How not to buy a wheelchair:
Oct. 16th, 2009 10:23 am![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
marinessHow not to get a wheelchair:
1. Admit, after significant badgering from family and friends, and after a very bad fall, that you need one.*
2. Head to wheelchair convention and try out some lightweight manual wheelchairs designed for shorter people. Cheer up and realize that maybe a wheelchair isn't so bad. Receive assurances from many very hot women and men that wheelchairs are actually very hot and sexy and you will look just fine in one and a lot better than you will look with a broken knee.
3. Easily get a script from the doctor. Feel reassured, knowing that central Florida's large elderly and disabled population means that a large selection of wheelchairs are readily available at a number of excellent and helpful medical supply centers, with trained staff willing and able to assist you in measuring you and working with you to provide the best wheelchair for your needs.
4. Call Cigna, an entity that terms itself a health insurance organization, and receive specific confirmation that yes, yes, they do cover supplies from Colonial Medical Supplies, based in downtown Orlando, as long as a prescription is provided.
5. Fuel up with French food. (Yay Sweet Traditions Bakery in downtown Winter Garden!)
6. Head to Colonial Medical Supplies. Because, to repeat the point, you have been assured by no less of an authority than Cigna that products purchased with a prescription at Colonial Medical Supplies will be covered by Cigna.
7. Be informed, kindly and regretfully, by a sales agent at Colonial Medical Supplies that in point of fact, they do not have an account with Cigna and that products, including wheelchairs, purchased at Colonial Medical Supplies, with or without a prescription, will not be covered by Cigna, and that in actual fact Cigna has never paid for any supplies purchased at Colonial Medical Supplies. "They keep sending people to us," the agent says. "I don't know why."
8. Call Cigna's 800 number and spend a few happy moments chatting with a computer.
9. Confirm with Cigna's agent that although just last week they claimed they did, indeed, work with Colonial Medical Supplies, in actual fact they do no such thing and never have. Receive names of two other companies in Orange County that absolutely, positively are durable medical supply companies that absolutely, positively will have wheelchairs available and that absolutely, positively work with Cigna.
10. Contact first company named. Number has been disconnected. Contact second company. Number has also been disconnected.
11. Contact AT&T Directory Assistance. Confirm that the second company does not in point of fact exist anyplace in Florida. AT&T is slightly more dubious about the first company, giving three potential companies with similar names. AT&T directory assistance person confides that this is why she no longer works for health insurance companies. "You wouldn't believe it but honestly having people shout at me here is so much less stressful."
12. Two of the companies named by AT&T do not sell wheelchairs. The third terminated its relationship with Cigna last year.
13. Call Cigna's 800 number and spend a few happy moments chatting with a computer.
14. Reach Cigna agent, who initially checks my address and notes that Cigna apparently does not cover any wheelchair suppliers in my zip code, Winter Garden. Announce that I am quite happy to go anywhere in Orange or Seminole Counties for the wheelchair, and that given that I am physically located in downtown Orlando, not in Winter Garden, at this moment, because Cigna sent me there, the Winter Garden address is irrelevant, even if a Winter Garden zip code is attached to the account. Agent cheers up and says chirpily that Cigna covers several wheelchair supply stores and she'll conference call me in.
15. Spend the next forty-five minutes listening to Cigna agent dial various companies listed in their database as customized wheelchair suppliers. These include: an emergency walk in clinic, a supplier of post-mastectomy supplies and breast reconstruction services, "the number you have reached is not in service...", two physical therapy rehab centers, two more companies that refuse to work with Cigna, and a drug addiction treatment center. Begin to question the quality of the Cigna database of customized wheelchair suppliers.
16. Reach a company that may possibly have customized wheelchairs. When the name "Cigna" is mentioned, there is a distinct hesitation on the other side of the phone.
17. Sympathize deeply with this hesitation. Realize, at the same time, that you have in no way consumed enough alcohol to deal with this.
18. Company reluctantly admits to working with Cigna, but is unsure what wheelchairs might be available, and asks for my location.
