mariness (
mariness) wrote in
accessibility_fail2009-10-23 10:26 am
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Wheelchair update: a rant
So on Monday morning I contacted the sole "wheelchair supplier" authorized by Cigna and ordered a wheelchair, even though as it turns out they do not actually supply wheelchairs; they verify the claims/prescriptions for wheelchairs and then contract a supplier to send the actual wheelchair. I was informed that I would hear from them within 48 hours. I was pretty skeptical.
Understand something: I do not want this wheelchair. I have fought against the necessity of getting this wheelchair, and only finally agreed to get one after a particularly bad fall in September that made it even more difficult to walk for several days and where there was a question of potential knee surgery and after months of having close friends talk me through this. I hate the entire concept of being in a wheelchair. (I hope I'm not offending anyone; if I am, I'm really sorry, and I'm very aware that I have issues here that I need to work through.)
So we are talking about going through the process of something that I need but do not want. The second thing is that I'm lucky: I'm not rich but I do have cash on hand to buy an ultralight folding wheelchairs - not a top of the line model but one that would work. The third thing is that I'm not married and depend on several people to drive me around so one of those platforms for cars to carry a wheelchair is just not practical.
Anyway.
So yesterday morning I called to find out what was going on. The woman who answered said that she didn't know why this was taking longer than 48 hours but she would check and call me right back. Naturally, she didn't. I called again in the afternoon, to be told that my request was still being processed and I needed to understand that they were handling lots of other people besides me and it would take time. "How much time?" I asked. "I don't know." "Can you at least give me an estimate?" "I really don't know."
I explained to her that without the wheelchair I was FALLING and injuring myself. Her exact words:
"Well, that's fine, but we still have to go through the process."
No, it's NOT FINE. It's not at all fine.
So I called Cigna again. They tried to give me the same names that already hadn't worked, then agreed to call CareCentrix again to find out what the issue is. CareCentrix repeated, to me and to the Cigna rep that they had to go through the process, and then gave me the real news: it will take another two weeks to process my claim (something I feel Cigna, not CareCentrix, should be doing) and then since we will be working with a provider in Miami (!) another few days for that provider to come because they won't make a trip for just one person so it has to be scheduled with other people and then it will take at least another 30 days to deliver the wheelchair. In the meantime, if this was a problem for me, I should feel free to buy a standard wheelchair on my own and if there was a transport problem add a lift to the car. (See above! Lift=not practical! Ignoring the problem that I can't push a standard wheelchair on my own! And why do you need a lift for a regular wheelchair anyway? Aren't those for power wheelchairs or am I showing my ignorance here?)
To her credit, the Cigna rep choked right along with me. "30 more days?"
"That depends upon the delivery service they choose. It may take longer."
"Why didn't you tell me this WHEN I INITIALLY CALLED?"
"Well, we have a process. And we need to go through the process."
The Cigna rep apologized. Meanwhile, I'm torn between just cancelling the entire thing and buying one on my own versus waiting for this stupid process. Especially since I'm becoming grimly convinced that they will deny the request, even with medical documentation from my personal physician, the clinic that treated me after my fall, and the Mayo Clinic showing the necessity.
Unquestionably, though, once it becomes practical, I'll be buying the power wheelchair on my own.
Understand something: I do not want this wheelchair. I have fought against the necessity of getting this wheelchair, and only finally agreed to get one after a particularly bad fall in September that made it even more difficult to walk for several days and where there was a question of potential knee surgery and after months of having close friends talk me through this. I hate the entire concept of being in a wheelchair. (I hope I'm not offending anyone; if I am, I'm really sorry, and I'm very aware that I have issues here that I need to work through.)
So we are talking about going through the process of something that I need but do not want. The second thing is that I'm lucky: I'm not rich but I do have cash on hand to buy an ultralight folding wheelchairs - not a top of the line model but one that would work. The third thing is that I'm not married and depend on several people to drive me around so one of those platforms for cars to carry a wheelchair is just not practical.
Anyway.
So yesterday morning I called to find out what was going on. The woman who answered said that she didn't know why this was taking longer than 48 hours but she would check and call me right back. Naturally, she didn't. I called again in the afternoon, to be told that my request was still being processed and I needed to understand that they were handling lots of other people besides me and it would take time. "How much time?" I asked. "I don't know." "Can you at least give me an estimate?" "I really don't know."
I explained to her that without the wheelchair I was FALLING and injuring myself. Her exact words:
"Well, that's fine, but we still have to go through the process."
No, it's NOT FINE. It's not at all fine.
