A Call to End the Insurance Coverage Olympics for Durable Medical Equipment

Getting my first power wheelchair back in high school remains one of the most liberating feelings I’ve ever experienced. Using my manual wheelchair to navigate the school building every day had become tiring both physically and mentally – physically, because pushing for long distances is tough since I have elbow contractures, and mentally, because having my eyes squarely at crotch-level of all my peers was rather unenjoyable. With my new power wheelchair, not only was I able to breeze through the halls and make it to my classes in a more timely manner, but also I had an entirely new world opened up to me thanks to the power seat elevator I opted to have included. The moment I raised myself up to full height for the first time, I knew the elevation feature would prove to be the most useful aspect of my wheelchair, one that I had long needed and would benefit me in several daily situations. Unfortunately, my insurance providers vehemently disagreed.

In the world of insurance companies, the power wheelchair with seat elevation (and power chair tilt) that I needed is known as Durable Medical Equipment (DME). Getting full coverage for even the most basic DME, let alone one with specific features, is often akin to fighting a battle while running uphill in circles. I’ve had requests for DME of all kinds denied, despite the fact that such equipment is vital for me to live my life independently. Aside from my obvious need for a plain old wheelchair to move from place to place, I also need it to perform certain other functions so I can tackle simple tasks. For instance, seat elevation has become integral as I go about my day-to-day, for everything from reaching things in the refrigerator and cabinets, to getting clothing from the highest rack in my closet, to grabbing items on the top shelf in stores without asking for assistance. Moreover, elevation gives me the opportunity to see eye-to-eye with people, instead of eye-to-crotch, which makes me feel on equal ground when it comes to professional networking and socializing.

And yet, when I was finally able to get a new power chair just this past summer, the quest for coverage ensued all over again. The insurance company initially deemed my seat elevator to be nothing more than a luxurious extra, rather than something that gives my body another means of functioning. Thankfully, with guidance, my family and I made it to the other side of the denial and appeals process, one that anyone who requires DME is likely very familiar with enduring. However, this frequently drawn-out, arduous process should not have to occur nearly every time people need to obtain equipment. It creates access barriers to basic necessities, and wastes resources, time, and energy of both insurance companies and people pursuing their cases to receive their DME.

From walkers and wheelchairs to oxygen tanks and insulin pumps, DME is both life-promoting and life-sustaining. All people, not just those who have disabilities, can thrive and contribute to their community with the right tools and equipment in place. It is time for insurance companies to refine and reform the current processes required for DME, because no one should have to partake in several rounds of insurance Olympics to acquire what they need to live.

Emily Ladau is a writer and disability rights activist whose passion is to harness the powers of language and social media as tools for people to become informed and engaged social justice advocates. She is the owner of Social Justice Media Services, which provides communications, outreach, and social media management services for disability-related organizations. Emily also maintains a blog, Words I Wheel By, as a platform to address discrimination and to encourage people to understand the experience of having a disability in more positive, accepting, and supportive ways. You’re welcome to connect with her on Facebook and Twitter.