19. "She lives in Winter Park." "Garden!" "Oh, Winter – what was that?" "NEVER MIND. I can get to to Winter Park." [For non locals, they're about a half hour to forty-five minutes apart, but by that time I really didn't care.]
20. Company even more reluctantly agrees that they do, in fact, have a location in Altamonte Springs, but they are not sure about the wheelchair availability. (The person we were speaking to was in Atlanta.) I give my height, weight and medical condition. Altamonte Springs location is called.
21. Several minutes later, Altamonte Springs location confirms that it does not have wheelchairs.
22. Still cheery Cigna agent announces that we still have one more company on the list! The next company, she assures me, is a national supplier of wheelchairs without a local Orlando location that can come directly to your door.
23. Point out to Cigna agent that this wheelchair is not a temporary thing and the general idea, agreed upon by Cigna originally, was that I would be able to go and try out different models to ensure that I found one that met my needs so that I don't have to buy any more wheelchairs in the future, and that no, I do not just want a random wheelchair shipped to my door. Cigna agent assures me that Cigna wants the same thing. She calls the national supplier of wheelchairs.
24. National supplier of wheelchairs no longer works with Cigna. They provide another company, who, interestingly enough, is not in the Cigna database. Next company is called.
25. AT&T drops the Cigna call.
26. Realize yet again that wheelchair shopping should not be done without the assistance of hard liquor. Purse is regrettably free of hard liquor.
27. Start calling next company; during that call, Cigna agent calls, resulting in some confusion. Cigna agent explains that this particular company does work with Cigna. Nearly fall over in shock. The bad news is that they do not accept calls from patients. My doctor needs to call them, explain my needs, and then they will send a wheelchair right to my door. If it needs to be adjusted for my height and weight, they can do that then.
28. Explain, again, that this is a long term wheelchair and that Cigna had agreed that I could be properly measured for a wheelchair that would be the right size (I have difficulty with standard sized wheelchairs because I'm short) and that I would be allowed to try out different wheelchairs to ensure I was in one that met my needs. "Well, you can call them and explain that, and you can have your doctor explain what you need."
29. "A. Wheelchair."
30. Clarify that what this means is that despite my policy that includes customized wheelchairs, Cigna has no actual way of letting me purchase, with my health insurance, a customized wheelchair fitted for my height and weight in central Florida, even though I will be paying 30% of the price.
31. Imagine what things might have been like if I'd been trying to buy a power chair.
32. Think just how many people – me, my parents, two different Cigna agents, AT&T, various receptionists, sales agents, and so on – had to waste significant time on this because of Cigna's inability to keep their computer database updated.
(In all fairness, it is possible that the Cigna agent misunderstood and that this final company can provide customized wheelchairs – I was too exhausted to call them again once I got home, but I will be following up on this.)
33. Ah, migraine. How nice to realize that for once, you have arrived with a genuine and completely explicable cause.
34. On the bright side, this means that I entirely missed the whole boy not in a balloon story.
********
According to Forbes, Cigna CEO H. Edward Hanway earned $12,236,740 in 2008; here's some more fun stuff about Cigna's revenue and profit in 2nd quarter 2009.
*********
* I have been using a standard issue wheelchair, but it's too heavy for me to use without assistance and is designed for taller people. The idea is to get an ultralight wheelchair designed for petite women – which do exist and are readily available, if perhaps not through Cigna – to increase my independence and have my friends stop worrying about me when I'm walking.
1. Admit, after significant badgering from family and friends, and after a very bad fall, that you need one.*
2. Head to wheelchair convention and try out some lightweight manual wheelchairs designed for shorter people. Cheer up and realize that maybe a wheelchair isn't so bad. Receive assurances from many very hot women and men that wheelchairs are actually very hot and sexy and you will look just fine in one and a lot better than you will look with a broken knee.
3. Easily get a script from the doctor. Feel reassured, knowing that central Florida's large elderly and disabled population means that a large selection of wheelchairs are readily available at a number of excellent and helpful medical supply centers, with trained staff willing and able to assist you in measuring you and working with you to provide the best wheelchair for your needs.
