Obtaining a Power Wheelchair through Medical Assistance 
by Dave Lerch 

How to obtain a power wheelchair if you have Medical Assistance as your primary coverage is a frequently asked question by those who need the equipment and others. There is a process, and once you understand that process, and follow the necessary steps it makes a world of difference in the amount of time and effort it takes to secure the equipment. The process outlined below is specific to Medical Assistance, many of these steps are required by Medicare, HMO's and other private insurances; 

1. Contact your physician and request a prescription. You may have to discuss your needs with him/her before you proceed, but a " prescription is necessary". 
2. Contact a Durable Medical Equipment supplier who is a Medical Assistance provider. The supplier you utilize is your choice., and should be assisting " you" throughout the whole process including the documentation end of it. The supplier will provide a mandatory MA97 form, which the supplier fills in a portion of the form and forwards it to your physician for completion. You should work with the supplier on the type of equipment you want according to your specific needs, such as seating and positioning components. 
3. You must make an appointment with an approved MA rehabilitation center to be evaluated for the equipment. A therapist will evaluate your needs and fill out the evaluation form which will determine the medical necessity of the equipment. This evaluation is absolutely required and it would be in your best interests if your supplier of choice was present to assist with recommendations and work in conjunction with you and the therapist.
4. The prescription, evaluation and the MA97 form, along with a narrative/letter from the physician and therapist are sent; along with product literature and specifications to the Medical Assistance office in Harrisburg for approval or prior authorization. The narrative/letter is a supporting document that justifies the need for the equipment and any special adaptations that may be necessary. The documentation is reviewed and a determination is made. You the beneficiary will be notified via mail usually within 30 days of submission. If you are denied, there will be an explanation as to why you were found ineligible. If approved, you must forward the approvals to your supplier for them to order the equipment. Equipment will not be ordered without the prior authorization paperwork. It is your responsibility to ensure the supplier receives the appropriate paperwork 
5. Once the supplier receives the paperwork from you (the beneficiary) they will review what will be ordered and may do some final measurements to ensure the specifications are correct. It is important to realize that in the narratives and on the evaluation form to qualify for a power wheelchair you must be unable to self propel a manual wheelchair. A statement in the narrative must reinforce that fact. If the Therapist or the physician documents that you are able to self propel you will be deemed ineligible for a power wheelchair. 

It is crucial that you remain pro active throughout this process. The closer you work with your supplier the better. You want to ensure that you express your needs and concerns accurately in order to facilitate the process. You also want to monitor the paperwork process, since the documentation part of the process determines eligibility. Make the necessary phone calls to all involved, will ultimately lessen the process. Don't expect others to do it all for you. Generally speaking the more involved you are in the process, the more likely your equipment will arrive in a timely manner. The average length of this process, from the time of your appointment at the rehab center, to the point of receiving the equipment, is a minimum of 60 to 90 days.

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