So I called Cigna again. They tried to give me the same names that already hadn't worked, then agreed to call CareCentrix again to find out what the issue is. CareCentrix repeated, to me and to the Cigna rep that they had to go through the process, and then gave me the real news: it will take another two weeks to process my claim (something I feel Cigna, not CareCentrix, should be doing) and then since we will be working with a provider in Miami (!) another few days for that provider to come because they won't make a trip for just one person so it has to be scheduled with other people and then it will take at least another 30 days to deliver the wheelchair. In the meantime, if this was a problem for me, I should feel free to buy a standard wheelchair on my own and if there was a transport problem add a lift to the car. (See above! Lift=not practical! Ignoring the problem that I can't push a standard wheelchair on my own! And why do you need a lift for a regular wheelchair anyway? Aren't those for power wheelchairs or am I showing my ignorance here?)
To her credit, the Cigna rep choked right along with me. "30 more days?"
"That depends upon the delivery service they choose. It may take longer."
"Why didn't you tell me this WHEN I INITIALLY CALLED?"
"Well, we have a process. And we need to go through the process."
The Cigna rep apologized. Meanwhile, I'm torn between just cancelling the entire thing and buying one on my own versus waiting for this stupid process. Especially since I'm becoming grimly convinced that they will deny the request, even with medical documentation from my personal physician, the clinic that treated me after my fall, and the Mayo Clinic showing the necessity.
Unquestionably, though, once it becomes practical, I'll be buying the power wheelchair on my own.
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Stupid insurance Processes.
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(but you are right about the wait.)
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as far as i know (a non-wheelchair user here) they are for people who can't get out of the wheelchair to put it in their car or don't have anyone to do that for them. the lifts are usually found on vans that are specially equipped with hand controls as the people in wheelchairs can't use the pedals.
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As far as transportation tech, here's a quick rundown.
Terminology is fuzzy because there are minimally overlapping sets of experts, each with their own jargon.
Generally a wheelchair lift is sturdy enough to hoist a person in their power chair ~ 600 lbs. Full size vans have lifts, and high-platform buses. You'll also see them on some porches, to get around the front stairs.
There are racks to hold a manual wheelchair, much like a bicycle. The manual must fold side-to-side (that's what the standard heavy "depot" chairs that you'll see in a clinic or a grocery store.)
Then there are hoists which lift a scooter or power chair from the ground up (and then often swing into) a minivan or SUV. Hoists just carry the equipment.
Living in Florida, you may have seen roll-on platforms. They can hold scooters & lightweight powerchairs but just the equipment. So you'd have to drive the device onto the platform from a standing position, and then lean on the car to get back to the drivers' seat.
Finally, there is the fabulous Tip Top Mobility Hoist, which is a rooftop carrier that lets you wheel up next to a car, transfer inside, and then grabs your chair and pulls it into a box on top of your car.
We're rooting for you, come'n'whine whenever!
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I did ask about renting a chair since I already have the letter of medical necessity (which has been faxed to Cigna) but that isn't covered by my policy.
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Anyway, he talked about going to visit family in Virginia and hearing about the healthfare and figuring to swing buy and see how it was since his own family members were talking it up like it was such a big deal. He'd figured it'd be a couple of folks getting their blood pressure checked, some nutrionists and the chance to talk someone's ear off about aches and pains.
He didn't understand why it should be such a bid deal.
Then he got there. In the rain. And there were thousands of people waiting to be seen by doctors and dentists; holding umbrellas, huddled under tents. And he was told people had been there waiting since 7am, and the fair closed at 8pm and they were considering extending it another day if they could scrounge up the resources.
He was in shock.
Why were so many individuals coming to a -fair- for healthcare?!
Then he went back to his family, finished his visit, had the company's private plane pick him up. Sat down in his leather jet seat, had the hostess put a gold plate in front of him for lunch and realized where all the money for healthcare was going.
I rolled my eyes some, since he seemed to want to get cookies for quitting his job and dipping his toes into advocacy. But I found it made a solid impression on me with how out of touch the current supposed caretakers of the healthcare system are with real suffering.
---
CareCentrix has a 30 day process they will only inform you of if you say WTF the magic number of times - indeed.
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But it's not just Cigna. My best friend is having issues with United Health Care over a freaking colonoscopy; my parents are also having issues with United over some of my father's heart tests - and they have top of the line insurance!
I get, of course, that many people (including members of Congress) have financial reasons for supporting health insurance companies. And if private health insurance acted more the way car/home insurance does, where I have my choice of insurers, can leave for another insurer if I'm unhappy, and can also opt out entirely by choosing not to have a car (ok, admittedly not everyone can do this) or a house, I'd have fewer issues. (I'd still have issues, mind you, because you only need car insurance for an accident, not for daily maintenance.) But that's not the system we have now.
And I still don't see why CareCentrix couldn't tell me that it would be 30 days when I first called them.
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1. Hating the idea of a wheelchair is one thing, but wait until you actually get into one and see how helpful it can be. I hope you will enjoy it.