4. Call Cigna, an entity that terms itself a health insurance organization, and receive specific confirmation that yes, yes, they do cover supplies from Colonial Medical Supplies, based in downtown Orlando, as long as a prescription is provided.
5. Fuel up with French food. (Yay Sweet Traditions Bakery in downtown Winter Garden!)
6. Head to Colonial Medical Supplies. Because, to repeat the point, you have been assured by no less of an authority than Cigna that products purchased with a prescription at Colonial Medical Supplies will be covered by Cigna.
7. Be informed, kindly and regretfully, by a sales agent at Colonial Medical Supplies that in point of fact, they do not have an account with Cigna and that products, including wheelchairs, purchased at Colonial Medical Supplies, with or without a prescription, will not be covered by Cigna, and that in actual fact Cigna has never paid for any supplies purchased at Colonial Medical Supplies. "They keep sending people to us," the agent says. "I don't know why."
8. Call Cigna's 800 number and spend a few happy moments chatting with a computer.
9. Confirm with Cigna's agent that although just last week they claimed they did, indeed, work with Colonial Medical Supplies, in actual fact they do no such thing and never have. Receive names of two other companies in Orange County that absolutely, positively are durable medical supply companies that absolutely, positively will have wheelchairs available and that absolutely, positively work with Cigna.
10. Contact first company named. Number has been disconnected. Contact second company. Number has also been disconnected.
11. Contact AT&T Directory Assistance. Confirm that the second company does not in point of fact exist anyplace in Florida. AT&T is slightly more dubious about the first company, giving three potential companies with similar names. AT&T directory assistance person confides that this is why she no longer works for health insurance companies. "You wouldn't believe it but honestly having people shout at me here is so much less stressful."
12. Two of the companies named by AT&T do not sell wheelchairs. The third terminated its relationship with Cigna last year.
13. Call Cigna's 800 number and spend a few happy moments chatting with a computer.
14. Reach Cigna agent, who initially checks my address and notes that Cigna apparently does not cover any wheelchair suppliers in my zip code, Winter Garden. Announce that I am quite happy to go anywhere in Orange or Seminole Counties for the wheelchair, and that given that I am physically located in downtown Orlando, not in Winter Garden, at this moment, because Cigna sent me there, the Winter Garden address is irrelevant, even if a Winter Garden zip code is attached to the account. Agent cheers up and says chirpily that Cigna covers several wheelchair supply stores and she'll conference call me in.
15. Spend the next forty-five minutes listening to Cigna agent dial various companies listed in their database as customized wheelchair suppliers. These include: an emergency walk in clinic, a supplier of post-mastectomy supplies and breast reconstruction services, "the number you have reached is not in service...", two physical therapy rehab centers, two more companies that refuse to work with Cigna, and a drug addiction treatment center. Begin to question the quality of the Cigna database of customized wheelchair suppliers.
16. Reach a company that may possibly have customized wheelchairs. When the name "Cigna" is mentioned, there is a distinct hesitation on the other side of the phone.
17. Sympathize deeply with this hesitation. Realize, at the same time, that you have in no way consumed enough alcohol to deal with this.
18. Company reluctantly admits to working with Cigna, but is unsure what wheelchairs might be available, and asks for my location.
19. "She lives in Winter Park." "Garden!" "Oh, Winter – what was that?" "NEVER MIND. I can get to to Winter Park." [For non locals, they're about a half hour to forty-five minutes apart, but by that time I really didn't care.]
20. Company even more reluctantly agrees that they do, in fact, have a location in Altamonte Springs, but they are not sure about the wheelchair availability. (The person we were speaking to was in Atlanta.) I give my height, weight and medical condition. Altamonte Springs location is called.
21. Several minutes later, Altamonte Springs location confirms that it does not have wheelchairs.
22. Still cheery Cigna agent announces that we still have one more company on the list! The next company, she assures me, is a national supplier of wheelchairs without a local Orlando location that can come directly to your door.
