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Sunday, January 7, 2007

You don't need that wheelchair....the (hidden) built in pre-existing condition clause

One by one, I've watched my friends being denied the wheelchairs they need to go to work by their insurance companies.

Instead, insurance companies offer them heavy, cheap alternatives which will make it difficult , if not impossible, for them to work full time, do their errands and get around. This is not just about whether the wheelchair is made of aluminum or titanium. One friend was told she was not eligible for a wheelchair under 30 pounds. Due to a birth defect, she has very short arms. I have no idea how she is supposed to propel herself to her full time job, mange around her house (where she lives alone), run her errands, etc. etc. in a chair that heavy.

So what's the point of having insurance for medical equipment if you do not get assistance with buying it? If they are going to deny us basic and necessary equipment, why should we pay premiums to insurance companies? It's like a built-in pre-existing condition clause that never goes away!

Of course, even if you are approved for a medical purchase, you still have to pay a per cent of the cost. So you're budgeting that in. When equipment is denied because in their view you don't need it (but you do), then you pay 100 per cent.

We could, of course, try using skateboards. It's cheaper and then we wouldn't have our finances tapped to the tune of thousands of dollars by paying for a wheelchair every few years. It certainly would be easier to push than those heavy wheelchairs.

I think perhaps that might make a nice visual at one's job, to show up on a skateboard and explain why. Of course, then you'd need an assistant to help you reach the file cabinets.

3 comments:

Rosemary said...

Medicare pulls the same stunt. Unless someone can move themselves in the wheelchair, using their arms, Medicare only pays for the one that has little wheels front and back. That makes it much harder to push a wheelchair over thresholds, curbs, etc.

Anonymous said...

Ugh. Yeah, I'm eligible for analog hearing aids (worthless) but not digital. I'm also eligible for cochlear implants (major surgery), but not hearing aids that would actually help me.

I hate insurance companies. They charge a fortune,and don't pay out.

Some states have programs for "vocational rehabilitation", which basically gets you the services/supplies you need to continue working. NY's is called "VESID". I don't know if they provide services/supplies for people that are currently working, though, as opposed to people that are out of work, or that were in the program prior to getting work.

Groups like the Lion's club also tend to do drives to help get supplies.

But I don't see why adults who have jobs and insurance should be required to make use of charity or rehabilitation services when these are things that insurance should pay for.

Makes me a big proponent of the Democrat's push for socialized/single-payer medical care in this country.

Ruth said...

db - that also increases dependence and caregiver costs!

sara- I agree that we shouldn't have to resort to charity resources when we work and have insurance. very glad you pointed that out. thx for commenting.