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Re: equipment funding

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  • aidipt
    Have you tried appealing the medicaid denial? I know it isn t common but if you can get a healthcare professional to give detailed and specific reasons why
    Message 1 of 7 , Sep 13 6:45 PM
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      Have you tried appealing the medicaid denial? I know it isn't common
      but if you can get a healthcare professional to give detailed and
      specific reasons why you need the seat lifter, and how it would be
      cost effective to do so, they may agree. It is important to include
      areas where the seat lifter makes it so medicaid does not have to pay
      for support personnel to do the same activity without the lifter. If
      you can, video the lifter in use and what happens if you don't have
      the lifter. (Pictues are worth so much as it makes you more than a
      piece of paper but rather a functioning human with special needs.)
      Explain the cost of the additional part in terms of medical dollars
      spent for support to do the activities with human support.

      If the seat lifter makes you more employable, make sure they know
      it. If you can't be employed because your chair isn't working or it
      isn't correct, it will ultimately cost much more than it would to
      approve the upcharged parts and they should know that too.

      If they are unwilling to pay for the adaptations, get them to agree
      to pay for portions of that specific chair so you only have to find
      find funding for parts of the chair rather than all of the chair.
      Medicaid is tough as it hold vendors to a higher standard. The
      vendor can't balance bill you for a chair that they agreed to pay for
      so the vendor is expected to take the hit on what is denied. If you
      can get it in writing from medicaid that they will pay for "x, y, and
      z", then maybe you can get "a, b, and c" paid by someone else. Do not
      look for that agreement until you have exhausted the first line of
      action which is appeal with ammunition as defined above.

      Hope this helps you and anyone else in this same quandry. Strong
      letter writing puctuated with pictures/ videos, really makes a
      difference when appealing the 1st, 2nd, and 3rd time.
    • mocha
      medicaid will replace motorized chairs every 7 years. Medicaid will replace batteries, and other parts as long along the way, per doctors orders. The only way
      Message 2 of 7 , Sep 13 7:52 PM
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        medicaid will replace motorized chairs every 7 years.
        Medicaid will replace batteries, and other parts as long along the
        way, per doctors orders.
        The only way they will replace sooner is if the chair is utterly
        irreparable.
        With that you also need a well written document from your doctor/
        therapist supporting this need.
        If you need customization, your doctor absolutely MUST include that
        in the paperwork with specific reasons.
        It is a lot of paperwork and time consuming, but in the end if that is
        what you need it is worth it.
        The key is to stay on the ball with the distributor as they are the
        ones dealing with medicaid.
        Also, make sure the distributor adhere's to all the customizations
        your doctor has written up for you.

        Is this your first replacement you are getting??
        When was the last time medicaid paid for repairs on your chair?

        good luck
        mocha

        On Sep 12, 2008, at 8:58 PM, s.w. wrote:

        > hi,
        > i'm sort of new to posting to group boards, so please forgive me if
        > this question has already been addressed.
        >
        > i have amc, and use a specialized power chair with a seat elevator for
        > daily living. i do have medicaid, but was told it won't pay to
        > replace such a specialized chair, which is now old.
        >
        > i've been trying to research whether there are grants out there for
        > wheelchairs, but i'm having serious trouble finding any info. i've
        > tried independent living centers, march of dimes and lists of
        > government grants.
        >
        > if anyone knows of other places to try, i would really be grateul for
        > your advice.
        >
        > thanks very much!
        >
        >
        >



        [Non-text portions of this message have been removed]
      • scarlet watts
        these are great suggestions, everyone. thanks so much! [Non-text portions of this message have been removed]
        Message 3 of 7 , Sep 14 4:25 PM
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          these are great suggestions, everyone. thanks so much!



          [Non-text portions of this message have been removed]
        • Allyson
          Hi. I have medicare medicaid and you were told right they will not pay over 4 grand for a elec. w/chair. I m not sure about you but I also have the elevate on
          Message 4 of 7 , Sep 18 2:16 PM
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            Hi.

            I have medicare medicaid and you were told right they will not pay over 4 grand for a elec. w/chair. I'm not sure about you but I also have the elevate on mine and ya it ran around 17 grand. I got mine covered through state/government rehabilitation services. Since you are using gov health care coverage you already meet the intial need for disability aides required to get aide for assistive equipment, if you are in school or are actively pursuing employment/employeed then you qualify and rehab services will cover all equipment needed to be a productive member of society.


            Ally



            "Here I sit wondering what everyone wonders. The three questions that
            no one seems to know how to answer. 3 top UNANSWERED questions of the
            Universe are:

            1. Why am I here?

            2. What is my purpose?

            3. What is that smell?"

            --- On Fri, 9/12/08, s.w. <scar2d2w@...> wrote:
            From: s.w. <scar2d2w@...>
            Subject: [Adults AMC] equipment funding
            To: amc_adults@yahoogroups.com
            Date: Friday, September 12, 2008, 8:58 PM











            hi,

            i'm sort of new to posting to group boards, so please forgive me if

            this question has already been addressed.



            i have amc, and use a specialized power chair with a seat elevator for

            daily living. i do have medicaid, but was told it won't pay to

            replace such a specialized chair, which is now old.



            i've been trying to research whether there are grants out there for

            wheelchairs, but i'm having serious trouble finding any info. i've

            tried independent living centers, march of dimes and lists of

            government grants.



            if anyone knows of other places to try, i would really be grateul for

            your advice.



            thanks very much!





























            [Non-text portions of this message have been removed]
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