From time to time, a consumer receives a power wheelchair that performs or appears differently than
from what he or she expected upon ordering. Maybe one expected an 8mph top speed, as advertised, but
the power wheelchair received only reaches 6mph. Or, maybe one expected a full-color joystick screen,
but received a simple joystick with only lighted bars. Or, maybe one expected full power seating, only
to receive basic seating. And, maybe one parks next to a friend's power wheelchair of the same model
– but where the friend's version has 8mph motors, a full-color joystick, and power seating – and thinks,
Man, I got ripped off! |
Of course, a consumer receiving a basic-configuration power wheelchair
hasn't really been ripped off. Rather, what's likely occurred is that the consumer didn't realize that
many power wheelchair models come in different “packages,” and the configuration received was probably
all that insurance would cover. In this way, it's important for consumers to understand how power wheelchair
“packages” work, as well as what to expect when their new power wheelchairs arrive.
A La Carte
Most governmental forms of insurance only fund the “lowest-cost alternative” power wheelchair,
meeting users' needs for “indoor use.” However, other forms of payment, from Workman's Compensation to
Vocational Rehabilitation to private pay, often cover higher-end power wheelchairs. Therefore, power
wheelchair models, especially in the rehab segment, are often available in several “packages” – from
various motors to electronics to seating choices – that comply with differences in funding limits, as
well as users' needs. For example, if one qualifies under Medicare/Medicaid for a “Group 3 Standard”
power wheelchair, one will receive a package typically consisting of 5mph or 6mph, 70A electronics, 22NF
batteries, and basic seating – that is, meaningful mobility, but not a top-of-the-line configuration.
However, if one has “better” insurance or funding, that same “Group 3 Standard” model can be upgraded
with 8mph, 100A electronics, Group-24 batteries, and power seating to best suit one's needs. Along these
lines, then, there's not typically just one configuration of a particular power wheelchair model, but
many, where it can be ordered to a vast array of specifications and price ranges, from upgrading motors
to electronics to batteries and seating.
Bring Your Reading Glasses
As a consumer, it's important
during the ordering process to work with the provider in understanding the available “packages” and “upgrades,”
and what configuration one's funding will cover? Rather than simply assuming that one will receive the
highest-end version shown on the brochure, one should review the order form with the provider, in relation
to funding, and explicitly understand what configuration one is ordering. Order forms are usually very
clear about what's standard versus optional – and many show Medicare/Medicaid funding codes, as well
– so reviewing the completed order form with the provider is an absolute way to understand how one's
new power wheelchair will be configured.
“Standard” Isn't Always Written in Stone
just because one's insurance won't fund upgraded components doesn't mean that one can't add them as an
upgrade to the order, paying extra out-of-pocket. Medicare's Advanced Beneficiary Notice (ABN), for example,
allows one to self-pay for upgrades not covered by insurance. Therefore, by understanding exactly what
configuration one can receive via insurance, one then also knows to assess any upgrades wished out-of-pocket,
as in upgrading from 6mph to 8mph motors.
Knowledge is Power
It's no longer true that power
wheelchairs come in one-size-fits-all configurations. Rather, many power wheelchairs are available via
a la carte packages, configurable to many funding and performance levels, with options to meet many needs.
When ordering your next power wheelchair, carefully confirm with your provider the exact configuration
that you'll be receiving, understanding any funding constraints and upgrade options that you may wish
to purchase. Then, not only won't you be surprised by the configuration that ultimately arrives, but
it might even be better than what you originally wished.
Related Article: Using Medicare's ABN
Toward Upgrading Your Mobility
Published 2/09, Copyright 2009, WheelchairJunkie.com