The Ultimate Guide To Getting a New Personalized Manual Wheelchair (US based)
I think you’ll agree with me when I say:
It can be a hard and tedious process sometimes when going through the task of getting a new custom manual wheelchair.
While it’s not necessarily a “walk” in the park (ha!), knowing the general process and expectations ahead of time can help you have a good and smooth experience when ordering a new wheelchair.
Today, I’m going to explain the process for getting a new personalized manual wheelchair. Specifically:
- The typical steps, timeline & insurance considerations
- The medical providers involved
- And important questions to ask as you go through this process
Let’s dive right in.
A. Typical steps, approximate timeline, & insurance
You can expect this process to take approximately 2-3 months to complete, as there are multiple steps that must be done before the wheelchair can be ordered.
Keep in mind, at least in the US, five years is the required time for keeping a wheelchair from an insurance standpoint.
If you change insurance companies, you might be able to get a new wheelchair sooner, but it depends on the company. Insurance companies like Medicare require one to have the wheelchair for 5 years.
B. The Process & Medical Providers Involved
- The first step to getting a new wheelchair is to meet with a primary care physician (PCP) or physical medicine rehabilitation physician (PM&R). With them, you would discuss your overall needs, living situation, and expected activities of daily living which the wheelchair would help make possible. The physician would then write a prescription for durable medical equipment, or in other words, the new wheelchair. It may be preferable to find a PM&R if your primary care physician is unfamiliar with writing prescriptions for a wheelchair.
- The second step is to meet with an occupational therapist (OT), physical therapist (PT) or both, as well as an assistive technology professional (ATP) from the durable medical equipment (DME) company.
Your daily needs, living situation, and goals for use of the wheelchair would again be discussed. Then, the ATP would take measurements for the chair. The ATP’s job is to work closely with the OT’s and PT’s, bringing intimate product knowledge of the equipment available.
- For the third step, you would meet with the ATP and a representative from your chosen DME manufacturer company. For me this ended up being Permobil since they make the TiLite wheelchairs.
This meeting can take place at the home or in a clinic/office. The ATP’s job is to meet with the therapist and client trying to get rehab equipment, discuss needs for daily life and ways to improve quality of life, bring knowledge about all equipment options, complete fittings, and make adjustments to the chair. The DME company that the ATP works for will run items through insurance for medical necessity and order the equipment.
Once the order for the wheelchair is submitted to insurance, the insurance company has 30 days to review and approve it.
- Finally, once the wheelchair is received, there would be a fitting and adjustments meeting with the ATP and DME manufacturer representative to ensure the wheelchair was made to the specifications provided and fulfills the client’s needs.
C. Important Things to Keep In Mind
- First and foremost it is very important to be a self advocate! While both the ATP and the DME manufacturer representative are highly knowledgeable, you ultimately are the one who knows the most about your situation and needs. Be vocal about what you need and want, listen to suggestions, but you make the final decisions!
- Do your own research! Before I even met with my doctor, I had already done quite a bit of my own research into different wheelchair companies and models, and had a relatively good idea of what I was looking for.
- Don’t be afraid to try to run something through insurance, the worst they can say is no. This is also why it can be helpful to have a knowledgeable PM&R write the prescription for the wheelchair. If there are features you desire on a chair but you are unsure if insurance will pay for them, having an experienced PM&R write you a letter of medical necessity with the prescription can sometimes make the difference between the features being denied or accepted.
We all know that dealing with insurance and the process of getting a new wheelchair can be a hassle sometimes, but I hope this post can help you navigate the process a little bit better.
Feel free to leave me a comment on Instagram or Facebook, and let me know what your experiences have been in getting new wheelchairs and/or equipment!