wheelchair truth

[at odds]

What is the name of your state? OHIO

Our son 9 has duchenne muscular dsytrophy(DMD) Our INS CO. denied a wheelchair so far twice saying since he not in it all the time they dont have to cover the cost. His primary doctor ,his MDA clinic doctor and his pt all say he needs it.
Here is my question: I have a large yellow dodge / freightliner sprinter van with w/c lift (Former DHL van ) On the side can I wright legally
( XYZ INS denies 9 yr old boy wheelchair, DENY THIS!)
On the back
( XYZ INS , WHAT DOCTOR IS IN THEIR WALLET)
Van is be a daily driver and parked across the street from xyz ins on street parking at times

 

[racer72]

Do you have the money to defend yourself in court even if you are right? There are other options. I was given a couple of wheelchairs for charitible purposes through an ad on Craigslist, I have also seen them listed for free. Or have the doctor call the insurance company, a pissed off doctor can be very persuasive.

 

[Jeeplady66]

I work for a major insurance company and had a similar situation with a small group. At the time the groups contract renewed with our company, they negotiated coverage of a motorized wheelchair for one of their members, covered as a durable medical expense after the deductable was satisfied. It made financial sense, because the member had fallen several times, broken bones, and the insurance company paid the claims, which were much more expensive than paying for the wheelchair and preventing further injuries.

If you have a group plan, talk to your Plan Administrator or HR person at work. They can discuss with the broker or agent handling the policy. Possibly, they can leverage the wheelchair when the contract renews for the year or consider other insurance carriers that may cover the wheelchair.

 

[cbg]

Just as an FYI, the fact that a wheelchair may be medically necessary does not obligate the insurance company to pay for it, if it is excluded under the policy (and durable medical equipment, which includes wheelchairs, is often either excluded or limited).

 

[at odds]

w/c truth

The INS co is a part several local hospitals, and owns one of the durable medical stores and if approved for anything,guest where you go ?
Our ins will cover once bed ridden and can not walk at all ,then with that met, he must still retain enough trunk strength to operate one safely as determined by their (board certified general surgeon) They refused earlier the request to see and pay for the MDA doctor as it wasn,t in their network . Luckily MDA picks it up when no ins will.
He has fallen more than than you can count , so far just 2 broken bones and a cast.
They did pay for the cast and ER and follow up visits
We carry him onto the bus in the morning and off at night . He rides w/c school bus as he falls on the steps on the bus the other kids ride .At school they have a aids that push him to classes, lunch etc.
They write the answers on tests and other needed work as his hands fatque easy and cant keep up without the asst. That is the same reason for a power chair vs manual ,his arms cant take it for long. In Duchenne the more you use, the more you lose to a point.
They dont want bad press and van would put it on main st. That was the reason for the legal standpoint of asking the Question.