Just Wanted To Share Some Good News!

[bouncy54]

I called our insurance company today and was told that they will pay 95% of the bill when I purchase a scooter. I'll ask the Dr. tomorrow to write out a prescription for one. I hope he knows how to do that. Then I take it to the Scooter store and ask them to get pre-approval from the insurance company. I was really surprised that they paid anything but guess I shouldn't have been. This particular Insurance Co. and the company my husband works for has been really good to me.

 

[SueM in MN]

Good luck in getting everything worked out.

 

[Eeyore5]

Congrats!

 

[bouncy54]

Good luck in getting everything worked out.

I'm not quite sure how to go about it. Since I'm not on Medicare, guess I wouldn't go through The Scooter Store. They make it sound like there's lots of paper work, but maybe that's just because they mostly deal with the government.

It kinda sounds too easy to just have the Dr. fill out a prescription then take it to a local store. Hopefully my Dr. has some experience with this.

 

[PinkyGeekyDo]

I'm not quite sure how to go about it. Since I'm not on Medicare, guess I wouldn't go through The Scooter Store. They make it sound like there's lots of paper work, but maybe that's just because they mostly deal with the government.

It kinda sounds too easy to just have the Dr. fill out a prescription then take it to a local store. Hopefully my Dr. has some experience with this.

Check with the insurance company again and see if they have a preferred retail provider for it. I have had more issues with medical supplies, big and small, I'm really careful now!

Good luck!

 

[bouncy54]

Check with the insurance company again and see if they have a preferred retail provider for it. I have had more issues with medical supplies, big and small, I'm really careful now!

Good luck!

Will do! I have Regence Blue Shield. Have you ever dealt with them?

 

[bouncy54]

Check with the insurance company again and see if they have a preferred retail provider for it. I have had more issues with medical supplies, big and small, I'm really careful now!

Good luck!

Oh.. I forgot. She did tell me that I need to stay "in our network" for the 95% coverage, so they must have a list. Hmmmm. Gonna have to check on that tomorrow.

 

[bbyee]

Oh.. I forgot. She did tell me that I need to stay "in our network" for the 95% coverage, so they must have a list. Hmmmm. Gonna have to check on that tomorrow.

That is *incredible* coverage to get your scooter! Most policies only pay up to 80% for in-network.

However, before you call The Scooter Store, please get the list of preferred providers for your insurance company. They will tell you who you need to deal with. Once you choose one of your providers from the insurance company's list, talk to the provider to 1) see what the process is; and 2) have them tell you exactly what the doctor's letter needs to say.

The reason I'm pointing these issues out is because of what I learned when I got my new power wheelchair last fall. Because of problems with Medicare fraud, most private insurers are now instituting policies to make sure that patients are really getting what they need and that they have a true medical necessity for such equipment. Even though this sounds like a pain as opposed to just calling somewhere, throwing down a letter, and saying "GIMMIE MY CHAIR!!!", it actually is more of a benefit to the *patient* because you are evaluated by a physical and/or occupational therapist and a decision for the proper medical equipment is made jointly with you and the therapist. You are also told exactly what the doctor's letter (prescription) needs to say, and a followup visit also includes a meeting with the equipment provider to make sure the *right* mobility device is ordered for you.

There will be more considerations that come up during this process - what you need for mobility, what will work best in your home and car, if you need any special seating options, etc. However, all this attention will make you even *more* satisfied with your mobility device once you finally get it, plus you can find out some "special" information along the way. You may learn from the equipment provider that a better piece of equipment could be available at the same price, for example, or learn why something you had your eye on might not be the best option for you.

Hope this helps!

 

[PinkyGeekyDo]

Will do! I have Regence Blue Shield. Have you ever dealt with them?

Not in a couple of years, DHs former employer had Regence but it was really really good and not the norm unfortunately.

We have Aetna now and getting anything from them has been a pain in the rear.

It shouldn't be too hard to get the information from them to make it a nice smooth purchase!

Hi from north of you BTW!

 

[SueM in MN]

Just a quick time for reply.
I would not go thru the scooter store. I would fine out who is in network and use a local company. If you have any problems or needs for repair, you need someone local.

 

[bouncy54]

Well, that was some short-lived good news. When I saw the Dr. yesterday, he explained that he's dealt with my insurance company many times and that yes, they are great at paying for mobility devices, they only approve them if you need them in the home... in other words, a motorized WC. I don't need one of those yet because I can always find a chair to sit down and I'm not walking any kind of distance. I need one for outside the home.

I called the Scooter Store which my insurance company recommended, and they said the same thing.

So I'm back to plan A. Going to be looking at purchasing a used scooter but will have to wait until we get our tax return early next year... if we get one.

 

[bbyee]

Talk to your doctor again. There might be a way that he or she would feel comfortable writing the orders where the insurance company will approve it.