Commentary: Insure mobility devices

2 days ago 38

It’s been 16 years since a motorcycle accident paralyzed me from the chest down.

But today, I can work and live independently, thanks to a revolution in wheelchair technology.

Unfortunately, not everyone in my position has access to the top-flight titanium or carbon fiber wheelchairs that have changed my life. That’s in part because Medicare — and the private insurers that follow its cues — don’t always cover them.

That needs to change. The millions of Americans who need a wheelchair to get around, to work, to live our lives, deserve no less.

My first wheelchair was a heavy aluminum-framed one. Today, I use an ultralight, smooth-riding carbon fiber wheelchair. I don’t know how I managed beforehand.

To appreciate the difference the composition of a chair makes, consider two scenarios. Wheelchair users who drive must cope with the problem of getting our chairs into and out of our vehicles — in my case, without the use of abdominal “core” muscles or leg strength.

A standard chair can weigh 30 pounds or more for the frame weight, but additional accessories are needed to fit the consumer. The newer technology of titanium or carbon fiber may weigh less than half that.

The alternative, of course, is staying home.

Now consider road shock. Imagine swinging an aluminum tube, a titanium rod and a carbon fiber composite at a tree trunk. With the aluminum, you feel pretty much the full extent of impact as vibration in your arms. With titanium, that’s reduced to a minor vibration. With carbon fiber’s crisscrossed filaments, you barely feel a thing.

Medicare only covers the cost of heavier, “standard” aluminum chairs. If beneficiaries want one of the new, lighter models, they have to pay for it upfront themselves. That can cost around $5,000, and in many cases much more when you add the options that make the chair a fit for you.

The wheelchair supplier then applies for Medicare reimbursement at the standard level of 80% of the cost of an aluminum chair — which, of course, is less than the cost of an upgraded wheelchair.

After Medicare reviews and processes the claim, the supplier reimburses the beneficiary for his 20% copay — which, again, is based on the lower-cost aluminum chair.

That reimbursement process can take months. It requires submission of medical orders and wheelchair manufacturer attestations. That delay imposes a heavy burden on many disabled Americans.

It’d be great if Medicare and private insurers covered the most advanced wheelchairs since these chairs are deemed by professionals as medically necessary.

Failing that, they should at least allow people to pay only what they owe in cost-sharing and would eventually receive as a reimbursement, rather than having to wait months for a rebate.

Congress needs to pass legislation to provide Medicare beneficiaries with access to titanium and carbon fiber wheelchairs. In the House of Representatives, that legislation is H.R. 5371, or the Choices for Increased Mobility Act of 2023.

This issue is personal for me in another way. After my accident, I went to work for a company that makes the lighter, more durable wheelchairs that have given me a new lease on life. I’ve made it my mission to ensure that others who need wheelchairs can experience what I have.

I still like to ride a motorcycle — modified to suit my needs, of course. I’m also a ski instructor and an avid bicyclist. Our national commitment to allow people with disabilities to make the most we can of our personal circumstances is exemplary. This simple, cost-free legislative change to Medicare’s rules would make an outsized contribution.

Chris Collin is a regional sales manager at Motion Composites, a company that designs and manufactures ultralight wheelchairs.