Insurance will not pre auth chair

[morgan617]

Apparently my insurance will not pre authorize power chairs, so in order to get one, I have to sign a waiver saying I will pay the several thousand dollars if my insurance says no after I get it. And they don't decide until you get it.

No chair for me...boohoo another lovely day.

[Dizzy Dame]

Morgan,

You might at least want to try a manual chair. I've been very happy with mine (as long as there's someone to push me and lift it in and out of the car). It's made a huge difference in what I can do (for example, now I can actually leave the house )

I wasn't approved for a power chair, my insurance company wanted me to prove that a manual chair wouldn't work for me. I got the manual chair thinking I'd use it for a few weeks, testify to how it doesn't help, then get my power chair, but now I don't even want a power chair.

Hopefully things will get better for you.

[Ernie]

Hi Morgan,

I am so sorry that your insurance company won't accept the power chair. I agree with Dizzy Dame that you could try a manual wheelchair. This way you could leave the house with someone else.

I had my manual wheelchair for 3 years before I got the power chair.

Maybe you can try again in a few months.

[Guest Belinda]

Sorry Morgan

[Sophia3]

Morgan

I am so sorry to hear about your insurance company. Doesn't that STINK!

I hope a manual wheelchair might be an option for you.

Sophia

[dizzygirl]

OMG!! Morgan I am so very sorry that the insurance compnay wont approve a power chair for you!! do they have any kind of PT eval you can go thru to get a powerchair to prove that a manula one wont quite work for you?? if you are paralsysing or fainting or just feeling like you do in general?

For me I really had to fight to get mine.. it took me from June until the day after I had my EP study in November before I got my powerchiar.....

I suggest PT eval.. and also if you have other docs tht have or are treating you w/ pots and are SUPPORTIVE of the POTS DX.. get them to write a letter for stating the nature of you illness and um..limitation involved..I had both cardiologist write letter for me.. along withthe doc who first sent the script for a chair..)

But getting back to the PT eval.. if they will aloow a PT eval as proof of a need for a powerchair.. I would try that route.. I was very symptomatic the day and days prior to my EVAL and it worked in my favor.. and showed them that I can not physically handle a manual chair.. that my heart and body in general cant tolerate the exerzersion.. (sp??)..I had the crazy bp (150/0)and HR(dnacing in the 200 mark) to back up what I was telling them.. iw as so on the verge of passing out..like right there..

I know you have documentation to back up what you are saying..

I dont know how things work in your state in regard to things.. but I just thought I'd offer my 2 cents worht on the matter.. I know how irfurriating this process can be..

you have a need for a powerchair.. and I'd hate to see you go with out something that might really help make your life easier.. or atleast a bit mangeable...

though manula chair isnt ideal (in my opinion) i guess it is better then nothing..

I'm so upset for you!

hang in there morgan..

hugs

linda

[Jacquie802]

Oh Morgan, what a disappointment. I really dislike insurance companies...I DO!!! Do you think if you have a manual chair for a few months that you could put in for a power one after? It's ridiculous though, because what's the point of having a manual (if a person didn't have anyone to help them) if your not able to push yourself....?? Hang in there.

Jacquie

[morgan617]

Well, I fainted at the vets last, so my husband said I am getting a chair and he could care less whether we pay for it or not. He just bought me a manual one for now and is telling them to start the process for the powerchair. he said he has had enough of me hurting myself. (I killed my butt and really wrenched my neck) My husband is very laid back, but he is brooking no argument from me. He is on jis way home with the manual one.

Geez....Oh, I do have a pt eval and they they say I am too weak for in home pt and he has seen me faint twice. So Dan will send that in, along with a letter from my ent that says I have such significant balance problems, I need a chair for safety.

so he just got home and i'm supposed to go sit in it....

[Ernie]

Hi,

That's a big move ahead that your husbad bought a manual chair. It shows he really loves you and cares for you.

I hope you will be able to have your power chair soon.

