Qualifying Diagnoses for Wheelchairs

Qualifying Diagnoses for Wheelchairs

Are you or a loved one struggling with mobility? A wheelchair can offer newfound independence and freedom. However, navigating insurance coverage and understanding eligibility criteria can be overwhelming. This guide will explore:

At Freedom Mobility, our goal is to empower patients in California with the perfect mobility solution. Here’s which diagnoses may qualify you for a wheelchair and how to navigate the process.

• Qualifying diagnoses for custom and standard wheelchairs
• Steps for getting approved for a power wheelchair

• Muscular Dystrophy
• Myopathy, Congenital
• Osteogenesis Imperfecta
• Paraplegia
• Parkinson’s Disease
• Post-Polio Syndrome
• Progressive Muscular Atrophy
• Schilder’s Disease
• Spinal Cord Injuries
• Spinal Muscular Atrophy
• Spina Bifida
• Spinocerebellar Disease
• Transverse Myelitis
• Traumatic Brain Injury
• Werdnig-Hoffman’s Disease
• And many others

Qualifying Diagnosis for Standard Wheelchairs 

If you’re unsure whether your patient's diagnosis qualifies for complex rehabilitative mobility equipment, get in touch with us and our Intake team can assist you. For those patients with less complex needs, we have a wide variety of standard power and manual wheelchairs, scooters, and other home medical equipment products. Some diagnoses that may potentially qualify your patient for a standard power or manual wheelchair include:

• Arthritis
• COPD
• Congestive Heart Failure
• Degenerative Disc Disease
• Diabetes
• Diabetic Neuropathy
• Fibromyalgia
• Osteoarthritis
• Obesity
• Scoliosis
• Sciatica
• Stroke
• And many others

How Do You Get Approved for a Power Wheelchair?

Getting a power wheelchair covered isn't just about your diagnosis. Insurance companies examine your ability to move, your medical history, and how much you need the chair. They may also ask you to try cheaper options, like a manual wheelchair or walker.

Here’s how to make things go smoothly:

1. Talk to your doctor: Discuss your needs and limitations. They can assess if a power chair is right for you and provide the necessary documents.

2. Contact your insurance: Understand their requirements for approval. They might need documents from your doctor, like medical records, functional assessments, and a power chair prescription. 

3. Complete the claims process: Your insurance will review your case and decide if you qualify. They’ll process the claim and tell you about your coverage.

4. Choose your chair: If approved, choose the right chair for your needs. Work with a reputable mobility provider like Freedom Mobility to find the perfect solution.

5. Enjoy your freedom: Once you select your power chair, a trained specialist will deliver and adjust it. They'll ensure the chair fits and provide instructions on how to use it.

If you have Medi-Cal as your insurance, check out these blog posts (Does Medi-Cal Cover Power Wheelchairs? and Does Medi-Cal Cover Wheelchairs?) for a detailed understanding of your coverage options.

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