At what point is a wheelchair a necessity?

[Jim-T]

Power Chair Vacation

Hello,

Well, I thought I'd update you on the results of my vacation during which I rented a front-wheeled drive Pride Jazzy power chair.

First of all, it took me awhile to get used to the joystick control. I banged into some furniture and walls, fortunately at low speed. I finally got used to the joystick control. For better mobility around the house, however, I think a mid-wheel drive chair will be the best choice.

Moving around the small condo, I was amazed at the amount of energy that the power chair saved me. The power chair let me to move around the house without becoming exhausted.

The other real plus of the power chair is the freedom from falls. Seated in the power chair I really felt safe. I wasn't continuously looking for something to grab in case I started to lose my balance.

On the negative side, it was impossible to reach even the bottom cupboard shelf when seated in the chair. Since I enjoy cooking, I think an elevating seat will be a necessity.

So, based on that two-week experiment, I've begun the what turns out to be the long process of obtaining a wheelchair through Medicare.

I've discovered that when medical personnel say that someone will be in touch with me within the next week that is really code for “There is absolutely no chance of anyone calling you from our office so you better count on calling us back.” So far, I've spent almost three weeks trying to get an appointment for a mobility needs and seating evaluation after I obtained a prescription from my doctor. Once I get the appointment, the process of getting a chair in my home will take six to nine months!

I still struggle a little bit with the idea that getting a wheelchair is giving up; but the convenience of effortlessly and safely moving around was extraordinary!

Best regards,
Jim

[kmallory1]

Jim, watch out for Medicare's time limitations. You have 45 days from the date of the physician's simple prescription to get the evaluation done, get it back to the doctor, and get them to write the documentation for the prescription for the specific chair.
Don't wait for them to call you. If the time expires you have to start over.

This is the busiest time of year for this, because of deductibles.

It took me 7 months to get mine, and I got surprised with a bill for $1,000 at the end. My Medigap policy had a high deductible. The wheelchair vendor kept saying Medicare covers this. I forgot that is just 80% of the cost.

My chair has the elevating feature, which is great. It helps with reaching things and with standing up. Neither Medicare or insurance covered that, it's not "medically necessary".

I wish you luck and lots of patience.

This document on the Medicare web site explains the process. (if MSWorld allows the link)

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/pmd_DocCvg_FactSheet_ICN905063.pdf

[Jim-T]

Thanks for the Information

kmallory1,
Thanks for the great information! Good to know that I'll be on the hook for the elevating seat. I've started the process. I'll see how slowly it goes. Age & MS have made me into a patient man.
Best regards,
Jim

[kmallory1]

Jim,
My chair is a Quantum Edge Q6. The seat elevates, but it can't be driven like that. So you get in position then elevate the seat. It will move a couple of inches, but to go across the kitchen it has to be lowered. The center of gravity is too high to move around with it elevated.

I had visions of driving around at that level. I did not realize that when I forked over the $2500 in advance for the feature.

The tilt and recline features were deemed to be medically necessary for positioning to prevent pressure sores, so they were covered. I wish I had added the power leg rests.

[kmallory1]

Correction

Sort of a correction. There is an elevating power wheelchair that you can drive while elevated, and is priced reasonably.

Look at the Jazzy Air online. It's priced at about $4000-$5000 online. The elevating feature is an integral part of it so I don't know how that will play with Medicare or insurance.

I just saw this while looking for something else. It's pretty cool!

[JerryD]

Sorry I am late to respond. I was walking with a walker and rollator for about a year. I have progressed (digressed) so quickly since June of 2016 that I was hospitalized for 2 weeks in a rehab and was prescribed a power wheelchair. I am currently using a Permobil M300 with optional seat height elevator (which was paid for out of my pocket) . I would be in big trouble if I didn't have a power wheelchair. I have balance issues, am considered a fall risk! I can fall when I stand up from my recliner chair to transfer to the w/c. That's my story, this year. Hope that you figure out your best course. Good luck

[Kimba22]

First of all, it took me awhile to get used to the joystick control. I banged into some furniture and walls, fortunately at low speed. I finally got used to the joystick control. For better mobility around the house, however, I think a mid-wheel drive chair will be the best choice.

