Check with local Office on Aging and hospital social workers who deal with this often. Don't take one doctor's word about a process being long and difficult as they may not know or don't want their and their staff's time taken with this.
Sadie, are you in the United States?
Respectfully, the reason I ask is because our experience with trying to get DME approved by insurance is much, much closer to what
@WonderlandisReality wrote about.
My husband works for a major airline that is widely regarded as having some of the best benefits in the industry, but their insurance won't pay for anything other than an old-school weighs-a-ton push wheelchair that does not meet my needs or abilities at all. We paid out of pocket for both of my personal mobility devices after jumping through every hoop, filling out every form, calling everyone we could. After it was denied, we filed an appeal, to no avail. During the entire process, I had the full support of my specialist, my PCP, and the nurses (who do the bulk of the work). They were willing to fill out any form, sign any paper, fax any fax...
And the outcome was still the same.
The majority of insurers in the United States simply won't cover a "
scooter"/
ECV/personal electric mobility device. Now, if I had been at the point where I required a powered wheelchair, that *might* have been different, but medically I don't (yet) meet that criteria.
I have fought this fight this more than once - when our daughter was younger we battled long and hard to get her a motorized device, but we wound up buying all of her equipment out of pocket. When the time came that I had to use a personal mobility device, the same thing happened.
I cannot speak for any state other than the one we live in, but Medicaid typically does not pay for such devices.
If you are on Medicare, you can (sometimes) get an ECV "free" (I use quotes here because it isn't free - someone has to pay for it...) but as budget cuts have been implemented and fraudulent claims have been found, it's now more difficult to get one of those "free" scooters delivered to your door. We have a friend who works at the VA, and he recently told us that it's even getting to be more difficult for him to get a lot of the accommodations that they used to take for granted would be approved.
Most Hospital Social Workers experience exactly what
@WonderlandisReality described on a daily basis. Most local senior service agencies have pitifully thin budgets that are stretched to the max; they may have a lending closet full of older used equipment... or they may not.
Sadly, there isn't a lot of consistency in the outcomes of these quests for equipment. I hope that someday there will be a system in place that deals fairly and equitably with everyone - and that I live long enough to see it!
