No one will pay for wheelchair repair, even with Medicaid... now what?
July 16, 2014 5:20 PM Subscribe
YANM medical billing professional, but I need help in getting my very expensive, recently-out-of-warranty electric wheelchair fixed. I live in NY, have (crappy) private insurance ( Oxford Liberty) through my mother's job and Medicaid due to a cerebral palsy diagnosis. My chair ( an Invacare model) was provided through my previous insurance and OL isn't accepted by the contractor that provided it. They take Medicaid, but refuse to put in a claim and keep passing the buck. I can't leave my house. What do I do?
A couple of questions:
- Can they deny me service if they don't take my private insurance, but DO take Medicaid? That seems ridiculous to me. I know there are a bunch of rules about "Medicare/aid-as-secondary-payer) situations, but I don't know what applies to me ( a 24-year old) and whether there are any loopholes I can go through.
- In the absence of an easy solution through the typical channels, what can I do to either:
* Have a repair done quickly and cheaply ( it was fine one day, then didn't move, and then didn't power on at all. It's an Invacare TDX SP with an MK6i controller)
OR
* Find another way to get mobile, quickly ( within a day or two) and cheaply?
I'm desperate. Help?
A couple of questions:
- Can they deny me service if they don't take my private insurance, but DO take Medicaid? That seems ridiculous to me. I know there are a bunch of rules about "Medicare/aid-as-secondary-payer) situations, but I don't know what applies to me ( a 24-year old) and whether there are any loopholes I can go through.
- In the absence of an easy solution through the typical channels, what can I do to either:
* Have a repair done quickly and cheaply ( it was fine one day, then didn't move, and then didn't power on at all. It's an Invacare TDX SP with an MK6i controller)
OR
* Find another way to get mobile, quickly ( within a day or two) and cheaply?
I'm desperate. Help?
Response by poster: I should look into LAPs, thanks. I'm in Queens, if it matters.
posted by marsbar77 at 5:26 PM on July 16, 2014
posted by marsbar77 at 5:26 PM on July 16, 2014
In that case, definitely try the New York Legal Aid Society.
posted by showbiz_liz at 5:43 PM on July 16, 2014
posted by showbiz_liz at 5:43 PM on July 16, 2014
You might try contacting your state's insurance commissioner.
posted by Michele in California at 5:48 PM on July 16, 2014
posted by Michele in California at 5:48 PM on July 16, 2014
How old is your wheelchair? I've heard of companies balking at repairing power chairs that were out of warranty, but if you're eligible for a new chair, I'd bet that a mobility/seating provider would be happy to supply a loaner while your new chair is being built.
Having Medicaid secondary means that your primary insurance has to deny payment to the vendor before Medicaid would pay. It's a dumb, frustrating system we have in this country, but a good mobility company will work with existing customers. I'd recommend calling another vendor. Good luck!
posted by little mouth at 5:57 PM on July 16, 2014
Having Medicaid secondary means that your primary insurance has to deny payment to the vendor before Medicaid would pay. It's a dumb, frustrating system we have in this country, but a good mobility company will work with existing customers. I'd recommend calling another vendor. Good luck!
posted by little mouth at 5:57 PM on July 16, 2014
You could try contacting Invacare directly. This page lists their customer service number as 800-333-6900. At the very least they may be able to troubleshoot the problem over the phone and help you fix it if it's simple. There may be a customer rep in the area who can come out and help.
You could also go to wheelchairjunkie.com and ask your question there. Make sure you ask about the chair problem and the insurance problem.
Good luck.
posted by firstdrop at 6:00 PM on July 16, 2014 [2 favorites]
You could also go to wheelchairjunkie.com and ask your question there. Make sure you ask about the chair problem and the insurance problem.
Good luck.
posted by firstdrop at 6:00 PM on July 16, 2014 [2 favorites]
There have got to be a bunch of Invacare dealers in NYC. I'd call several others before I spent a lot of time fighting the one you know isn't helpful.
posted by jon1270 at 6:01 PM on July 16, 2014
posted by jon1270 at 6:01 PM on July 16, 2014
Response by poster: Thanks for the great info so far. Just to clarify, what would I be asking another vendor to do? Fix the chair? Does it matter that they aren't the ones who built it? It was custom-built, so I'm not sure how that works.
posted by marsbar77 at 6:03 PM on July 16, 2014
posted by marsbar77 at 6:03 PM on July 16, 2014
The ones who "built" it didn't forge the steel and mold the plastic parts. For the most part I'd guess it's a conglomeration of standard parts, like tinker toys, that other Invacare specialists will be familiar with and have access to. The company who built it for you doesn't have a monopoly on some magic ingredient.
posted by jon1270 at 6:08 PM on July 16, 2014
posted by jon1270 at 6:08 PM on July 16, 2014
OP, you'd be asking another vendor if they could fix the chair OR if they could build you a new one. Insurance will typically only reimburse for a custom power chair once every x years (varies depending on insurance). You didnt mention the age of your chair, but if your OL insurance would pay for a mew chair, that is an option to consider. Contacting Invacare directly might help narrow your search for someone who will quickly provide you service, that's a good idea.
