Most commercial insurance carriers don’t cover loaner equipment for CRT users? 

It’s common to expect a loaner or rental car coverage when your vehicle is being repaired, but most commercial insurance carriers don’t cover loaner equipment or the associated temporary replacement fee for CRT users while their chair is being repaired. Medicare, on the other hand, does cover a temporary replacement during a repair, but only for one month. Because of other factors that extend the CRT repair timeline, such as prior authorization requirements, repairs can sometimes take up to two months to be completed. 

Educate Yourself: Temporary replacement coverage can differ depending on your insurance carrier. Seek to understand your health plan benefits, including any provisions regarding temporary replacement when your primary chair is being repaired.

How Would Temporary Replacement Coverage Help CRT Users?

CRT equipment is highly customized and specifically tailored to each user’s needs—so a lengthy repair isn’t just an inconvenience. CRT equipment ensures users can live their lives with optimum mobility and independence, and repairs often leave users without the equipment they need to do so. Loss of mobility and independence often lead to lost wages, missed appointments and time with friends and family in addition to potentially dangerous medical complications. Temporary replacement coverage would help CRT users by: 

• Since many CRT users don’t have reliable backup chairs, temporary replacement coverage would ensure CRT users have the ability and equipment needed to keep moving through their daily lives, even though the replacement chair may not be customized to meet all of their customized needs.  
• Temporary replacement coverage would help reduce health risks associated with loss of mobility. 
• Temporary replacement coverage may enable CRT suppliers to maintain a wider range of loaner options, though replacement chairs are not a direct replacement and cannot be customized to fit every CRT user’s specific needs. 

Did You Know You Can Make a Difference?

As a CRT user, your experience can help legislators and health insurance carriers understand the value of coverage for wheelchair replacement. You can help by: 

Research What’s Happening in Your State: Follow advocacy organizations like NCART, iNRRTS, AAHomecare and other advocates to stay up-to-date about ongoing efforts and learn what is happening in your state. 

Share Your Story: Lawmakers may not fully understand the positive impact temporary wheelchair replacement coverage could have on your daily life. By sharing your story and real examples of how having access to a loaner chair would affect your life, work and health, you can help them understand the benefits temporary replacement coverage would provide. Find your elected officials. 

Did you know that temporary replacement coverage is only one of several issues currently creating barriers for CRT users? Learn more.

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For Complex Rehabilitation Technology (CRT) users, a wheelchair breakdown isn’t just an inconvenience. It means that daily life is on hold indefinitely. While most mobility equipment is designed to last five years, the wearable key components will require maintenance and replacement to keep your chair running its best and avoid catastrophic failures — which can mean missing work or school, being bed-bound or facing potential health risks. 

For CRT users, it’s not a question of if they’re going to experience a chair failure, but rather when. Research has shown that 64% of wheelchair users experience a failure in a given six-month period. Recent research has also shed light on the scope and impact of these failures—and what the data reveals is cause for attention.

Common Parts that Don’t Go the Distance

Mobility equipment is highly customized, often comprised of thousands of components. Just like a car or home appliance, the wear and tear caused by daily use takes its toll, sometimes leading to chair failure. 

For manual wheelchairs, research has shown that some of the parts that fail most frequently include: 

• Casters,
• Tires,
• Bearings,
• Armrests, and
• Footrests. 

Power chair users face failures in all the same areas with a few additional vulnerabilities, including: 

• Electronics,
• Batteries, and
• Motors/actuators. 

Recent research has shown that on average, these parts last about two years—less than half the expected five-year lifetime of the chair. This isn’t a quality issue, but due to the wear and tear of an active life. You’d never expect your car’s tires or brakes to last the entire lifetime of the vehicle, and CRT equipment that is used day in and day out to ensure independence and mobility is no different. 

Those with More Complex Mobility Needs Face a Higher Risk of Chair Failure

More complex mobility needs result in highly customized, complex mobility equipment—which means an increased number of parts and components that could potentially fail. 