23. Point out to Cigna agent that this wheelchair is not a temporary thing and the general idea, agreed upon by Cigna originally, was that I would be able to go and try out different models to ensure that I found one that met my needs so that I don't have to buy any more wheelchairs in the future, and that no, I do not just want a random wheelchair shipped to my door. Cigna agent assures me that Cigna wants the same thing. She calls the national supplier of wheelchairs.
24. National supplier of wheelchairs no longer works with Cigna. They provide another company, who, interestingly enough, is not in the Cigna database. Next company is called.
25. AT&T drops the Cigna call.
26. Realize yet again that wheelchair shopping should not be done without the assistance of hard liquor. Purse is regrettably free of hard liquor.
27. Start calling next company; during that call, Cigna agent calls, resulting in some confusion. Cigna agent explains that this particular company does work with Cigna. Nearly fall over in shock. The bad news is that they do not accept calls from patients. My doctor needs to call them, explain my needs, and then they will send a wheelchair right to my door. If it needs to be adjusted for my height and weight, they can do that then.
28. Explain, again, that this is a long term wheelchair and that Cigna had agreed that I could be properly measured for a wheelchair that would be the right size (I have difficulty with standard sized wheelchairs because I'm short) and that I would be allowed to try out different wheelchairs to ensure I was in one that met my needs. "Well, you can call them and explain that, and you can have your doctor explain what you need."
29. "A. Wheelchair."
30. Clarify that what this means is that despite my policy that includes customized wheelchairs, Cigna has no actual way of letting me purchase, with my health insurance, a customized wheelchair fitted for my height and weight in central Florida, even though I will be paying 30% of the price.
31. Imagine what things might have been like if I'd been trying to buy a power chair.
32. Think just how many people – me, my parents, two different Cigna agents, AT&T, various receptionists, sales agents, and so on – had to waste significant time on this because of Cigna's inability to keep their computer database updated.
(In all fairness, it is possible that the Cigna agent misunderstood and that this final company can provide customized wheelchairs – I was too exhausted to call them again once I got home, but I will be following up on this.)
33. Ah, migraine. How nice to realize that for once, you have arrived with a genuine and completely explicable cause.
34. On the bright side, this means that I entirely missed the whole boy not in a balloon story.
********
According to Forbes, Cigna CEO H. Edward Hanway earned $12,236,740 in 2008; here's some more fun stuff about Cigna's revenue and profit in 2nd quarter 2009.
*********
* I have been using a standard issue wheelchair, but it's too heavy for me to use without assistance and is designed for taller people. The idea is to get an ultralight wheelchair designed for petite women – which do exist and are readily available, if perhaps not through Cigna – to increase my independence and have my friends stop worrying about me when I'm walking.
(no subject)
Date: 2009-10-16 03:10 pm (UTC)*insert black humor about government bureaucrats and health care reform here*
(no subject)
Date: 2009-10-16 03:12 pm (UTC)(no subject)
Date: 2009-10-16 03:52 pm (UTC)(And it was probably #11 that saved your sanity.)
You are 100% correct that you need a lightweight (sometimes called "sports") wheelchair, and they do make them small enough for you (you may need to go to pediatric sizes...). Definitely you want to try them out to make sure it's the one for you.
BUT in my experience buying chairs (in the middle of the fourth one) going to the showroom gets you nothing but grief. Your insurance company is* going to pay a ridiculous amount of money for this chair; part of the expense will cover the wheelchair specialist coming to you to drop off various models for you to try for a couple of days each. Even more than bicycles, you need at least a couple hours living in it to judge the fit.
(And if you ever go to a powerchair, the first one is never right. Best bet is to buy it used out-of-pocket so you can figure out what you need.)
(no subject)
Date: 2009-10-16 05:29 pm (UTC)I'll be calling the final wheelchair company on Monday - I just don't have the energy today.
(no subject)
Date: 2009-10-16 05:31 pm (UTC)(no subject)
Date: 2009-10-16 08:43 pm (UTC)(no subject)
Date: 2009-10-16 09:18 pm (UTC)woah.