Hi Jim,

I've been using a power chair for several years, know how to navigate very well, yet still bang into things periodically. I fought the idea for quite awhile in the beginning, but turned out to be the best decision I could have made. I still walked short distances as long as I possibly could, but the chair allowed me the freedom to move around the house with all the struggles I was having (greatly limiting my movement around the house) and fear of falling.

The mid-wheel drive has the smallest turning radius, and spins on a dime. Makes them good choice for use in the home or any tight space. Only type of chair I've ever used on vacations, too. Helps being able to turn on a dime in an elevator!

Insurance generally only pays for a new power chair every 5 years. You might not think you need tilt/ recline/ elevating leg rests right now, but get them if you can, because this is a progressive disease. Good luck with both your patience and with your new chair.

Here also is one of the more helpful links I've found explaining the differences between front, mid, and back wheel drive power chairs, from MDA, but helpful to anyone considering a power chair: https://www.mda.org/quest/article/fr...hats-right-you

My chair is a Quantum Edge Q6. The seat elevates, but it can't be driven like that. So you get in position then elevate the seat. It will move a couple of inches, but to go across the kitchen it has to be lowered. The center of gravity is too high to move around with it elevated.

I had visions of driving around at that level. I did not realize that when I forked over the $2500 in advance for the feature.

The tilt and recline features were deemed to be medically necessary for positioning to prevent pressure sores, so they were covered. I wish I had added the power leg rests.

kmallory,

I also have a Quantum Q6, have had it 5 years. Now waiting for a new one - ridiculously slow vendor, already approved by insurance (6 weeks ago!), should be ordered this week. I didn't get the elevating seat option the first go around, but did get tilt/ recline/ and elevating leg rests. I have significant leg spasticity, so no issues with elevating leg rests being approved.

Do you think the elevating feature was still worth it? Thought it would be nice, but then again have done without it all this time. Therapist thought it would also aid my transfers into a regular bed. Not 100% sure, but during my wheelchair evaluation, thought the vendor said you could move with the elevating seat option. (Could've been confusing that with the standing wheelchair - of course, insurance won't cover that). But just looked it up on line, and looks like this is a feature now. http://www.quantumrehab.com/ilevel-power-chairs/

Thanks for your input.

[kmallory1]

Kimba,
I think the elevating feature was worth it. I use it every day, for getting to a standing position, using stand and pivot transfer. It also helps in the kitchen, reaching items on the countertop or in the sink.
When elevated, the chair just moves a few inches when you push the joystick forward. You can't move it with anything like normal speed. So technically it moves, just not enough to be useful.

[Jim-T]

Thanks for the great information!

Hi,

Thank you for all the helpful comments.

This is why I love MSWorld!

Best Regards,
Jim

[kmallory1]

Jim and Kimba,
I stand corrected about driving the chair while elevated! The new I-level feature lets you do that and MAY be covered by Medicare or insurance, according to the link provided.

That's great news and a big step forward for those of us battling insurance restrictions for quality of life.

[Kimba22]

My chair is a Quantum Edge Q6. The seat elevates, but it can't be driven like that. So you get in position then elevate the seat. It will move a couple of inches, but to go across the kitchen it has to be lowered. The center of gravity is too high to move around with it elevated.

I had visions of driving around at that level. I did not realize that when I forked over the $2500 in advance for the feature,

Kimba,
I think the elevating feature was worth it. I use it every day, for getting to a standing position, using stand and pivot transfer. It also helps in the kitchen, reaching items on the countertop or in the sink.
When elevated, the chair just moves a few inches when you push the joystick forward. You can't move it with anything like normal speed. So technically it moves, just not enough to be useful.

Jim and Kimba,
I stand corrected about driving the chair while elevated! The new I-level feature lets you do that and MAY be covered by Medicare or insurance, according to the link provided.

That's great news and a big step forward for those of us battling insurance restrictions for quality of life.

