My Poisoned Chalice: How My Dream Wheelchair Morphed into a Nightmare

My dream of owning a Redman power wheelchair has now morphed into a nightmare.

I can remember back to the first time I saw the Redman power chair. It was sometime in my early teenage years. I flipped open a Quest magazine, and there it was, all in it's glory, a rear-wheel drive, standing, power wheelchair. It had once only been a fantasy, but there on that glossy page, it became a potential reality. Every time I received a new copy of Quest, I would skim through the pages, find my guilty pleasure, and stare at it, wishing that one could one day be mine.

See, I wanted to stand, and be mobile at the same time. The standing frame that I owned at the time, was stationary. I hated being trapped in one spot. I also desired to stand not only for health purposes, but for the benefit of height as well. Gaining height would allow me to freely access more things on my own, and it would also allow me to look people in the eye, rather than always sitting at butt-eye level.

Back when it came time to order my second power wheelchair, I asked about a rear-wheel drive, standing power wheelchair. I was told that that type of chair did not exist, that standing chairs only came in front-wheel drive. I did not want a front-wheel drive. Therefore, I did not get a standing chair.

Fast forward about five years, it came time for me to get another power wheelchair. Again, I expressed my desire of having a rear-wheel drive, standing power wheelchair. This time when inquiring about the wheelchair that I wanted, I included the name Redman. Again, I was told that that type of chair did not exist. And again, I did not get a standing chair.

So, when it came time to order my last power wheelchair, I decided to skip over a local Durable Medical Equipment (DME) supplier, as they would not sell the Redman chair to me; I contacted the company that sells Redman, Medi-chair, myself. At first, this seemed like a wonderful idea. Cutting out the DME made it possible for me to get the exact type of chair that I had been dreaming of for over half my life. However, this dream that finally seemed to be turning into reality quickly became an illusion.

When my rear-wheel drive, standing, power wheelchair was delivered, it was too big; the depth of the seat was too long, the height of the back was too tall, and the chair was too wide. The chair, right from the start, was not what I had ordered. Yes, it was a rear-wheel, standing power wheelchair, but it was not made to my specifications; nor did it have the "pediatric" kit installed as promised (that my insurance company approved).

I made the mistake of accepting the chair. It did not fit all my needs. It did not give me the proper support. However, being without a power wheelchair for months in combination with finally getting the chair of my dreams, made me delusional to the fact that this new chair was not made to fit me properly.

The chair not fitting properly was only the beginning. Medi-chair began claiming that my insurance company did not pay the full price for my chair. It boils down to Medi-chair believing that they should be in network with my insurance, but my insurance deeming Medi-chair as out of network. If Medi-chair was in network with my insurance, my insurance would not have paid much more than they did; however, I would have been covered from having my chair repossessed!

When ordering the Redman chair, Medi-chair said that they were satisfied with the amount my insurance indicated that they would pay. So, for them to claim after the fact that my insurance company did not pay enough means that they lied about being content with how much my insurance company said they would pay.

Medi-chair also claimed that they did not contract with Medicaid. This means that Medi-chair would not be able to bill Medicaid, and that the co-pay would fall on me. After not receiving the desired amount from my primary insurance, Medi-chair requested to contract with Medicaid; in doing so, they asked for their contract to retroactively go back to July, 2016. This would allow Medi-chair to bill Medicaid, even though they were not contracted with Medicaid during the time of the purchase. Medi-chair was able to get Medicaid to pay $8,848.92 more on top of my what my primary insurance covered and my co-pay.

Medi-chair had also told us that we would not be charged anymore than our co-pay; this is stated in our contact. However, if they have already lied to us, then how can I believe that they will not charge me any more out of pocket? My insurance company told my mom that Medi-chair said they had no such deal with regard to not charging me more out of pocket. See, I am not completely protected by Medicaid. Medicaid paid on certain parts of my chair; Medi-chair cannot charge me for the remaining amount on these line items. However, Medicaid did not pay for other specific parts of the chair and Medi-chair CAN in fact bill me for any of the remaining expenses on these line items not touched by Medicaid.

