Discussion in 'Fibromyalgia Main Forum' started by Mindy2, Jun 12, 2003.

  1. Mindy2

    Mindy2 New Member

    I forgot to ask if anyone has received a scooter from medicare? I got a perscription from a specialist,a few months ago, for a scooter, to get me out of the house. I had told him I hadn't been in a grocery store for 3 years. He told me to get a scooter and GET OUT OF THE HOUSE! Now I am told you CAN"T get one from medicare, unless you are so bad you can't take a step. Is this true, and will I have to pay myself to get one? Can anyone shed some light on this, for me.
    Thanks so much,
  2. dd

    dd New Member

    I was told that as long as you have a script from your doctor that have to issue you one. There will probably be a co-pay though.

    Good luck.

  3. dhcpolwnk

    dhcpolwnk New Member

    The rules *do* say Medicare covers wheelchairs and scooters only if the person would otherwise be confined to a bed or a chair. That *isn't* what the Medicare statute says, however, nor is it what the regulations say. These rules are guidelines that the insurance companies that administer Medicare in differe regions follow. Fortunately, sometimes the rules aren't always applied strictly.

    I've been fighting Medicare's ridiculous DME coverage standards--especially regarding wheelchairs and scooters--for years! That's a major issue for disability rights activists who are involved with health care policy, as I have been for a long time. Now, however, I also find myself dealing with it personally.

    As of May 1, I qualified for Medicare (after 2 years on disability benefits due to MS). I've been using a scooter since December 1987--mostly in the community, but occasionally in the house as well. After my husband was laid off from his job as an electronics engineer in 1992, we started paying for our own coverage with Kaiser Permanente. Unfortunately, the plan didn't cover either prescription drugs or DME. Sometimes, though, we also had coverage through one of Neil's post-layoff jobs (which turned out to be temporary). During that time, my older scooter (the Lark scooter I got in 1987) needed some repairs, new batteries, new tires, etc. It was all covered. And later, they even paid for a second scooter for me because I needed more back support than the seat on my Lark provided.

    So I hadn't really expected this much of a problem. After all, I'm not asking for a new scooter. In fact, I don't even *want* a new scooter. My Lark is very powerful and very maneuverable (and a model that's no longer being manufactured), and I have found a back rest that gives me the back support I need. All I want is help paying for upkeep.

    Here's what they told me:

    1 - In order to get coverage for repairs and maintenance, I first need to be approved as if I was getting a new scooter or wheelchair.

    2 - Both of my scooters are so old that they probably won't authorize repairs even if I'm approved for a scooter.

    3 - They will authorize a *new* scooter for me only if I need it in my house.

    My neurologist (the one who initially refused to accept the Devin Starlanyl fact sheet on fibromyalgia for neurologists) had an assistant call me to say that I don't qualify for a scooter. This despite the fact that the man has never seen me when I *wasn't* using my scooter. No explanation as to why he refused to prescribe the scooter. (I've had it with him, by the way. I'm changing neurologists. Unfortunately, he's the head of the department, though, so the new neurologist may not be willing or able to help much.)

    I have another option, and that is to go through the physical therapy department for an evaluation. But even if I manage to get the okay, I still may not get what I want--help paying for upkeep on my old scooter (probably less than $500) --instead of a new scooter, which will cost at least $2500!

    Right now, Congress is considering reforms to the Medicare system, including adding a prescription drug benefit. Unfortunately, the proposal that seems to have the best chance of passing is *not* good for people with disabilities and appears to pay for the prescription drug benefit by putting a cap on spending for DME, like wheelchairs and scooters.

    This may be just the right time to contact your congressman and your U.S. Senators to tell them *not* to cap DME and that they need to change Medicare's ridiculous standard for wheelchair and scooter coverage!

    Sorry this is so long, but it's an important subject. I have even more to say about it, but I'll stop now. If anybody's interested, I made a presentation about this a couple of years ago to the California HICAP Association, which was set up to help Medicare beneficiaries. The text of my speech is posted at my personal web site, LRM's Place. You can find it by doing a Google search for my full name, Laura Remson Mitchell. I think it's the first hit. The title of the speech is "Disability Rights and Medicare Wrongs." You can try searching for the title, too.)

    --Laura R.M.

    [This Message was Edited on 06/12/2003]
  4. lea

    lea Member

    If you are only trying to get upkeep of your scooter and batteries, then they WILL pay---that is, if any insurance company originally paid for your scooter.
    Call them.
    good luck
  5. dhcpolwnk

    dhcpolwnk New Member

    I hope you're right about Medicare paying for upkeep and batteries. I got my first scooter in 1987, when we still had traditional insurance. I don't even remember who the carrier was, but I might be able to find the paperwork. (In our family, we don't throw much away!) The scooter I got in 1993 was through Kaiser, and they have a record of it. But the woman I spoke with in DME told me that both scooters may be so old that they won't pay for repairs, and several people have told me I can't get *any* coverage for services dealing with my scooters unless I'm approved to *get* a scooter.

    Thanks for the encouraging words.

    --Laura R.M.

    [This Message was Edited on 06/12/2003]
  6. lea

    lea Member

    You are welcome and good luck.
    BTW, the scooter place(s) should also give you this info.