would be done in those three easy steps. But here’s the real deal:
1) Get a prescription or order from your doctor to start the process.
2) Meet with a Wheelchair Specialist to discuss the necessary parts for your special needs for comfort and mobility. Unfortunately, there’s no guarantee these parts will work because you’ve never tried them before or even physically seen them. Sometimes it’s a picture from a catalog or the internet.
3) Meet with an Occupational Therapist (O.T.) or Physical Therapist (P.T.) to assess your needs and discuss the recommendations from the Wheelchair Specialist. The therapist needs to write a “Letter of Medical Necessity” for the Medical Equipment Store to submit to the Insurance Company.
4) Get another doctor’s appointment to review the recommendation from the Wheelchair Specialist and O.T. or P.T and get a “Letter of Medical Necessity” for the Medical Equipment Store to submit to the Insurance Company.
5) Make sure the Medical Equipment Store gets both “Letters of Medical Necessity” and submits it to the Insurance Company for authorization.
6) Wait for the Insurance Company to send confirmation of coverage. Once you’ve received the authorization notice, make sure the Medical Equipment Store orders the parts which consist of a frame, seat, back, leg rests and arm rests.
7) When all the parts arrive from various manufactures, the Medical Equipment Store assembles it. Once the parts are ordered and the wheelchair is assembled, you finally get to try it. If it doesn’t work, you get to start the order process again for a different part.
When you are confined to a wheelchair fourteen to sixteen hours every day it needs to be comfortable and well fitted for your special needs. Unfortunately, because of the customization they are expensive and because of the many hours per day they are used, they wear out. So about every five years you have to go through this process. The expense is outrageous, several thousand dollars, and you don’t know the total cost or your deductible portion until the wheelchair is delivered. The drawn-out process and frustration of orchestrating each step is tiring. You literally have to supervise every step or they don’t get carried out, and if too much time passes the Insurance Company can back out and you have to start the process all over again.
Personally, we started this process on October 16, 2013 with the first doctor’s appointment. Yesterday, March 17, 2014 (our lucky day) Mark finally got his new wheelchair. Because it is getting harder for me to transfer Mark in and out of the wheelchair, it was recommended we get one that reclines for change of position. It’s very nice, but because it reclines the wheels are set back on the frame, making it harder for Mark to propel. Also the frame is longer than the previous chair, making it harder to turn corners and get into our van that’s customized for a wheelchair. It also sits a little higher making in impossible to get under the table and desk. We’re giving it some time to see if we can make some adjustments, but at this point we are unsure if this wheelchair was the best option for Mark. Unfortunately, this isn’t something you can resell and buy another.
My advice: start this process before your wheelchair needs replacing. If you wait until you need a new one, you’ve waited way too long.