Thursday, July 9, 2009

Oh, is that a MOTORIZED scooter? Kay's Insurance Saga

She looked like a kid on Christmas morning as she flew through Target. It was her first ride on a TravelScoot, and it didn't take long to see it as a manageable way to ease the pain associated with walking long distances.

"She" is my sister Kay, who lives in New Jersey and works in New York city. Her commute begins with a long drive to the ferry, then there's the hike from the parking lot to the ferry, and once the ferry lands there's a seven-block trek to her office. Every evening is a repeat of the same process. Can you imagine doing this 5 days a week? And can you imagine doing it when a medical problem makes it very painful to do so?

One of the benefits of Kay's insurance plan is that they cover medically necessary mobility equipment. What they don't mention in the plan documentation is how hard it is to navigate the process to get this equipment. On this blog we're going to follow her progress, which hopefully will soon come to a successful conclusion.

The phone calls

Call #1) The customer service rep told Kay that she needs to have her doctor (or a representative from his office) call and give pre-cert information.

Call #2) Kay called to get additional information about call #1, only to be told that she was given incorrect information during call #1. What Kay needs to do is to ask her doctor to write a letter of medical necessity, which he did.

Call #3) With the letter of medical necessity in hand, Kay calls the insurance company again to find out how to proceed, only to be told that she received incorrect information in call #1 and #2, and that her insurance does not cover scooters. Maybe wheelchairs, but not scooters. When Kay questioned her, at some point the rep said, "Oh, is that a motorized scooter?" She wouldn't admit that she'd been wrong when she said they didn't cover scooters, but she proceeded to tell Kay that she needs to have her doctor call and give pre-cert information.

We're still in the middle of the story, but as new information emerges, I'll be posting it here.

If you have tips, tricks, or advice to share, or if your insurance paid for your TravelScoot, please post comments here about it or email them to me at Thanks!

1 comment:

  1. I hope Kay gets the insurance to pay for her scooter.. but if they wont pay, I hope she buys one on her own. It sounds like she could really benefit from one. I can't imagine making the trip she does everyday to work without a scooter.