CRT equipment is highly customized, meaning a CRT user with spinal muscular atrophy (SMA) needs a wheelchair that’s tailored to meet his or her individual needs, which may differ widely from those of other wheelchair users with different diagnoses. Customizations can range from custom seating systems that help with posture and pressure relief to advanced positioning like recline or tilt, alternate drive controls and more—but each addition adds to the complexity of the equipment and increases the number of components that could potentially fail. 

Research proves that point. In a 2021 study, researchers analyzed more than 6,000 caster failures across five wheelchair models, including manual and power chairs. The results? 

• Users of tilt-in-space manual chairs experienced high-risk failures twice as often as users of ultralightweight manual chairs. 
• Users of Group 3 and 4 power wheelchairs, often prescribed for CRT users with the most complex mobility needs, faced 15–26% more high-risk failures than Group 2 users. 

There Are Real Consequences to CRT Breakdowns

A 2018 study published in Archives of Physical Medicine and Rehabilitation found that when a breakdown had immediate consequences—such as being stranded, injured, or missing work or appointments—CRT users: 

• Reported higher pain levels and poorer perceived health,
• Were about 2 times more likely to be rehospitalized, and 
• Face a higher likelihood of developing pressure sores within 12 months. 

In addition to medical complications, breakdowns can also affect income, mental health and participation in work, family and community life. 

Why Preventive Maintenance Matters

It’s impossible to engineer mobility equipment with parts that will never fail—but research has shown that if preventive maintenance were a covered benefit, we could help more CRT users avoid catastrophic failure, injury, medical complications and many other adverse consequences. 

Currently, most insurance carriers don’t cover preventive maintenance for CRT equipment, so CRT users must wait for a part to fail before they can get it repaired. Studies have shown that regular maintenance can reduce accidents, lower long-term repair costs and improve outcomes.

Mobility equipment technology continues to evolve—but insurance provisions for preventive maintenance on that equipment has not. Learn more about why preventive maintenance should be a covered benefit and how you can advocate for change. Let’s get moving together to make a difference.

The post Like Cars, Wheelchairs Need Regular Maintenance appeared first on NSM — National Seating & Mobility.

While preventive care, such as bi-annual dental exams, preventive screenings and physical exams, is routinely covered by health insurance providers, preventive maintenance for CRT equipment is generally not covered. As a result, many CRT users feel they must wait for a part to fail before seeking a repair, which often leads to longer repair times, decreased mobility and independence, lost income, missing out on family and social events, and sometimes even contributes to medical complications.

How Would Coverage for Preventive Maintenance Help CRT Users? 

CRT equipment is highly customized and often comprised of thousands of components. Since CRT users use mobility equipment daily, the wear and tear adds up. Parts wear out or require frequent maintenance to keep the wheelchair working at optimal levels. Like routine oil changes or tire rotations on a car or scheduled tune-ups for household appliances, preventive maintenance for CRT equipment would benefit CRT users and their caregivers in several ways:

• Reducing catastrophic equipment failures by catching wear and tear before it contributes to additional damage or malfunctions.
• Ensuring frequent adjustments so that the chair is configured to a CRT user’s specific needs, including posture, alignment, pressure distribution, comfort and more. 
• Reducing health risks that can develop when a CRT user is immobile or incorrectly seated, such as pressure sores and musculoskeletal issues or falls and collisions caused by equipment failure.
• Preventing loss of mobility, allowing CRT users to work, spend time with friends and family and keep moving through their lives.
• Minimizing repair wait times since catastrophic equipment failures often lead to lengthy repairs and allows CRT users and caregivers to plan ahead for routine maintenance rather than deal with an emergency when a chair fails.

What Does Data Reveal about the Value of Preventive Maintenance for CRT Equipment? 

