Assistance for Adaptive Equipment

Adaptive equipment can make what was difficult, possible. But it can be expensive. Be a smart consumer when it comes to buying wheelchairs, ramps and stair lifts. To get the best possible equipment at the lowest price:

• Ask your doctor for a referral to an occupational or physical therapist (OT or PT) and for the names of reputable local vendors, preferably with CRTS staff (certified rehab technology supplier).
• Shop at a medical equipment provider, sometimes called a rehabilitation technology or assistive technology supplier.
• Ask if the vendor participates in Medicare or Medicaid if you are a beneficiary.
• Be sure the vendor is accredited by RESNA, the Rehabilitation Engineering & Assistive Technology Society of North America.

Medicare, Medicaid and most private insurance plans cover prescribed wheelchairs, ramps and lifts to some extent. Be prepared to face rejection the first time you submit a claim. But keep trying; insurers respond to persistence. Here’s how to bolster your case:

• Check insurance coverage and restrictions, including required paperwork, such as a doctor’s prescription and pre-approval.
• Check Medicare coverage. You can maximize your benefits by using a medical supplier (vendor) who agrees to accept the Medicare-approved amount as payment in full. You generally pay your 20% co-pay and any remaining Medicare Part B deductible. Non-participating suppliers do not have to accept assignment. Their charges may be higher and you will also have to wait for Medicare to reimburse you.
• Organize the information required for reimbursement, such as the nature and onset of your disability, employment history, family gross income and monthly expenses.
• Prepare a justification statement if required. Tell your health-care professional to ask the Society for the Appeal Letters for Insurance toolkit. This toolkit contains model letters that meet standard requirements for insurance claims.
• For Medicaid, check coverage with your state Medicaid office. Find the number in the State Government section of your phone directory, probably under Health Services or Health and Human Services (names vary by state). Or call an MS Navigator® at 1-800-344-4867.
• Check with the statewide assistive technology program and statewide alternative financing program for additional options.
• Connect to the program in your state that can offer legal and advocacy services to assist individuals with disabilities obtain assistive technology devices.
• Check your vendor’s return policy and your insurance claims appeal process. Keep meticulous records. Save all letters and notes of phone conversations. If it comes to it, follow the appeals process, and complete all the steps on time.

Taxes: You should be able to deduct out-of-pocket costs for medical necessities from your federal taxes. To support these deductions in an IRS audit, get a letter from your prescribing doctor, and keep a copy of your prescription in your file. 

Secondhand equipment can cost half the original price. It can also be the best way to acquire backups or special-use wheels. Secondhand may even be a smart choice for a primary chair — if you don’t meet your insurance plan’s criteria but need the help that wheels provide.

• Start your search through a good medical equipment vendor.
• Check the classified ads of publications for people with disabilities.
• Look for online offers at craigslist or eBay.
• Get the word out—ask people if they know of any used equipment for sale.

Buyer beware: Give used equipment a thorough check-up. If you buy used equipment from a private party, ask a medical equipment vendor check it out. Ask the vendor if it is willing to repair the equipment if needed. Before you buy, ask a physical or occupational therapist to measure the equipment to ensure it fits you.

• Pass It On Center – National AT Reuse & Technical Assistance Center
  Offers a nationwide directory of Reuse Locations that accept, as well as distribute, used equipment.
• USA TechGuide
  Web guide to wheelchairs, mobility scooters, and assistive technology choices.
• UsedHME.com
  Nationwide web-based listing service, where the public can buy, sell or donate used home medical equipment.
• Disabled Dealer
  Nationwide online marketplace for private parties to buy and sell accessible vehicles, medical equipment and adaptive accessories.