Hi kmallory,

I appreciate your response, and knowing why it was worth the extra cost to you. I know someone who had it covered under Medicaid. But they also wore full leg length ankle, foot, knee orthotics (making it hard to bend the knee). Now she has regained her mobility and doesn't even need it (good for her). My insurance company also denied it, citing it was not medically necessary. Guess they didn't get the memo yet, or more likely choose to ignore it. The occupational therapist did note this feature would facilitate transfers to my bed. And that I now have neck problems (bone spurs), aggravated by looking up. Guess they'd rather fork the money out for a hospital bed, possibly a lift, and more PT (or more) for my neck. First level appeal was still denied. Unfortunately, can't enlist the help of my wonderful MS Specialist to aid in a further appeal anymore (he passed away).

My current chair is also the Quantum Q6 edge. Supposedly, this chair has the narrowest footprint. It's been a good chair for me, but the right motor needs to be replaced now (vendor says they only replace both motors if one wears out, his reasoning compared it to a wheel alignment ). It squeaks because the brushes wore out and now metal on metal. I decided to wait instead of getting it fixed. Wasn't a good choice, but fully expecting my new chair by now.

I thought it was more chair than I needed when the tilt/ recline features were recommended, so decided to put off the elevating feature. (Still could walk at the time, although not without a great deal of effort). The vendor told me he wouldn't recommend a chair without tilt/ recline to someone like me. He anticipated possible future needs in the next 5 years, based on my level of disability at the time. He also said the elevating feature could be added later and gave me the impression it was no big deal. So decided just to wait. Have since been told the chair must be sent back to the manufacturer to add it. So, would mean even more cost with shipping along with not having my chair for an extended period.

Shortly after ordering my current chair, I had 2 major relapses and other serious health issues that left me hospitalized and bed bound for months. Never did fully regain my previous function. So turned out to be a good thing the chair had been ordered and was in my possession when I finally came home from the hospital/ inpatient rehab.

iLevel drive is a new feature. I think it was introduced a year ago? Was glad you mentioned how yours couldn't be driven this way, so I could look into it. That did help reinforce my decision to go for it. The Quantum Q6 Edge has now been superseded by the Q6 Edge 2.0, which is available with iLevel drive. The original Edge is still available (and cheaper) for those not wanting this feature. Extra stability now allows for operation of the power chair with the seat elevated (up to 10 inches) while at walking speed of up to 3.5 mph. (I was quoted $2495, so my out of pocket cost is still the same as yours was. Price went up $1000 from what I recall 5 years ago.). Will be nice being in closer face (and hearing) range with others (I also have a tall family). Can see it as being helpful in crowds, don't get noticed (or heard) by most people when in a crowd. People don't notice and constantly cut right in front of you.

The Permobil 300 JerryD mentioned has a 8 inch seat elevator option. Permobil has a new F Series powerchair which will elevate up to 14 inches. Another cool option with that chair is the seat will tilt laterally up to 45 degrees. Not quite standing, but would still be a great feature to have. Would be nice to save my knees from hitting things below and much easier to reach things. That one is front wheel drive, but I could get used to it. Right, dream on ... saw something on YouTube mentioning this was a $40,000 chair. Yikes.

Also saw the TEK Robotic Stabilization device. It's basically a moving platform you are held upright on with special straps, without using a full chair. Makes for a small footprint that can be used in tight spaces. Can be lowered and raised again to get lower, get both into and out of a chair, get on/ off the side of the bed, even help on the commode. More cool technology. Too bad it's nothing I could ever afford.

But will count my blessings that I am fortunate enough to have a power chair. I know I would loose my independence without it. Now waiting for my new one to be delivered before the end of the month since my deductible has been met for the year. It was approved by my insurance 7 weeks ago! Beyond frustrated it's taken so long for the vendor to place my order. Kept being told not to worry, there was plenty of time. Really? I should've had it already. Finally got placed today. Supposedly I will get it in time ... (sure hope so, or will be looking for a new vendor come January)

BTW Jim,

Your power chair "vacation" was a good idea!