[morgan617]

It's a little red pediatric chair and I fit well. But it sort of makes me sad, you know...

[Sophia3]

I can't say I understand the chair making you sad, because I don't use one. but I hope you are able to come to terms with that.

I was like that about a handicapped sticker for my car for a long time. Now that I have it, I use it on bad days and sometimes on bad days ALL THE SPACES ARE TAKEN!?

But I guess there is some grieving involved in having to depend on a wheelchair. And you have so many things unanswered in YOUR case that it has to had to the despair and frustration with the medical and insurance community.

With that said, i would love to have a great husband who decided he had had enough and is getting you a chair no matter what!! :-)

so, I hope you are able to get past the sadness...but I also think that would be very natural, Morgan.

Perhaps folks who have used a chair can give you more support.

[janineerrn]

Hi,

If you can get your doc to write out on an order sheet or a rx an order for an electric wheel chair

also stating that your upper body strength is insufficient to allow you to perform your ADL's with a munual wheel chair, it should get you pre approval. a PT eval. will help too.

Good Luck

Janine

also call the power chair company and talk to the person who does the insurance and ask him/her what orders worked to get approved with your particular insurance company.

[dizzygirl]

Morgan..

your Hubby sounds like a real sweetie pie!! you lucky girl!! LOL

[morgan617]

My son thinks it's cool. I am going out in public with it on Sunday.

A lot of people think we do this stuff for attention and all I can think is, I don't want people looking at me. How stupid is that. It's not like a "vain" thing. It's like an embarrassing thing. Ah well, I've gotten used to everything else, I will to this too.

And I do feel very fortunate to have my husband so supportive. He pushed me all over the house in it and ran into all kinds of stuff, so I told him he needs driving lessons, lol.

I am leaving it where I can see it all the time, so I can get used to it, then I will go out and use it.

I have a letter from my ent, my pt and my pcp, so hopefully the power chair will get covered. morgan

[Jacquie802]

Hi Morgan,

Try not to feel embarressed about using the wheel chair....I'd rather use a wheel chair then fall on my bum! Anyhow, it's great how supportive your husband is. If the ins. company doesn't approve you for an electric wheel chair, then they are ridiculous. Good luck and let us know how your outting Sunday goes!

[Poohbear]

Morgan,

Just wanted to say that I do understand what you mean when you talk about the difficulty of using the chair.

The day my chair got delivered I thought I would be excited because I was so tired of crawling around the floor trying not to pass out and not being able to do things for myself on really bad days but instead, when it arrived I broke down in tears and cried for about an hour (thankfully, after the guy demonstrated everything and left!). For me, it was a reality check. On the one hand I knew I needed it, on the other hand I desperately wanted NOT to need it and staring at it right in front of me made me face the reality a bit more harshly. At first I would look at it and think, "I'm not that sick" and then I would laugh at myself because I had been crawling around on my floor trying to function (obviously not the activity of a healthy person unless your 7 months old!!).

The other difficulty I had was I would not allow myself to get "attached" or "used to it" until I had the EOB in my hand showing insurance had paid their part. Although, I did not realize I was doing this until the day I got the EOB. I was afraid the company would have to come take it if insurance did not pay and i didn't want to be hurt, yet again, so I held back from using it. Once insurance paid though I started using it more and it has made a big difference for me. I can function much better on my own and even on my really bad days I can usually manage by myself now.

It's also true that other people in the world sometimes treat you different when you are in a chair. It's been an eye opening experience for me. Some people offer assistance to you because they assume you need it. Some people will not look at you because they don't feel comfortable. Try to remember that how people treat you when you are out and about is largely a reflection of THEIR beliefs and comfort level. The more confident you are in your chair, the more eye contact and casual conversation you make to others the more comfortable everyone will be. BE YOURSELF, that will always shine through and that's all that matters.

[Miriam Poorman-Knox]

Morgan,

Does your Insurance co have an appeals process? Also here in Pa. the ELKS have for years lent, given durable medical equipment to folks who need. Miriam