Friday, April 22, 2016

Medical Supply Companies, Medicaid and the Madness: My Debacle of Needing New Batteries

After two months of pursuing new batteries for my power chair, my chair has died. Back in February, I noticed that the gage on my chair -- that indicates the charge of the batteries that run my chair -- was acting wonky. This gage consists of three green bars, four yellow bars and three red bars. Typically, the bars gradually disappear to indicate the charge that is left in the batteries; it usually takes about twenty-five miles of driving to completely drain the batteries. However, on the day I began to notice it acting wonky, all of the green bars would all of a sudden disappear, then all the yellow bars would follow, then two of the red bars would disappear as well, leaving one blinking red bar (and this is all within a mile of driving my chair). The bars would then appear again -- without charging my chair -- which is not normal.

At the time, I lived near a medical supply company (MSC), Bellevue Healthcare (BHC), and I instantly went to this MSC to figure out what was wrong with my chair. BHC confirmed my suspicion that it was the batteries, and that they needed to be replaced. So, I ordered new batteries and I left. 

BHC informed me that it could take up to three weeks to receive the new batteries after my insurance company approved the order. BHC also told me that they would contact me when my insurance company did confirm the order. A week after I placed the order, BHC had yet to call me. When I checked in, the MSC told me that they had not contacted me because they had not heard back from the insurance company.

When two weeks had past without hearing back from BHC, I contacted them; when they still did not have an update, I called my case manager at Northwest Regional Council (NWRC). However, she was on vacation, and I just ended up leaving a message. I waited for the week and a half that my case manager was out of the office, and when she did not call back on the day she said she would be back in the office, I gave her another call, but ended up leaving her a second message. She did not call back.

By this time I had called the MSC a couple of times, and had learned that it was not my primary insurance, but Medicaid that was not approving the batteries for my chair, therefore, slowing the process. Since I had not gotten anywhere with BHC, and had yet to hear back from my case manager at NWRC, I gave her a third call, and left a third message; she did end up calling me back, but I missed her call, so she ended up leaving me a message. In the message, my case manager explained that she would be in the office from 1:00p.m. to 3:00p.m. the following day, and to give her a call back during that timeframe; I called her at 1:10p.m., and she was not there. I ended up leaving her a fourth message.

Around the same time, a couple of weeks ago, I received a call from the main office of BHC, the MSC that I am working through to get the new batteries; the lady who called me said she was concerned that I was still without new batteries, but informed me that Medicaid had still yet to approve the batteries, and that they -- BHC -- was doing all they could do to speed up the process.

Fast forward to two nights ago, my chair died; I was going along with my business, and my chair just shut off. I had my mom flip the switch on the back of my chair, off and back on again, just to see what would happen. Unfortunately, this did not do anything, so I had her plug my chair in to charge. Charging did not help either; when the charger was plugged into the chair, it displayed the fault light, and then shut off. This is not normal; when the chair is charging, a red light and green light turns on. Then as the chair begins charging, the red light turns off and the green light begins to blink. It blinks faster and faster until the light stops blinking and becomes solid green indicating that the batteries are fully charged.

Yesterday, I spent the day trying to find out what was happening with the entire battery process. I called my case manager from NWRC for a fifth time; when I could not reach her, I asked my mom to call someone else from NWRC. I called the lady from the main office of the MSC, and my mom said she would talk to someone at NWRC.

The lady from BHC informed me that she had contacted Medicaid every week since I had ordered my new batteries; she explained that is all they could do, and that I could call Medicaid myself and try to speed up the process. I asked if there was anything else that could be done. If it was legal, I would just pay out of pocket for my batteries. However, I can not do this; because I have Medicaid, it is against the law for any MSC to charge anyone with Medicaid. The lady at BHC told me that if someone who was not related to me or lived in my household sent the MSC a check for $469.90, then that would cover the remaining costs (that should be covered by Medicaid), then the batteries could be ordered and sent to the branch of the MSC near me. I questioned the cost as my understanding was that my primary insurance was covering eighty percent of the battery cost, leaving Medicaid with just twenty percent. I questioned the price as I thought $469.90 was quite high for being twenty percent of the total cost of batteries; I know medical supplies are expensive, but not that expensive. It turns out that my primary insurance company is not covering the eighty percent that they would have otherwise if I had met my deductible for the year (which I have not).

Since the lady at BHC suggested that I call Medicaid, I asked my mom to call Medicaid for me and ask them about the progress of my batteries. The guy at Medicaid pretty much told her that it was solely the MSC's job to contact Medicaid, therefore he could not help us! So, the MSC told me to talk to Medicaid, but Medicaid said to contact the MSC and have them pursue the process of ordering batteries as that is their job, not the consumer's.

My mom also called NWRC and asked to talk to someone; she explained what was going on, and that I had been trying to get in contact with my case manager. Even though the lady who my mom talked to was really nice, she informed my mom that she could not help us as she was not my assigned case manager, and that we would have to wait for my case manager.

Today, I received a call from a different lady from the head office of BHC, the MSC that I am working with to get my batteries. She informed me that the reason that Medicaid was not approving my new batteries was due to them not having any record of my power chair. It turns out that when I purchased my power chair, my primary insurance covered the cost of my entire chair, and the MSC that I purchased my power chair through, bypassed Medicaid altogether; this sped up the process then, but unfortunately is complicating this process now.

When I was 18, I was advised to sign up for Medicaid; if I waited until I could no longer be on my dad's insurance through his work, then I would probably not be able to get Medicaid in a timely fashion or at all. However, I am rethinking about how beneficial it really is to have Medicaid; primary insurance has covered all my power chairs; when I have needed other parts for my power chair and my primary insurance has not covered those costs, NWRC covered them (but they do not have money allocated to do that anymore). When I have gone to specialty doctors, Medicaid did not cover the copays either; the only thing Medicaid has covered is a few regular copays I have had to pay in the last five years (but not all of them). I am grateful for these costs being covered, but if Medicaid is not going to cover the majority of my medical costs not covered by my primary insurance, and the system has made it illegal for MSCs to charge me out of pocket, I do not see the point in having Medicaid -- even when I no longer have private insurance through my dad's work.  

I am stuck. I am without a way to get batteries; I cannot buy batteries because I have Medicaid, and Medicaid will not purchase me batteries because they do not have a record of me having a power chair. Without batteries, I am without my power chair; I am without my independence and freedom. I feel as if the system does not want people with disabilities to have access to an equal opportunity, and therefore not be successful in life. I need batteries to be independent, to go out into the community and be apart of society, but when I do not have access to batteries, I am trapped, and forced to be hidden away. When I am out of sight, I am also out of mind; no one has to see me anymore, and they do not have to wonder about me anymore. When I am hidden away, I am forgotten. No one assists the forgotten, and I will be trapped forever.

3 comments:

  1. There is a battery store here in PA that sells batteries for many different kinds of machines. I am wondering what would happen if I walked into the store with your (dead?) battery and asked, "How much for another battery similar to this one?" (Rechargeable, same volts, similar Amp-hours, similar size.) The answer might be very interesting - then again it might not; but it seems to me that it might be worth a try.

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    1. It would be interesting to know what they would say!

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  2. After doing a little homework on your blog subject, I found that Medicaid is supposed to work "synergistically" with Medicare to help pay for the electric wheelchair. However, Medicaid is supposed to pay a portion of the cost Medicare doesn't cover. Medicare Part B, if your doctor deems it necessary for you to get around, can be used to rent or buy an electric wheelchair. I would keep hounding Medicaid until something gets done. Good luck!

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