The Daughter Chronicles

Saturday, March 15, 2008

The annoyance of DME

That's "Durable Medical Equipment," in case you're wondering. We have quite a lot of it.

Mia has wrecked her wheelchair. Well, not exactly wrecked it, because she can still use it, but done some damage to it, to the point that we need a new one. She ripped the head rest part off a while ago, after it had been weakened from constant abuse. Then, a few weeks ago, she kicked the foot plate so hard it broke off. One of the bolts had come out a while ago, and as it uses weird "special" bolts, you just can't order replacements - and believe me, I've looked. So it was already a bit unsteady, and Mia likes to kick, so one day - pow! It was then that we knew we needed to get her a new one. She's had this one for almost three years, and her PT was thinking we would need to get a new one pretty soon, so this was the opportunity.

The good thing is, of course, that we don't need to go through insurance, thanks to Mia's money. Her PT recommended one that he's used for a few other kids and likes, so we looked for it on-line. I talked to her lawyer and made sure that the court would allow us to spend the money on it. We always have to go through the court for everything, and we have to wait for it to be approved. It's always approved, but we still have to wait for the petition, and the court is usually very slow. It's still quicker than insurance!

While I was looking for the price, I noticed that the web site didn't list the price of the base. The seat is one price, but there are three different bases for it - a four-wheeled base, a three-wheeled one, and one that allows you to use it as an eating chair. But the prices aren't listed until you choose the seat, which is annoying. You might think the seat and base would be one price, because it's a freakin' wheelchair, after all, but they're two separate prices, and of course you need a bunch of accessories. The chair we want is over $3500.

Think about that for a moment. I know we don't have to worry about insurance, but that's still nothing to sneeze at. If we did have to worry about insurance, we'd come up against the fact that many insurance plans have a limit to the amount they're willing to spend on DME. On one of our plans, the limit was $1000. Not a lot falls under the listing, but for this, we would have had to spend $2500 out of pocket for something that she desperately needs. I assume some plans have a higher limit, but it's still frustrating.

I mention this because it's tough for people who are not in Mia's somewhat unusual financial state to get what they need for their children. Most people have private insurance and a state plan, but there's always a possibility that the family will have to pay quite a bit out-of-pocket. Plus, the delays as each insurance plan processes requests is annoying as well. Health insurance is a problem for so many people, and it's sad that for kids with disabilities, it's often worse than for most.

For us, that's not really a problem. But I'm often reminded, when we're getting stuff for Mia, how tough it is for so many others. And how we spend government money on so many other things that are less important. That's a fight for another day, I suppose.


  • I used to work as a customer service rep at Blue Cross back in 1990. I'm betting that if you recall DME limits of $1000, they probably haven't gone up a great deal, except for inflation. If you're talking group insurance (one you get from your employer) then they generally get coverage that will cover most people "reasonably" well. If one has expenses outside of the "norm", you'll get hammered. And I won't even talk about individual insurance, which is just outrageous for everyone.

    By Blogger Roger Green, at 18/3/08 4:00 AM  

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