(no subject)
Date: 2009-10-16 09:34 pm (UTC)(no subject)
Date: 2009-10-16 09:34 pm (UTC)(no subject)
Date: 2009-10-16 09:48 pm (UTC)(no subject)
Date: 2009-10-16 11:24 pm (UTC)Yeah, the gubmint really fails at health care....
(no subject)
Date: 2009-10-17 12:06 am (UTC)Clearly Cigna is not seeing things this way.
(no subject)
Date: 2009-10-17 12:28 am (UTC)DAMN.
Yeah, we totally can't have government bureaucrats RUINING OUR HEALTH CAREZ.
(no subject)
Date: 2009-10-17 12:30 am (UTC)These politicians keep coming on NPR saying, "And the great news is, you can keep your current insurance after reform!" and I'm going, "On what planet is that great news?"
(no subject)
Date: 2009-10-17 01:14 am (UTC)The best thing to do at this point, IMO, is to go to an online provider. If you shop carefully, and get one that's adjustable, you can get a decent one without fitting, and good wheelchairs (ie, the long-term ones) can be adjusted surprisingly much post-market.
I am a short fat chick, and I use the Quickie Revolution, in hot pink, mind you, which is a very awesome folding(!) ultralight with great stability -- the only flaw is that the scissor-lock brakes suck donkey nads; I haven't tried the swingaway ones, but they can't possibly be worse. It folds like a lawn chair and stows in the trunk of the car. (I have heard rumor that it even fits in an airplane overhead bin; I've not found a flight attendant who will let me try yet, alas.) It is 24lb. Did I mention the hot pink?
You can get a very good price at Sportaid, which is where I got mine, or order direct from mfr. I would get it in writing from
the dogfuckersCigna that they will reimburse you.In measuring: You want the seat depth to be at least 1" less than you think you do. You do not want armrests. (It makes it very hard to push yourself, which is what you are going to want to do most of the time.) You want at least 4 degrees of camber; I wish I'd gone for 8, and will be swapping out the camber tube soon. (More camber = better mechanical advantage. Makes your profile a little wider, but not horribly so.)
I will happily talk your ear off about the process of ordering mine, and what I wish I'd gotten and not gotten, if you decide to go that route.
(no subject)
Date: 2009-10-17 01:16 am (UTC)When I worked for a university, we switched health insurance companies every year as the university, partly out of concern for its employees, and genuinely out of worry since it also operated medical, dental and pharmacy schools and campus and thus needed to keep employees healthy, desperately tried to find a plan that wouldn't kill employees with copayments and so on. When I worked for a small business, the employer finally gave up trying to find something the company and the workers could afford. When I worked for a non-profit, that organization had to waste time explaining why health insurance costs were eating up so much of its budget to the board.
And this was all without giving employees a choice of insurance companies - just plans under the specific company. Trust me, Cigna would NOT have been my first, second or even third choice. I'm not saying that a public option would be great - it might suck. But I don't see where that would be any different than what I have.
(no subject)
Date: 2009-10-17 01:25 am (UTC)My COBRA insurance expires in December, so I'll be paying out of pocket at that point anyway (since on disability I earn too much money for Medicaid and I'm not eligible for Medicare, and with two pre-existing conditions, one linked with cancer, we can forget the idea of regular insurance.) I just wanted to get Cigna to help pay for this one (I'm paying part of the cost anyway) since - I'll shock you - I'm not independently wealthy.
The problem is that my policy (I looked it up) specifically states that durable medical equipment has to be provided through a Cigna-approved provider (unlike out of network doctors that are just covered at a lower rate). Some tests do as well (this is why we are still arguing over the billing for a CT scan performed at the Mayo Clinic - apparently there was another Cigna approved CT scan place in Jacksonville, but Mayo wanted that done at Mayo and to be honest I never even thought of checking for other CT places).
I'm off to check out your links now!!!
