At Spinlife we hear that question repeated every day, by frustrated insurance beneficiaries just like you, trying to locate a Power Wheelchair supplier.
There isn’t a simple, short answer but I will do my best to explain. Let me add, this information is not intended as a policy statement from Medicare. This is an informational blog post written in plain language to help our readers understand a complex issue.
America’s largest group of insurance beneficiaries are covered under the Federal governments Medicare Plan A and Plan B (Hospitalization and equipment). When coverage guidelines are set by Medicare, the other private insurance companies will follow suit, and change their guidelines to follow those set by Medicare.
For many years Medicare paid for power wheelchairs as Direct Purchases. In other words, if your Physician documented beyond a doubt that you needed a Power Wheelchair to complete your activities of daily living inside your home, they would purchase the chair for you from your local Medicare Provider. Moreover, they would purchase from the Power Wheelchair supplier the chair deemed most appropriate for your individual needs, as long as those needs were also documented medically. Your local Power Wheelchair provider was able to work with your physician to obtain the documentation required to prove medical necessity and supply your power wheelchair.
The criterion to qualify changed periodically during those years, and medical necessity gradually became more difficult to substantiate. An unfortunate factor at work was that disreputable organizations were found to be “playing the system” or basically committing fraud against Medicare. Those organizations have thankfully been shut down, but in the aftermath of such activity, Medicare changed the method by which they would pay for Power Wheelchairs. Power Wheelchairs became “Capped Rental” items.
Changing power wheelchairs to Capped Rental items affected both the suppliers of the equipment and you, the beneficiary. For basic (group 1) power wheelchairs, suppliers are required to bill Medicare and the beneficiary (their co-payment) monthly for 13 months to pay for the equipment.
It’s like a rent-to own arrangement. During that time, the equipment still belongs to the supplier, not the beneficiary. After the 13 months is up, they transfer the title to the beneficiary and the item belongs to you. Limited options or customizations are offered on those basic rental chairs, and there is no requirement that the rental chair is new, either.
Our customers frequently ask for guidance when it comes to purchasing a lift chair, particularly….
“What in the world does infinite position mean and why do I need that?!”
First, let me explain what it means. Infinite position chairs are electrically controlled with a wired remote hand control that lifts and reclines them with no effort on your part, save for the pushing of a button. What sets Infinite Position Chairs apart from 2 or 3 position lift chairs is the fact that they have two separate motors that individually control the backrest from the seat and footrest portion of the chair. The hand control has additional buttons allowing you to change the angle of the backrest up and down, and independently change the position of the seat and footrest using different buttons on the hand control. This can be really helpful in mitigating a number of physical issues, and allow for you maximum comfort when relaxing since you can really “fine-tune” the position of your chair.
Breezy Elegance wheelchairs make choosing easy! Choosing the right wheelchair, with the features that are “just right” for yourself or a loved one can sometimes be a daunting task, now Sunrise Medical has simplified the process..
Realizing this, Sunrise Medical developed a new series of “bundled feature” chairs and called it the Elegance line. What a simply great idea!
Starting with a lightweight aluminum folding frame, Sunrise Medical added great comfort and convenience features, and made them standard on all three of the Breezy Elegance Wheelchairs. Features like footrests that fold up, swing out, swing in, and remove completely. Adjustable height armrests with arm pads that can be turned back to front, making either full or desk length arms in a snap. The padded back upholstery is tension- adjustable to “give” where you need it, spoke wheels and quick-release axles are included at no charge. Each model even includes a Sunrise Medical Jay wheelchair cushion to complete the total package.
Lift chairs are really helpful for getting you up and out of your easy-chair with the touch of a button. No handles to pull, no need to push down on the footrest with your legs—the motor and remote hand control take care of all that for you. Designed for safety and comfort, the time it takes to go from fully reclined to fully standing is right about 36 seconds. Our customers just love their lift chairs, but a fairly common remark from your product reviews is,
“I just wish it would raise up a little faster!”
Pride Mobility listened to your comments and responded. Their new First Up Quick-lift technology cuts the cycle time in half! The option is offered on most of Pride’s popular lift chairs.
I’d like to take a few minutes to talk about one of today’s most popular mobility aids- the rolling walker or “Rollator”. Lots of people are confused by the terminology, but either name is fine – they both really mean the same thing. Rollators are great when you need a little help with balance, or have to sit down and rest once in a while.