Researchers have conducted several studies that point to the value of preventive maintenance for CRT equipment in preventing injuries, accidents and medical complications. Chair failures can also affect income, mental health and participation in work, family and community life, which studies have noted as well. 

Here are a few highlights: 

• Research has shown that proactively checking up on equipment can lead to fewer accidents.
• While most CRT equipment is intended to have a five-year “useful life,” a number of components and parts routinely fail before that. These include casters, tires, bearings and more for manual chairs and electronics, batteries and motors for power chairs. 
• The more complex the mobility equipment, the higher the probability of a high-risk chair failure, often affecting CRT users with the most severe diagnoses and need for mobility solutions. 
• When a chair failure results in immediate consequences—being stranded, missing work or appointments—CRT users face a higher likelihood of developing pressure sores or being hospitalized. 

Learn more about the research that supports the value of preventive maintenance in ensuring CRT users can enjoy the highest levels of mobility and independence possible. 

Educate Yourself: Tennessee was the first state to enact legislation requiring its state Medicaid program to cover annual preventive maintenance for CRT equipment but legislation is under discussion or consideration in several states. Tennessee’s legislation, which took effect in July 2024, requires qualified technicians to perform all preventive maintenance services under manufacturer guidelines. Learn if legislation is being considered in your state. 

Did You Know You Can Make a Difference? 

As a CRT user, your experience can help legislators and health insurance carriers understand the value of coverage for preventive maintenance. You can help by: 

Research What’s Happening in Your State: Follow advocacy organizations like NCART, iNRRTS, AAHomecare and other advocates to stay up-to-date about ongoing efforts and learn what is happening in your state. 

Share Your Story: Lawmakers and health insurance providers may not fully understand the positive impact preventive maintenance could have on your daily life. By sharing your story and real examples of how equipment failures have impacted your life, work and health, you can help them understand the benefits covering preventive maintenance would provide. Find your elected officials. 

Make Your Voice Heard: In many ways, private healthcare insurance providers follow the example of Medicare and Medicaid. Call the Centers for Medicare and Medicaid Services (CMS) directly at 1-800-633-4227 to urge coverage of preventive maintenance. 

The post Did You Know: Preventive Maintenance appeared first on NSM — National Seating & Mobility.

Most private health insurance carriers and state Medicare or Medicaid programs do not cover transportation to wheelchair evaluation or repair appointments. Coverage that does exist varies widely by state and provider. If CRT appointments are covered under non-emergency medical transport (NEMT) provisions, health insurance carriers often set specific medical necessity requirements that CRT users must meet. In many cases, a healthcare provider must make the request for transportation and provide documentation that it is medically necessary. 

Educate Yourself: To learn more about what’s included or required in your state’s Medicaid program, please reach out to your state’s Department of Health and Human Services or comparable department. Find your state’s department here. If you’re covered by a private insurance carrier or Medicare, reach out to your insurance carrier for more information on what types of transportation may or may not be covered under your plan and the process for using those benefits to cover transportation to your CRT branch appointments.  

How Would Covering Transportation Help CRT Users? 

When it comes to CRT equipment, there’s no “one size fits all.” Each mobility device is highly customized to meet each individual user’s specific needs. A customized manual or power wheelchair can consist of a variety of individual components—all of which require frequent adjustments and repairs since CRT equipment is used on a daily basis. Because of this level of customization, many repairs need to be made by certified technicians. If CRT users can’t travel to their wheelchair provider for an appointment, the technician will come to them. 

Data tells us that 85% of repairs are completed in the home, and in-home repairs are always an option, especially for CRT users who are unable to travel due to their condition or other factors. But if you choose an in-branch appointment, there are benefits including:  

• In-branch repairs give technicians access to more parts than can be stocked on a van as well as specialized equipment/tools and the space needed to complete complicated repairs. 
• If an additional repair or maintenance need is discovered, the technician may be able to complete them without scheduling a follow-up appointment. 
• Technicians can see more CRT users in a day and serve them more quickly. 

