The Art of Health Insurance Appeals: My Battle for a Power Wheelchair Seat Lift

As I was strapped into my electrical stimulation bike while simultaneously lifting weights I had my Bluetooth snuggly positioned into my ear listening to my “Rock it Out” music to keep my motivation over that next hour.  Pandora played a song by the black-eyed peas, which came out in 2010 called “I’ve got a feeling.” It’s an incredible dance song when you want to feel pumped up and I used to play it on repeat before my accident in 2010 when I was living at my home in the Bahamas…

… It was a time in life that reflected simplicity, clarity, and pure joy.  Life was so simple back then.  I was pumping myself up last week because I’m in another battle of a lifetime with Blue Cross and Blue Shield (BCBS) for a new power wheelchair…

… I started the uphill mission of working with my durable medical supplier, my physical therapist, and my general practitioner…

… Two weeks ago I did, finally, receive a letter from BCBS saying that they were denying me a very critical function of the wheelchair called the seat elevator.  This allows my power wheelchair to go up and down.  Most insurance companies do not think this function is medically necessary for folks in wheelchairs.  I then called all the parties involved and there was a complete disconnect among my medical providers.  So, in a very Ali fashion, I decided to take matters into my own hands.  The age-old saying “when you want something done right, do-it-yourself,” holds true 100% of the time …

… Without further ado, this is the appeal letter I sent into the BCBS appeals committee last week.  I will keep you posted on what their decision will be, but when you really want something, you’ve got a fight tooth and nail to get it.  Sadly, this is the reality we live in and the fact that we have to justify why we need certain items to insurance companies to, not only survive with the spinal cord injury, but to thrive with it is slightly disheartening.  However, this is the healthcare system we presently have to navigate within!

Read the rest on Push Living Magazine: https://pushliving.com/the-art-of-health-insurance-appeals-my-battle-for-a-power-wheelchair-seat-lift/