Standing Wheelchair Funding Guidelines
Medicare
Can I get a standing wheelchair funded under Medicare?
Medicare is the most challenging of the funding sources for standing chairs. However, our wheelchair users have been often been able to get some of the features covered by Medicare while another funding source (i.e., Medicaid, Private Insurance, the beneficiary) covers up the balance.
Medicare is the most challenging of the funding sources for standing chairs. However, our wheelchair users have been often been able to get some of the features covered by Medicare while another funding source (i.e., Medicaid, Private Insurance, the beneficiary) covers up the balance.
Medicaid
Can I get a standing wheelchair funded under Medicaid?
Medicaid coverage of a standing chair is based upon the client having a “Letter of Medical Necessity” for the device. Historically, state medicaid has been known to cover standing chairs when the appropriate criteria is met.
Medicaid coverage of a standing chair is based upon the client having a “Letter of Medical Necessity” for the device. Historically, state medicaid has been known to cover standing chairs when the appropriate criteria is met.
Workers' Compensation or Private Insurance
Can I get a standing wheelchair funded by private insurance companies?
Private insurers will often cover the cost of purchasing standing wheelchairs. The first step is to check the “Policy Determinations” for durable medical equipment coverage. Then, check to see if there are any exclusions for standing devices.
Private insurers will often cover the cost of purchasing standing wheelchairs. The first step is to check the “Policy Determinations” for durable medical equipment coverage. Then, check to see if there are any exclusions for standing devices.
Vocational Rehabilitation (Rehab)
Can I get a standing wheelchair funded under Vocational Rehabilitation?
Vocational Rehabilitation is a Federally funded program that is administered individually by each state.
Vocational rehabilitation is a process which enables persons with functional, psychological, developmental, cognitive and emotional impairments or health conditions to overcome barriers to accessing, maintaining or returning to employment or other useful occupation.
Quite often people need the use of a standing wheelchair to return to their previous employment, attend school, or, gain new employment.
The best way to find a Vocational Rehabilitation office near you is to use a search engine on the internet. Simply enter your state and then the words “Vocational Rehab.” For instance, if you live in Florida, search for the terms:
Florida Vocational Rehab
Please note that different states may have different names for vocational rehabilitation. For instance, in Texas, the name is DARS (Division for Rehabilitation Services), while in Michigan it is called DVRS (Division of Vocational Rehabilitation Services).
Vocational Rehabilitation is a Federally funded program that is administered individually by each state.
Vocational rehabilitation is a process which enables persons with functional, psychological, developmental, cognitive and emotional impairments or health conditions to overcome barriers to accessing, maintaining or returning to employment or other useful occupation.
Quite often people need the use of a standing wheelchair to return to their previous employment, attend school, or, gain new employment.
The best way to find a Vocational Rehabilitation office near you is to use a search engine on the internet. Simply enter your state and then the words “Vocational Rehab.” For instance, if you live in Florida, search for the terms:
Florida Vocational Rehab
Please note that different states may have different names for vocational rehabilitation. For instance, in Texas, the name is DARS (Division for Rehabilitation Services), while in Michigan it is called DVRS (Division of Vocational Rehabilitation Services).
Private Fund Raising
How does one go about raising funds on their own?
There are many reasons for standing, as we have outlined in the FAQ’s section of this website.
Unfortunately, some funding sources do not always agree. If, after repeated appeals, you are still denied a standing chair, do not lose hope. There are still ways to obtain the device, one of which is through fund raising.
There are many reasons for standing, as we have outlined in the FAQ’s section of this website.
Unfortunately, some funding sources do not always agree. If, after repeated appeals, you are still denied a standing chair, do not lose hope. There are still ways to obtain the device, one of which is through fund raising.
Charitable Organizations
Are there charitable organizations that will help me with the purchase of a Stand-Up Wheelchair?
Yes, there are many charitable organizations that are willing to assist with the purchase of your wheelchair. Please contact a LEVO representative using the contact form on our site for referrals to potential charitable partners as well as assistance in applying to a charitable organization for funding.
Yes, there are many charitable organizations that are willing to assist with the purchase of your wheelchair. Please contact a LEVO representative using the contact form on our site for referrals to potential charitable partners as well as assistance in applying to a charitable organization for funding.
