Learn about Insurance Reimbursement

Here's how insurance reimbursement works. Because we want you to get the lowest possible prices and the widest selection of quality products, Living Well Stores does not accept ("bill") Medicare, Medicaid or private insurance. Insurance and in particular, Medicare places huge restrictions and burdens on dealers that often translate to higher prices and more limited selection for healthcare products that customers are purchasing on their own.

 

Can I buy from you and then get reimbursed?
For things other than power mobility products (we talk about those below) you can certainly try to get reimbursement. Your success will depend on the exact circumstances of your need, whether a doctor wrote a prescription for your required product and whether you file all the appropriate billing paperwork correctly.

Can you supply an invoice that I can submit to insurance?
We will of course, supply you with an invoice showing what you purchased, for how much, when purchased and how it was paid. But often insurance companies and Medicare have special invoice requirements. Because of the complexity, we do not have or supply any other kind of invoice, nor can we complete or sign one you may have located elsewhere. 

What about power mobility scooters and insurance?
If you ever watched late-night television, you’ve seen the claim: “Your power chair (or scooter) will be paid in full by Medicare.” 

It’s hard to believe those promises go back over ten years ago. In those days rampant fraud cost taxpayers almost a billion dollars a year. Then Medicare (and private insurers too) rewrote the rules. Today, you might still be able to have insurance pay a portion of the cost of your scooter but it’s complicated, time-consuming and just plain unlikely. Additionally, the “Medicare approved” choices are often the least innovative and desirable products available.

Here are typical steps and requirements you might have to go through in order for Medicare or other insurance to pay:

  1. You must see your doctor in person and discuss your need with them.
  2. Your doctor must certify in writing that you require a mobility product to get around inside your home. In other words, insurance will only consider your claim if you need one to get from the living room to the kitchen, bedroom to bathroom, etc. Insurance will not pay for you to have a scooter to get to or around the shopping mall, sporting events, etc. Your doctor will be certifying this under penalty of criminal prosecution, so you can expect her to be very cautious.
  3. You will then need to bring the doctor's orders to a scooter dealer in your area who is registered to accept your insurance or Medicare ("in-network"). Your insurance company or Medicare will not let you shop just anywhere.
  4. The dealer will recommend a scooter model based on your needs and which insurance/Medicare approved models that he sells.
  5. Unless you have additional insurance coverage for medical equipment, you will be expected to pay 20% of the cost and insurance will pay 80%. Because of the costs involved in accepting and billing Medicare, the dealer’s price will be anywhere between 30 and 70% higher than prices you’ll find with companies like us. Oftentimes, the portion of the purchase price you'll be expected to pay comes close to what you'll pay for your power mobility product out of your own pocket.

 

Can I buy from Living Well Stores and then file for reimbursement?
Some scooter purchasers have been told by their insurance company that they could purchase the scooter of their choice and then “file for reimbursement”. If the experiences of hundreds of other customers are any example, the answer is that it’s unlikely you’ll actually get any reimbursement. In most cases, after spending months gathering all the paperwork, filling out forms, submitting documentation and making follow-up phone calls, your claim for reimbursement will be denied.

If you file for or receive insurance reimbursement, you cannot use our extended warranty
There’s one last thing you should know. We are not able to honor an extended warranty claim if you attempt to receive or actually receive reimbursement from an insurance company or Medicare for your power mobility product. So, for instance if your Living Well Stores scooter should need service after the manufacturer’s warranty has ended and when you purchased it, you applied for or received reimbursement with your insurance company or Medicare, you would have to pay for those repairs yourself. 

The bottom line
Living Well Stores is committed to the highest ethical business standards and to delivering the best possible shopping experience, the best selection of products and best overall prices.

Have questions about this or any other topic? Click here to write us. 

Living Well Stores is awarded the 2018 Better Business Bureau Torch Award!

Presented annually since 1996, the International Torch Awards for Ethics honor just 200 companies nationwide that demonstrate best practices, leadership, social responsibility and high standards of organizational ethics that benefit their customers, employees, suppliers, shareholders and communities. The award embodies the Better Business Bureau mission of advancing trust in the marketplace. The International Torch Awards are brought to you by the Better Business Bureau Institute for Marketplace Trust.