Hi John, That 5-7 year guideline has changed in the last couple of years, depending on which side of the fence you reside. If it is cheaper to repair and restore a powered chair, those years could go well beyond the 5-7 guideline. And if a person's physical status has changed, with a doctor's order and new PWD would be considered sooner. Just ask anyone who has been evaluated for a new chair the last 18 months. Much has changed and more changes coming. Best Wishes In a message dated 12/15/2009 2:30:05 P.M. Central Standard Time, [email protected] writes:
Medicare is the primary and Medicaid is secondary insurer to replace a wheelchair. You're eligable to replace a wheelchair every 5 years, 7 years in some states or you pay Medicaids portion. If you are ready for a new chair, talk to your doctor first. They must prescribe it. BW, john ____________________________________ From: medethics Cvlrights <[email protected]> To: Dan <[email protected]>; [email protected] Cc: [email protected] Sent: Mon, December 14, 2009 1:54:56 PM Subject: Re: [QUAD-L] Wheel chair - has anyone been able to get insurance to pay for electric and manual wheelchair? If I understand correctly, by design, Medicare is the primary and Medicaid would be secondary insurance in every state. Medicare is federal and Medicaid state, so the federal benefits would take precedence. If I also read information on insurances correctly, it is allowable to have both a manual and powerchair chair paid for by one or both within the 5 years. I have seen this happen for others. I understand there is a process to go through. So if Medicare refuses, then Medicaid should or may pick up the tab. I believe it is often most effective to have his physiatrist or other medical doctor and PT fill out the forms and advocate on your behalf, or go through a wheelchair clinic. ____________________________________ From: Dan <[email protected]> To: [email protected] Sent: Mon, December 14, 2009 1:34:58 PM Subject: Re: [QUAD-L] Wheel chair - has anyone been able to get insurance to pay for electric and manual wheelchair? If one has Medicare, ie SSDI, and a private insurance which is primary? Does this vary by state? Dan