If Medicaid, Medicare and private health insurance carriers covered wheelchair evaluation and repair appointments under their NEMT provisions, more CRT users would have access to their local branches for CRT-related appointments, protecting their health, preserving their independence and helping to keep their wheelchairs in optimal working condition.

Did You Know You Can Make a Difference? 

As a CRT user, your experience can help legislators and health insurance carriers see the need for change. Here’s how you can help: 

Pay It Forward: If you are able to travel to a local branch for a repair appointment, please consider doing so. This often results in a quicker repair timeline for you and allows technicians to prioritize CRT users who cannot travel due to diagnosis, condition or other factors with in-home appointments, ensuring everyone gets the help they need as quickly as possible. 

Share Your Story: Reach out to your state’s health and human services department and elected officials at both the state and federal level and explain how accessible transportation policies affect you. Find your elected officials. 

Make Your Voice Heard: Contact your health insurance carrier or Medicaid advisory groups. Call the Centers for Medicare and Medicaid Services (CMS) directly at 1-800-633-4227. 

The post Did You Know: Transportation Coverage appeared first on NSM — National Seating & Mobility.

Prior authorization is basically asking your health insurance carrier for permission before ordering the parts to complete a repair on CRT equipment that has previously been approved as medically necessary. The process involves submitting several documents and a variety of information to your insurance provider for approval. These often include: 

• A prescription,
• A repair evaluation; 
• An equipment or repair estimate, and 
• A Letter of Medical Necessity (LMN). 

Educate Yourself: Prior authorization requirements can differ depending on the health insurance carrier. Learn about your insurance carrier’s requirements and who is responsible for each step in the process so you know who to reach out to if documentation is missing or delayed. Also note, if you change health insurance carriers at any time during the repair process, you will have to start the process over with your new health insurance carrier as they likely have different prior authorization requirements.

How Would Changing the Prior Authorization Process Help CRT Users? 

Prior authorization creates bottlenecks in the process, delaying CRT users from getting the repair they need to achieve the level of independence and mobility they desire. Reforms to the prior authorization process and requirements would shorten the repair timeline and help CRT users keep moving, allowing them to enjoy daily activities and avoid additional health problems such as respiratory issues or pressure injuries that can develop from not having regular use of their customized mobility equipment.

A few ways prior authorization can slow down the process of making timely repairs include: 

• The authorization process is lengthy, often requiring several types of documentation to be completed by different members of the CRT user’s care team, including physicians, therapists and Assistive Technology Professionals (ATPs). Waiting for approvals from your health insurance carrier often makes up for nearly half of the repair timeline, adding one to four weeks to the process. 
• Authorization is required before ordering equipment or parts needed for a repair. It takes time to order, repair and deliver CRT equipment, and CRT providers cannot start the process until the health insurance carrier has approved. 
• If prior authorization is denied, you must appeal the decision, which often means submitting or resubmitting additional documentation and waiting for the health insurance carrier’s decision. 
• Even if your chair was previously approved and determined medically necessary, your health plan may require you to submit a prescription or Letter of Medical Necessity for most repairs—even replacing a battery. Learn more.

What Are Some Potential Solutions to Improve the Repair Timeline Process Related to Prior Authorization?

Reforms to prior authorization are needed to improve the CRT experience for users and their caregivers. These include: 

• Removing requirements for a prescription and a statement of medical necessity for repairs to equipment that has already been approved as medically necessary.
• Removing prior authorization or establishing a threshold up to $1,500 for minor repairs or frequently replaced parts to reduce unnecessary wait times and keep CRT users moving.  

Did You Know You Can Make a Difference? 

As a CRT user, your experience can help legislators and insurance carriers see the need for change. Legislation that seeks to remove or limit prior authorization is currently being considered in several states. You can help by: 

Research What’s Happening in Your State: Follow advocacy organizations like NCART, iNRRTS, AAHomecare and other advocates to stay up-to-date about ongoing efforts and learn what is happening in your state. If legislation is under consideration in your state, research and seek to understand how it would change the prior authorization process for you and your health insurance carrier. 

