Finding help to pay for durable medical equipment.

February 28, 2023 9:41 AM

Do you know of any organizations in the US that help pay for durable medical equipment?

I've been diagnosed with neuromuscular weakness and I need a cough-assist vest to prevent infections and suffocation. I have an insurance deductible that leaves me on the hook for $1500 to get the vest. I don't have that, and have no way to get that. I've been scouring the Internet for grant resources for DME, and none of them do respiratory. Are you aware of any that could possibly help?

posted by headspace to Health & Fitness (6 answers total)

Best answer: Try Modest Needs.

https://www.modestneeds.org/about-us/grants-types-self-sufficiency.asp

Generally, Modest Needs offers Self-Sufficiency Grants to qualified individuals / households who need help to afford two specific types of expenses:

Unexpected or emergency expenses that an individual or family living paycheck-to-paycheck could not possibly afford without a short-term hand-up.

Examples of expenses of this type with which Modest Needs has helped in the past include everything from the cost of medical care not covered by insurance to the cost of repairing or replacing a major appliance to the cost of required work tools or uniforms to the cost of legal fees to complete an adoption to - tragically - the cost of burying a family member that has unexpectedly passed away.
posted by chariot pulled by cassowaries at 9:58 AM on February 28, 2023 [6 favorites]

Best answer: Just to confirm, Modest Needs is legit. It's not an ideal system, but, then, in an ideal world we wouldn't have to be cobbling together schemes to get costs like this paid. $1500 is within their limits.
posted by praemunire at 10:15 AM on February 28, 2023 [6 favorites]

Best answer: Apologies if you’ve already tried this route, but have you asked the team managing your condition if they know of any routes to get assistance with this? If you’ve spent any time in a hospital for your condition recently, or if you go to a clinic associated with a hospital, they should have a social work or case management department that may know of local resources that don’t have an internet presence.
posted by MadamM at 10:47 AM on February 28, 2023 [5 favorites]

Best answer: Seconding MadamM's comment, but I also want to add - the rules at your health insurance plan may not be as firm as you think. With a condition like yours, you may have been assigned a nurse Care Manager, and they will have resources and methods you aren't aware of to help you get what you need. They also have ways to escalate your case beyond any automatic "no" you may have received just from your doctor putting in a request for an insurance authorization - they know exactly what language to use to get to a "yes" if a yes is even remotely possible.

The way you find out about your Care Manager if you don't know if you have one is to call the Member Services/Customer Care line at your insurance company, tell them you have a complex medical condition, and ask if you have a care manager. If you do, they will get you to their phone line or voice mail. If you don't, they will get you to someone who can assign you a care manager.

(I know this is not directly responsive to the question, just hoping it is an avenue of help. If not, mods please feel free to delete.)
posted by invincible summer at 1:27 PM on February 28, 2023 [4 favorites]

Best answer: Another possible route is purchasing the vest second-hand. No US insurer pays for used equipment, so there's a diffuse market in used DME at very low prices. Excellent condition equipment generally goes for half the co-payment.

Reach out to a support group for diagnoses with breathing issues -- cystic fibrosis, muscular dystrophy, ALS, COPD spring to mind -- to let them know you're looking for a cough-vest that fits your specifications. Here's a local contact for the Cystic Fibrosis Foundation.
posted by Jesse the K at 3:47 PM on February 28, 2023 [4 favorites]

Response by poster: I don't know if anyone is keeping an eye on this thread, but I wanted to add a tearful, grateful postscript. A kind, anonymous Mefite just gifted me an entire cough-assist rig with vest for the price of shipping. I cannot express how stunned and grateful I am for this Mefite, and for this community, which made this possible. Thank you all so much, and thank you, Nonny. I'm literally going to breathe easier going forward.
posted by headspace at 10:33 AM on March 29, 2023