The other day, I received an appeal letter addressed to my insurance company supposedly written by me, but actually written by Medi-chair; I was expected to sign this appeal letter and send it back to Medi-chair so they could send it on to my insurance company. This appeal letter would be the third appeal letter sent to my insurance company -- the first two written by me -- pleading for the entire cost of my chair to be covered. This DME letter was poorly written, and I really did not like what it said; I would not have written the letter in the manner that Medi-chair did. Medi-chair explained that they wrote the letter using tactics in order to persuade the insurance company to pay more money. This sounds manipulative to me.

Medi-chair explained that in order to get the appropriate amount of money, they have to use these tactics all the time. They also said that in order to get the desired amount, they must negotiate with the insurance company and that they do this every day, all day. They expressed that they expected to have to work with my insurance company as this is normal for them. My question is, if they expected to have to negotiate with my insurance to get the payment they desired, why did they tell me that they were happy with the amount my insurance agreed to pay?

My insurance company has officially decided that they will not pay Medi-chair anymore money. Medi-chair explained that my insurance company was going to pay $6,200.00 more, but then retracted their offer. At first, my insurance company did not say that they had offered Medi-chair more money, but when asked, my insurance company explained that when they offered Medi-chair the desired $6,200.00 more (a quote expressed by Medi-chair as a reasonable amount), Medi-chair began to try and negotiate for even MORE money. This is when my insurance company retracted their offer and said they would not pay Medi-chair anymore money. My insurance company does not negotiate with companies. They agreed to Medi-chair's price, but when Medi-chair wanted even more, my insurance company said no, and retracted their offer all together. My insurance company agreed that the extra amount that Medi-chair was primarily seeking was a reasonable amount; however, once Medi-chair began bartering for even more money my insurance company became unwilling to continue working with Medi-chair.

I am still unsure if I will be able to keep my chair, and if I will be able to do so without a large bill falling on my shoulders. I am also not positive of whether I will be able to get my chair to better fit my specifications or even serviced. If Medi-chair does not get the desired payment for my chair, who's to say that Medi-chair will not treat me with good service in the future? I already feel like I have been treated with subpar customer service.

I also do not want to invest money into a chair that could ultimately be taken away. I would love a lower back and more adequate side laterals, but this would come by my expense.

It is better to have an uncomfortable chair, than to not have one at all.

I am stuck in the middle of two entities, two entities that claim to have my best interest; but, I do not feel as if they have my best interest. If they truly had my best interest, I would not be in this situation.

MEDI-CHAIR WAS HAPPY TO WRITE A LETTER STATING THAT THEY WOULD NOT TAKE MY CHAIR BUT THEY DID NOT INDICATE WHETHER OR NOT THEY WOULD PROMISE TO NOT CHARGE ME THE REMAINING COST OF THE CHAIR. I would rather they just take the chair than promise me that they will not take the chair and end up charing me an outrageous amount of money that I cannot afford to pay.

UPDATE:

The information above was written awhile ago. I held this post as I was waiting for the final outcome to be resolved. I have now received the official letter signed by Medi-Chair stating that my power chair has been paid in full. My insurance company really stepped up and reflected their claim of "having my best interest". My insurance company decided to return the $6,200 offer to the table as long as Medi-Chair would write that this amount would complete the bill of sale of the chair and that Medi-Chair would not come after me for the rest of their desired money.

This whole experience with Medi-Chair has prompted me to speak up about what happened to me in order to eliminate the DME's ability to manipulate Medicaid to get the most money possible.
First, it should not be legal for DME's to charge a consumer a co-pay and then retroactively pick up another payment from Medicaid.
Second, DME's have figured out how to break down the cost of durable medical equipment into specific line items so that they can charge the consumer out of pocket if Medicaid does not pay toward a certain line item.
It is illegal for DME's to charge consumers with Medicaid any extra "out of pocket" costs. However, if each part of a piece of equipment has a separate price, then DME's are not technically charging a consumer the difference of what Medicaid does and does not cover.
It is very important to know how your insurance company works and what your policy states. This experience has also taught me to understand the difference between the terms "In-Network" and "Out-of-Network". Always ask you insurance company whether they contract with the DME and if the purchase will be In-Network. Do not trust what the DME says!