(no subject)
Date: 2009-10-17 01:36 am (UTC)(no subject)
Date: 2009-10-17 01:37 am (UTC)Having done this song and dance myself (I'm self-employed, with Ehlers-Danlos Syndrome, one of those fun disorders that come comorbid with everything else under the sun), I discovered my state has a medical insurance program that isn't for high-risk patients, just people who don't have any other option, that nobody knows about. I did some Googling, and it looks like Florida has a similar program: Cover Florida. They must take you if you're converting your COBRA (HIPAA makes that necessary anyway) and the pre-existing condition blackout is only a year.
It looks like, with your location, you could get coverage through Blue Cross or UHC, neither of which are Cigna. (I've had some good luck with BCBS, which is who MD's state plan is through.) The monthly rates are really cheap, but that's because they don't cover everything that a private plan might -- but being underinsured is better than being uninsured, right?
(Apologies if you were already aware of all this; I've found that most people don't know about their state options for health insurance that aren't the high-risk pool, which often costs thousands of dollars a month. I pay $250/month for my insurance through the MHIP program, which is a). cheaper than the COBRA was and b). so fucking much cheaper than an individual policy would be (I was quoted stuff in the four figures monthly.)
(no subject)
Date: 2009-10-17 01:39 am (UTC)(I should also add, the reason I originally got the chair without the push handles were all the reports of random strangers walking by and grabbing your chair to move you without so much as saying hello, either to 'help' or to get you out of their way. It still happens without the push handles, but it happens much less often, and I can then just run over their feet.)
(no subject)
Date: 2009-10-17 01:56 am (UTC)Even without push handles, it's not terribly difficult to manage her wheelchair. I grip thee two main posts on the sides of the back panel. Steering isn't a problem and I don't have trouble maintaining a grip on the fabric of the seat back, nor does it take much force to push the chair. It's so well-designed that it's less effort than a maneuvering a grocery cart around the supermarket.
There are a couple downsides to the lack of handles, including the need to walk more closely to the chair. In order to get enough force to push uphill, I have to bend over somewhat awkwardly and shorten my stride (I'm 5'11" and have a long natural stride). On a recent trip to Walt Disney World, where we averaged 6-7 miles each day and I did a significant amount of pushing, having to shorten my stride made my knees ache in the evenings.
The lack of handles also makes it next to impossible to exert downward force on the chair, which means I can't pop a wheelie for her and get those front casters over a gap or a rough curb. She handles that herself and then I go back to pushing once she's on a smooth surface.
To sum up: handles would be nice, but aren't absolutely necessary. If you share her hatred for the out-of-control feeling of having someone else pushing you, the lack of handles does seem to cut down on the number of times strangers will try to move her around.
(no subject)
Date: 2009-10-17 02:11 am (UTC)(When I was trying to get my first chair, due to increasing mobility restrictions and to going off to college, my insurance company first claimed that I didn't need a wheelchair at all because I was not literally bed-bound [because of course being able to walk from the bedroom to the bathroom meant I was just being lazy for not walking all over the place?], and then tried to argue that I didn't need a power chair because, and this is the reason they actually gave, I could still play the violin [never mind that violin-powered manual wheelchairs are few and far between]. Alas, I was slightly too young for the hard liquor coping strategy...)
(no subject)
Date: 2009-10-17 02:26 am (UTC)Like you said, it's such a good thing the insurance bureaucracy is keeping the government bureaucracy out of our health care!
(no subject)
Date: 2009-10-17 02:34 am (UTC)Pfft -- just get creative! Pulling back on the top of the chair back, while kicking forward at the base of the chair, might get a wheelie effect if you get the force vectors right.
Of course, there is the minor detail that she would run you over multiple times in retaliation, with pointy objects glued to her wheel for extra fun, but ...
;)
(no subject)
Date: 2009-10-17 02:51 am (UTC)But yes, there's a big difference between handling a violin and pushing a chair. I actually would have more problems with the violin (raising my arms at all can make me dizzy) but pushing the chair would, I assume, be considerably more fatiguing.