Veterans' Administration (VA) Funding
How does one go about obtaining a standing wheelchair chair through the Veterans Administration
When attempting to get funding through the VA system, the veteran must have Doctor’s approval to start the process. They can get that by either a Dr. visit, or a clinic visit if they are already receiving therapy. Once the Doctor agrees the veteran needs a wheelchair, they are typically sent to the therapy department for an evaluation. It is at this point that the client should bring up their desire to obtain a standing wheelchair. This “eval” is typically done by an OT, PT, or KT at the VA hospital. In some rare cases, the Prosthetics department actually does the eval, protocol can vary with each VA.
Once the eval is done and a quote is generated, it is sent to prosthetics. Some VA’s have a medical review committee that must approve it before it is ordered. Some don’t have this committee involved in the process at all. The timeline for this activity can vary from one VA to another. It can take as little as two weeks or as long as 3 months. Most of the time it is done in less than a month overall.
The key here is to proceed with the process once the client has determined he/she has a need for a standing wheelchair.
When attempting to get funding through the VA system, the veteran must have Doctor’s approval to start the process. They can get that by either a Dr. visit, or a clinic visit if they are already receiving therapy. Once the Doctor agrees the veteran needs a wheelchair, they are typically sent to the therapy department for an evaluation. It is at this point that the client should bring up their desire to obtain a standing wheelchair. This “eval” is typically done by an OT, PT, or KT at the VA hospital. In some rare cases, the Prosthetics department actually does the eval, protocol can vary with each VA.
Once the eval is done and a quote is generated, it is sent to prosthetics. Some VA’s have a medical review committee that must approve it before it is ordered. Some don’t have this committee involved in the process at all. The timeline for this activity can vary from one VA to another. It can take as little as two weeks or as long as 3 months. Most of the time it is done in less than a month overall.
The key here is to proceed with the process once the client has determined he/she has a need for a standing wheelchair.
Appealing a Denial
In the event that the initial funding request for the standing wheelchair is denied or pended, additional documentation may be necessary to clarify why the equipment is medically necessary. In some cases, the entire wheelchair is denied/pended, and in others, only certain components are questioned. It is important to look over the documents below for general guidance in responding to a denial or pended request. Additionally, the NCART Standing Device Funding Guide is an excellent resource describing the Appeals Process.
Often times, it may be difficult to determine the precise reason for denial or questions that the funding source may have. It is essential that you obtain a copy of the written denial to help you understand how to respond appropriately. The sample appeal letter links below are based on some common reasons for denying a standing wheelchair request. If you are unsure about the specific reason for denial, please contact [email protected] and someone will help you know how to respond most appropriately.
Often times, it may be difficult to determine the precise reason for denial or questions that the funding source may have. It is essential that you obtain a copy of the written denial to help you understand how to respond appropriately. The sample appeal letter links below are based on some common reasons for denying a standing wheelchair request. If you are unsure about the specific reason for denial, please contact [email protected] and someone will help you know how to respond most appropriately.
Necessary Documentation
Letter of Medical Necessity
Prior Approval on a standing wheelchair requires a specific protocol and careful documentation. It is critical that special attention be paid to how things are submitted.
An equipment supplier will submit a request for the standing wheelchair. It is important to include clinical documentation that strongly supports the medical necessity of the recommended device. One of the most important documents is a letter of medical necessity (LMN) written by the treating/prescribing clinician. Typically, this letter is from a physical/occupational therapist and/or physician, but can be written by any treating medical provider.
Examples of LMNs for standing wheelchairs can be found by clicking the links below. Additionally, the NCART Standing Device Funding Guide is an excellent resource outlining what to include in the LMN.
Prior Approval on a standing wheelchair requires a specific protocol and careful documentation. It is critical that special attention be paid to how things are submitted.
An equipment supplier will submit a request for the standing wheelchair. It is important to include clinical documentation that strongly supports the medical necessity of the recommended device. One of the most important documents is a letter of medical necessity (LMN) written by the treating/prescribing clinician. Typically, this letter is from a physical/occupational therapist and/or physician, but can be written by any treating medical provider.
Examples of LMNs for standing wheelchairs can be found by clicking the links below. Additionally, the NCART Standing Device Funding Guide is an excellent resource outlining what to include in the LMN.