posted by little mouth at 6:16 PM on July 16, 2014
posted by little mouth at 6:16 PM on July 16, 2014
Response by poster: Makes sense. Not to threadsit, but I just realized that asking this vendor for a denial doesn't help. It's not Oxford that's denying anything... it's the vendor that doesn't take Oxford. " What insurance do you have? OL? "Oh, that's too bad. Here are two other places that might be able to help you" " But I have... Medicaid and you guys take... " " Buh bye now!"
posted by marsbar77 at 6:19 PM on July 16, 2014
posted by marsbar77 at 6:19 PM on July 16, 2014
I read once that Masonic Lodges sometimes have donated wheelchair programs -- if so, perhaps they have members who can repair wheelchairs or can refer you to someone who can repair yours inexpensively?
posted by Jacqueline at 9:25 PM on July 16, 2014
posted by Jacqueline at 9:25 PM on July 16, 2014
What's wrong with your chair? I have an Invacare and it periodically needs batteries and I've had to replace the charger twice, but that's just normal maintenance stuff and expected. I found the wheelchair sales places, including Invacare, worse than useless - they charge exorbitant prices for nothing or next to nothing, here in Spokane, anyway. The chairs are really very simple to fix and the parts are available online at 1/4 the price from the dealers. I've had my chair/scooter for seven years now and love it to pieces, and it's an Invacare, which is a good brand. Most problems are electrical and I take it to one of those places that sells batteries for everything from hearing aids to airplanes; they do a wonderful job of checking everything and fixing just what's needed, and their batteries are about half what the Invacare dealer charges.
If you have no way to access the innards of your chair and no friend to help you take it apart and transport it to a fixit place and the problem is an electrical one, I'd seriously consider hiring someone to transport you and the chair to a battery place. They do complete electrical inspections and fix only what needs it and they're very reasonable compared to the dealers. I'll bet you could find someone on Craigslist who could transport you, or even a church may be able to help with some big guys with a truck who could volunteer to do the job.
Feel free to memail me if I can help figure out what's wrong with your chair and I wish you good luck and ask you not to get frustrated and give up. There is help available.
posted by aryma at 11:16 PM on July 16, 2014 [3 favorites]
If you have no way to access the innards of your chair and no friend to help you take it apart and transport it to a fixit place and the problem is an electrical one, I'd seriously consider hiring someone to transport you and the chair to a battery place. They do complete electrical inspections and fix only what needs it and they're very reasonable compared to the dealers. I'll bet you could find someone on Craigslist who could transport you, or even a church may be able to help with some big guys with a truck who could volunteer to do the job.
Feel free to memail me if I can help figure out what's wrong with your chair and I wish you good luck and ask you not to get frustrated and give up. There is help available.
posted by aryma at 11:16 PM on July 16, 2014 [3 favorites]
and it sure sounds like dead batteries, especially since it's just off warranty - my batteries last about a year - or a failure of the charger.
posted by aryma at 11:19 PM on July 16, 2014
posted by aryma at 11:19 PM on July 16, 2014
To answer your first question, yes they can refuse to provide service. There are places that do out of pocket only and refuse to take any kind of insurance or Medicaid. I know you said the chair was expensive, do you know how much the repair will cost? Was the vendor able to give you any ideas of what the problem may be or what the cost may be?
Try some of the troubleshooting here...or try their directory of technicians. They specifically do not take insurance, but may be able to give you an idea if you can get this repaired cheaply out of pocket.
Also try this place: Community-Based Wheelchair Program
posted by freejinn at 11:21 PM on July 16, 2014
Try some of the troubleshooting here...or try their directory of technicians. They specifically do not take insurance, but may be able to give you an idea if you can get this repaired cheaply out of pocket.
Also try this place: Community-Based Wheelchair Program
posted by freejinn at 11:21 PM on July 16, 2014
For some temporary relief call the local Masonic Chapter, or the local Shrine. As mentioned above they sometimes have equipment to loan.
Although you mentioned your chair was custom built I'll bet you that there are similar chairs ( the base model, aside from mods) available on Craigslist. Offer no more than a couple of hundred, because as expensive as these things are everybody who needs one gets one through their insurance. The ones on CL are usually from estates. It took me months to even get lowball offers when I had a chair listed. I eventually gave up and donated it to the Masons.
posted by Gungho at 6:39 AM on July 17, 2014
Although you mentioned your chair was custom built I'll bet you that there are similar chairs ( the base model, aside from mods) available on Craigslist. Offer no more than a couple of hundred, because as expensive as these things are everybody who needs one gets one through their insurance. The ones on CL are usually from estates. It took me months to even get lowball offers when I had a chair listed. I eventually gave up and donated it to the Masons.
posted by Gungho at 6:39 AM on July 17, 2014
Would it help to have a functional manual chair until the electric gets fixed? The Red Cross runs an equipment loan program and you might be able to borrow a (crappy) manual chair for free in the meantime. Link
posted by crazycanuck at 7:16 AM on July 17, 2014
posted by crazycanuck at 7:16 AM on July 17, 2014
This thread is closed to new comments.
posted by showbiz_liz at 5:25 PM on July 16, 2014