Insurance Isn’t Always Right:

After more than a year of waiting, I finally received my new power wheelchair in March of 2021. I had to be measured and fitted appropriately first in November of 2019. My health insurance first refused the chair in its entirety. Even though it had been more than five years and I needed a new one. Health insurance allows me to receive a new power wheelchair every five years. I received my first one in August of 2013.

Power wheelchairs such as the one I use are considered complex rehab technology. They typically cost several thousand dollars and are equipped with custom seating systems, seat elevators, power-tilt, and other functions to improve the well-being of their users. For insurance to approve medical equipment, letters of medical necessity must be quite thorough and detailed. In my case, it entailed demonstrating how a manual wheelchair and other less expensive pieces of equipment wouldn’t meet my needs.

My health insurance approved the chair after receiving more substantial letters of medical necessity from my team at Boston Children’s Hospital. When I received the news in the mail, I was relieved. My insurance, on the other hand, refused to pay for the seat elevation feature on my new power wheelchair because it wasn’t deemed “medically necessary.” I don’t need the seat elevator to stay alive or prevent health issues. However, the seat elevator helps me maximize my independence and participate in more activities.

I use the seat elevation function to assist me with things like brushing my teeth and reaching high cabinets in my apartment’s kitchen, as well as filling a glass of water. Not having to be concerned about my balance is a huge relief. When I’m in science class and have to complete a lab, this feature comes in handy. I am also less dependent on my PCA because of the seat elevation function on my chair.

When it comes to spending time with friends and family, I use my seat elevator to be at eye level. When I’m sitting in my chair, I don’t have to strain my neck to talk to others. Before the COVID-19 pandemic, this function made trips to the arcade more enjoyable for me. I was able to play air hockey with a friend on my own because I could reach the table.

Medical necessity shouldn’t be the only reason health insurance companies approve equipment, and other supplies for disabled people. Sometimes even when someone needs something, they still won’t approve it. On social media, I read posts about health insurance denying someone the appropriate amount of catheters in a month.

I want health insurance providers to understand that disabled people, like everyone else, deserve to live life to the fullest. Just because someone doesn’t require something for medical reasons doesn’t mean they shouldn’t have access to it to improve their lives.