I know the answer to this question may vary but I'm wondering what to expect when we have to buy a power wheel chair for Bradley. I told someone we were probably looking at $10,000 minimum along with the expense of a wheel chair accessible vehicle. I know the MDA will provide $2000 every 5 years and then we do have Blue Cross Blue Shield Insurance (PPO).

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THe price depends on what you need on the chair, I have two sons with Duchenes 18 and 22, they are both on their 2nd power wheelchair, my 18 year old just received his new one a few months ago, we have Blue Cross and Blue Shield of Mn, we have a $10,000 a year durable medical limit, plus we have Missouri Healthnet (medicaid) his chair was $38,000, Insurance did not pay based on that amount though, the chair is not fancy by any means, it has tilt and recline, the base is made by Invacare, but the tilt and recline seat itself is made by Emotions??, he had that type of tilt and recline seating system on his other chair and was use to it and liked it, his other chair was 6 years old and really needed to be replaced, my other son's chair (22 yr old) was in the $28,000 range 4 years ago, by the time ins and medicaid paid on the chairs we did not have to use the $2,000 from MDA, we are already making changes to my younger sons chair for a different controller to drive chair, he has lost alot of strength in his arms in the time it took to get it approved, ordered and here, which took about 6 months.
Wow, sounds very expensive. I don't think we could qualify for a medical card so we would only have the MDA and Blue Cross Blue Shield of IL. We have been saving money for Bradley to attend college but recently I found out that having that money in savings will hurt his chances of getting SSI. I was thinking he may need that after he turns 18. So now I'm thinking we could use that money for a power wheel chair when the time comes.....we almost have to with all that the wheelchair will cost.
Lisa:

Kory was in his second wheel chair when he passed away. We had BCBS network P when we got it. They declined it the first 3 times and I appealed. They finally approved it. Kory's had lift & recline. I didn't pay a single dime out of pocket. I know we had met our deductable and had also maxed out our out of pocket for the year so I guess that's why it was covered at 100%. The first one he had wasn't nearly as nice and cost us around 3000.00 out of pocket.

I gave the wheelchair away back a few months ago to another parent on PPMD. You may luck out and find someone that has outgrown theirs and is just giving it away. The family that took Kory's doesn't need it yet but put it up incase they need it later.

Best of luck,
Kim
well we are military so they help a little,
Dalton's chair cost 15000 but
I was told we could have went through the MDA and probably got it cheaper
Hi,
Saving for college is always a good idea. There are ways to still qualify for SSI once your son turns 18, even if you are helping with college tuition. The savings will need to be in your name not your sons. If you would like more information I would be happy to help. My son is 22 and will be graduating from college this June :-). He has received SSI and support from the Department of Vocational Rehabilitation with college tuition since turning 18.
Katherine

Lisa Jones said:
Wow, sounds very expensive. I don't think we could qualify for a medical card so we would only have the MDA and Blue Cross Blue Shield of IL. We have been saving money for Bradley to attend college but recently I found out that having that money in savings will hurt his chances of getting SSI. I was thinking he may need that after he turns 18. So now I'm thinking we could use that money for a power wheel chair when the time comes.....we almost have to with all that the wheelchair will cost.
Thanks Katherine.
We are planning to take his name off of that Savings Account. We also have a CD that we may need to make sure is in our name instead of Bradley's. What about Savings Bonds? My mother in law used to purchased savings bonds for the kids every birthday and every Christmas for several years. I'm think they too are in the children's names. How soon before Bradley's 18th birthday should we start applying....or do we need to wait until he is 18 since we know we are over income?
Kimberly,
That makes me feel better about things.....maybe we won't have to pay a lot. Our out of pocket maximum is 1500 and our deductible is 1000-the out of pocket max includes the deductible. So we do have good insurance. It sounds like we just have to make it clear that it is medically necessary. It seems that they did not want to pay for Bradley's manual wheel chair at first so I think the doctor had to write a letter or sign a letter informing them that is was medically necessary....but the medical supply company took care of all of that.
Lisa Jones said:
Kimberly,
That makes me feel better about things.....maybe we won't have to pay a lot. Our out of pocket maximum is 1500 and our deductible is 1000-the out of pocket max includes the deductible. So we do have good insurance. It sounds like we just have to make it clear that it is medically necessary. It seems that they did not want to pay for Bradley's manual wheel chair at first so I think the doctor had to write a letter or sign a letter informing them that is was medically necessary....but the medical supply company took care of all of that.

Lisa:

When I appealed I pretty much poured my heart out. I went for the sympathy and it really worked. They only wanted to give Kory a manual chair. MDA paid for the manual as we got both the power and manual (for backup purposes). BCBS would only help with one not both. Plus the company that I work for helped with BCBS. You have to let them deny it so many times before you can do the appeal.

Kim
This may be obvious to all, but check to make sure your insurance covers durable medical equipment. We have BlueCrossBlueShield of MI, but because we have an individual plan (not a group), we can't get coverage for durable medical equipment. If you are considered self-employed, you will want to check on this.
Justins first powerchair that we got almost 7yrs ago was $20,000. It was a basic chair without many frills. Our insurance company denied it as it didnt cover dme's. We fought it for many years and they finally covered half of it. We used a great dme company that wrote off the rest because of the hassells that we had all gone through. Justins second chair will be delivered in a couple of weeks. Through a waiver program that Justin is on, he has Texas medicaid and he also has private insurance. We wont be out anything for this chair.

--Samantha
We have BCBS and we haven't paid more than maybe $500 for my son's wheelchair. He's in his second power chair now and is 17. It cost well over 23,000 but I don't know off the top of my head how much. I suggest you order new chairs near the end of the year when you will have likely met a good portion, if not all, of your insurances deductible/out of pocket expenses. Get a cost estimate from your provider too. That way, if needed, they may be able to roll some of the costs, if not covered in one year, into the next year. We've not had to do that. I usually place medical equipment orders in October and so fat that has worked for us. By then we've met the out-of-pocket and it's covered at the highest rate and MDA's measly bit has covered the rest.
We just picked up Justins new powerchair yesterday......the grand total on it was $53,745......Justin has private insurance and Medicaid(through MDCP in Texas), so the chair was covered 100%...Thank Heavens!!

--Samantha

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