Increasing Independence for Nate
Due to spina bifida and developmental delays, four-year-old Nate is unable to walk, stand or crawl independently. He has always relied on a caregiver to carry him from place to place or push him in a toddler stroller to get where he needs to go. This summer, Nate’s team of doctors and therapists recommended a power wheelchair, which would increase Nate’s independence and allow him to explore and interact with his environment at home, school, and in his community. Nate tested a power wheelchair and immediately his parents noticed a positive improvement as they watched Nate navigate his surroundings independently for the first time in his life.
But Nate’s Medicaid insurer denied coverage for a permanent power wheelchair. Fortunately, his parents turned to PHLP for assistance.
We challenged the insurer’s denial and worked with Nate’s parents and his medical team on stronger letters of medical necessity and other supporting documentation. Nate’s parents even borrowed the wheelchair a second time and took videos of Nate using the chair in his home and community to prove how beneficial it is for him. Once this new information was submitted to Nate’s insurer, they immediately overturned their denial and approved the power wheelchair.
Nate has been using his power wheelchair for the last few weeks, and his parents report that he is happy to be on the move!