2. Rigid, nonfolding wheelchairs are FAR lighter than folding wheelchairs, which makes them easier for me to handle and get in and our of cars. They actually _do_ fold somewhat if you ask for the option: their backs fold down. I have fit my wheelchair and its wheels into multiple small sedans, either in the back seat or in the trunk.
I wish you luck in this. It took me months and months to get my wheelchair, although part of that was because my vendor had me try a bunch of different types to be sure I got th eright one for me.
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2. Hmm. Two of the people who drive me around use a Volkswagen Bug (this is the main person) and a Mazda Miata (not as frequent). The Miata trunk space is the real question here. But I will definitely keep that comment in mind since the weight of the chair is a real concern for me - I want to be able to push myself, and I fatigue VERY easily, so the lighter the better.
Thanks!
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HA HA HA HA!
I had the opposite experience; everyone thought I was maybe jumping the gun in getting the chair.
I also fatigue easily, and after trying out the best folding model they had and a run-of-the-mill titanium rigid, there was NO question which was easier to push.
Oh! And while I'm dispensing advice: bicycle gloves. I wish I'd had them from the get-go.
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I do have the bicycle gloves! I use them on my trike. They're AWESOME. Special bonus: they help reduce my hand swelling. I actually have two pairs now - a fingerless one for the nine months of the year where it's too hot to wear full gloves here, and a fingered one. Getting those was the best advice the bike store gave me, by far.
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http://www.flickr.com/photos/haddayr/sets/72157614985153804/
It cost $13.
(I'm also very sorry if I'm squeeing and geeking out over equipment and stuff and you are just freaking out at the idea of a chair. You and I are Opposite Girls, I think -- I don't know why, but I never had emotional hurdles with mobility equipment. I wanted to get where I needed to go in the easiest possible fashion for my abilities, and I realize that this is a very VERY upsetting issue for many people.)
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Unfortunately the setups for cane/crutch holders don't usually seem to work with quad canes, but I am making shameless use of a Crafty Friend to create a cane holder that I can use with the scooter and the wheelchair.
And no need to apologize. I'm on a major learning curve here and the more I can learn about equipment the better for me.
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Best of luck, whatever happens. :\
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It's beyond stupid, because if I have another bad fall and need knee surgery - the only reason I agreed to get this wheelchair in the first place - Cigna will have to pay a lot more for the knee surgery than for the wheelchair. On the other hand, they probably can tell that my COBRA coverage ends in December and then I and my assorted health issues will be United Healthcare/CoverFlorida's problem. (Which won't cover any pre-existing for a year.) So all they're risking is that I don't have a bad fall in November.
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The model I have is a P210, but they change model numbers every year or 3, and you probably want a never version. Advantages of the folding models include ease of finding a place to attach tie-down straps (which is necessary in paratransit and medical transportation vehicles and also most buses), compatibility with standard wheelchair accessories, and of course the option to take the velcro-attached seat cushion off, lift (or have someone else lift) the batteries & battery tray out, and fold the chair up -- mainly but crucially useful when the only transportation option is a sedan.
Unless you really truly need one of the chairs with the tall, padded seats, I recommend against them; they may look cool, but they're rarely as convenient in practice, but are frequently foisted onto first-time wheelchair users (even though they're more expensive!) by manufacturers, providers and even insurers.
I highly recommend you insist that someone bring several models for you to try out so they can see which chair actually fits YOU -- and you may need to get their agreement to do this in writing. One poor woman in my building had to give her chair away because the idiot insurance company paid for a chair rated for a 350lb person even though she's under 5' and really needed a "child"-sized chair. (Unfortunately for adult little people, that is the industry term.) She literally could not use the chair because she slid all over the seat and couldn't reach the controls safely. Most people don't get that lousy a fit, but wheelchairs are NOT NOT NOT one-size-fits-all.
Also, I have to specifically warn you away from a Jazzy brand chair unless that's the only brand Cigna will cover *AND* you have it in writing that they'll also cover both parts and labour for repairs. The place that does all the work on my chair won't work on Jazzy chairs both because they break down ridiculously often and seriously even when essentially brand new and because dealing with the manufacturer to get the parts is ridiculously difficult. (The only other brand they don't do is Hoverounds, and that's just because HR doesn't let anyone but their own people service their chairs, so it's not that they just want me to use the brand or brands they sell or get kickbacks from or something.)
Like I said, I bought my chair used, for all of $600. Since some people's insurance covers a new power chair every couple of years, there's often a healthy second-hand market. Sometimes you can even get a "second-hand" chair that's basically unused, as when (like my neighbour) the chair their insurance provides is unsuitable to the point of unusable, or when the insurance takes so long to get someone their chair that they die or otherwise become unable to use it in the meantime. Just, again, watch out for those crappy Jazzy chairs, as they really do flood the market in many places.