On this Friday’s Halloween edition of the podcast, we talk about the latest health policy news and hear patient horror stories about insurance delays, the high cost of care, and so much more.
We are sad to announce that this is the final show for our field correspondent, Kate Pecora. But to honor her time spent speaking with patients and caregivers in the Patients Rising community, we are sharing her story this week.
Kate lives with spinal muscular atrophy (SMA), which requires her to use a wheelchair. But getting medical devices covered by insurance is not always easy. Here’s a preview of Kate’s story.
Kate Pecora: “I can't tell you how many phone calls I had to make specifically to the insurance company, and then to the durable medical equipment company and to my doctors. I think in total I probably spent a week's worth of working hours on getting this chair, and that is the experience of nearly everybody that I have talked to that has ever had to go through this process, specifically of getting anything of greater value than $5,000.
So I can tell you my chair is an ultra-lightweight manual wheelchair and so for me, off the shelf it would've cost around $6,000. Some of these wheelchairs can cost up to 30, 40 thousand dollars depending on the type of equipment they have, the functionality, whether it's a standing chair or something like that. So, you know, insurance companies are gonna drag out this process as long as they can to say something isn't medically necessary.
I think for me, the biggest kind of joke was when I received the first denial of my wheelchair and in context, I've used a wheelchair since I was around 10 to 12 years old is when I really started using it for daily use. My particular insurance company said that it was not medically necessary for me to be choosing a wheelchair. It’s ridiculous, and so that started the whole appeal process, which lasted the full 30 days, so that was a whole month.”
Kate shares her full story and the fight to finally get the wheelchair she needs in this Friday’s episode.
