How often can I get a new wheelchair from BCBS?

[funklab]

So, anybody got any information on this?

I have heard some people on here who manage to get a chair every two years, some every five, and some only when "medically necessary".

It has been about two years for me, but I would really like a better chair, the one I have right now does not fit me (because it was measured poorly, and because I have lost a whole lot of mass in my lower body, especially legs). But I would also like to try and get some decent rims out of BCBS as well, the crappy sun rims (or something like that) that I have now really get on my nerves.

Anybody got some good advice for tricking an insurance company into buying you another wheelchair?

[Rbrauer]

if you stay with the same company they typically keep a running file. The last chair I got they gave me just a bit of grief about as it had been 5 years. Could have been the person reviewing the request, maybe not. First time I ever got any negative feedback from them (BCBS) Sorry.. no tricks.. no treats..

[fuentejps]

no tricks, just get a ltr from your sci doc saying its a med nec. im about every 2 yrs, although ill run this zr for 3 maybe.......hmmm our ins carrier is changing in january, so maybe not.

[funklab]

no tricks, just get a ltr from your sci doc saying its a med nec. im about every 2 yrs, although ill run this zr for 3 maybe.......hmmm our ins carrier is changing in january, so maybe not.

Fuente, who is your ins company?

I don't really have an SCI doc. Actually I don't really have a primary care doc (its one of those come in and see whichever doc is here that day type of offices).

What do you tell them to constitute medical necessity every 2 years?

[fuentejps]

i tell him my chair is beat up, i have bcbs currently. he says im the one thats in it, i should know what i need

[Eileen]

Some of those barely scratched chairs could be donated to something like the following program...

http://www.wrp.org/

[woman from Europe]

But no chair keeps more than two years. Mine is beaten up for sure. If it keeps longer it is because I haven't used it.

[LooseCannon]

I'm with Blue Cross Blue Shield and my policy says every three years, according to the DME. I'm an active person and at the end of three years my chairs are still in good shape; they look worn but function fine.

[woman from Europe]

Oslo is full of cobble stones and curbs, I don't think any American is taking so many curbs in a day than I am and other wheelers here. Even the way up to the street from my house has cobble stones.

[LooseCannon]

Oslo is full of cobble stones and curbs, I don't think any American is taking so many curbs in a day than I am and other wheelers here. Even the way up to the street from my house has cobble stones.

True. The environment has a lot to do with it.

There's no cobble stones in my village (Boiling Springs, PA) and the side walks in the nearest suburb are wheelchair friendly.

I usually replace caster wheels or wheel bearings every 6 - 8 months; tires annually; seat and hard back upholstery annually; front fork and axle bearings annually (just as preventive maintenance).

All of that stuff is easily and expected to be replaced.

My frame takes the most abuse when taking it apart to get in/out of the car. I flip the char on it's nose to take on/off the wheels and the concrete or asphalt over time dents, scrapes and thins out the aluminum tubing. (Yes I know that I could install velcro padding to protect the aluminum but the padding makes it to difficult slide the chair around when on it's nose.)

[SCIfor55+yrs.]

It is intersting to read about the experiences people have with seemingly the same insurance. BC/BS is terribly restrictive in this area, and fuentejps reports that his experience has been as good as it gets. The problem with comparing is that insurances are usually administered by regional or even state offices. Coupled with the fact that most companies offer a variety of coverage plans results in wide differences. The bottom line is that for accurate information, you have to get it from the same area and be sure you are comparing similar policies/coverage.

[woman from Europe]

I have change my axel twice but never my forks. But I am destroying the frame, suddenly my chair is going left or right and then I know the frame has gone. But I am changing tires and casters quite often, I changed them two weeks ago in the rehab. I changed my tires in May and in Nashville in June too.

So I guess it is the curbs and cobblestone. And all the step people are dragging me up and down inside to the shops. I can go down two steps alone but not up without anything to hold in.