Share Your Story: Reach out to your insurance carrier and elected officials at both the state and federal level and explain how changes to prior authorization requirements would improve your daily life. Find your elected officials. 

Make Your Voice Heard: In many ways, private health insurance plans follow the example of Medicare and Medicaid. Call the Centers for Medicare and Medicaid Services (CMS) directly at 1-800-633-4227 to changes to prior authorization requirements. 

The post Did You Know: Prior Authorization appeared first on NSM — National Seating & Mobility.

Most of the time, catastrophic equipment failures don’t just happen. There are usually signs your CRT equipment needs attention and recognizing them means you can get the appropriate service needed before significant damage is done. Let’s consider a few of the top signs your CRT equipment might be ready for a tune-up. 

1. It hasn’t been serviced in a while.

If it’s been more than a year since you had your CRT equipment evaluated, there’s a good chance it needs some attention. The level of wear and tear depends on your lifestyle, but daily use can result in loose bolts, casters that need to be cleaned and other adjustments that need to be made to your wheelchair on a regular basis.

2. Your chair is suddenly hard to maneuver.

Whether you use a manual or power chair, if it suddenly becomes difficult to push or maneuver, it’s time to set up an appointment with your equipment supplier to have it checked out. Resistance, stiffness or jerky motions in power or manual wheelchairs can all suggest issues that need to be taken care of sooner rather than later.

3. Your chair starts making a new or unusual noise.

Noticing a squeak, rattle, grinding, or clicking noise? These sounds could indicate loose components, dirty casters, or worn-out parts that need repair. A registered technician can diagnose the problem and recommend needed maintenance to keep your chair in working order.

4. Your chair’s battery isn’t holding its charge as long.

If you use a power chair and start to notice decreased battery life, it’s time for an evaluation. Over time, batteries lose their ability to hold a full charge, so this could indicate normal wear and tear, but could also point to a faulty charger, inadequate charging habits, electrical issues or other factors that affect battery life. Talking with a technician about your lifestyle and needs can help highlight specific causes and allows the technician to test the battery and electrical system to ensure everything works properly.

5. You notice visible wear and tear or feel extreme discomfort.

Because you use your CRT equipment on a daily basis, wear and tear is normal, but you need to keep an eye out for worn or deflated tires, dirty or worn casters or any changes to your equipment that cause discomfort or instability. If you notice loose bolts, squeaky wheels, or worn-out casters, contact your CRT provider and they can evaluate your chair to determine if anything needs to be replaced or repaired.

You’re the first to notice changes in your CRT equipment. If you detect any of these issues, set up an appointment with your wheelchair provider.

If you already work with National Seating & Mobility (NSM) or are looking for a new CRT provider, contact your local NSM branch to set up an appointment to evaluate your equipment. In some cases, a remote evaluation may be possible to help diagnose the problem. 

Click here to schedule an appointment with your local NSM Branch!

Take Action

Contact lawmakers to discuss the importance of preventive maintenance for CRT users. Simply share your story! 

Looking for a few small maintenance tasks you can perform to help extend the life of your chair? Read this article. 

While research has shown that preventive maintenance can play a vital role in preventing catastrophic failures, most insurance providers do not currently cover it. NSM and other industry advocates are supporting research and proposing legislation to make the case for preventive maintenance coverage, and several states are considering legislation that would provide coverage for preventive maintenance.

Follow advocacy organizations like NCART, iNRRTS, AAHomecare and other advocates to stay up-to-date about ongoing efforts and learn what is happening in your state.

The post 5 Signs Your Complex Rehabilitation Technology (CRT) Equipment Might Need a Tune Up appeared first on NSM — National Seating & Mobility.