Evercare, will insurance cover group 4 chairs?

[Windjammer]

Evercare is suppose to cover what medicare C does. I am asking if it will cover the cost of a electric chair group 4. They are trying to be a PPO for me and I don't trust the concept or the salesman. Do they cover DME's with Pride? and what does Pride think of the insurance company. Has Pride worked with these people?

[Windjammer]

ok, I did my home work. I looked up the EverCare company and all the promises they had mentioned. I called Medicare and they said there was a type of scam going on with 90% of sales people saying they are being paid by medicare to go out and sell these exstened insurance coverage, medicare C.

They are not hired nor does medicare or medicaid suppport their efforts to exstend any kind of insurance coverage and there is no such thing as medicare or medicaid part C, which EverCare claims to be covering only threw them. So, DME providers do not seem to reconize this insurance company nor do they cover group 4, 3 chairs. I did not hear from Pride and what they think about this company. I am understanding that there are quite alot of companys that are falsely representing themselves. They are not connected to medicare or medcaid.

There was 3 providers I did contact. They returned call with, all saying, do not contract with them there is a hidden co-pay that people with limited income can not afford.

[bulldog]

The person that told you there is no such thing as Medicare Part C, did not know what he/she is talking about.

Take a look at:

http://www.medicareconsumerguide.com...re-part-c.html

Evecare may be a scam, but you can't take everything that a Medicare functionary says as gospel

[Windjammer]

Thank-you Bulldog for the site. It was a medcare person on the phone that told me there is no part C.

[dretto]

Your home owners or rental fire ins. will cover your scooter. Check it out.

[bulldog]

Yes, do check it out. Your insurance company may require you to buy a rider. That was my situation. But the cost was hardly anything.

[Windjammer]

thanks bulldog and dretto. the insurance I was looking at with evercare was a PPO that was suppose to do what medicare was suppose to do. I don't make enough to purchase any kind other insurance even my funural bill will haver to go to the state.

I am on medicare and medicaid and they do pick up what I need not what I want but EverCare said they are suppose to take the place of medicare as a ppo and they did not cover half of what medicare does, like DME's, dental. When I talk to providers they said to stay with medicare. With your help bulldog (ty), I looked up medi part C and I am starting to understand a little better what is available and is passing the information on to my providers. I won't get a new chair but will keep my Jazzy 1122 and TDX5 and just maintain them. They are good chairs with alot of milage on them but medicare/medicaid will maintain them. I just have to learn more about Medi part C.

ps. the new dentures are being picked up by medicare and 20% is going to medicaid. My cost O%

[Corey Lewis]

Windjammer,

I'm going to have one of our Medicare folks here have a look at your questions and help get you some answers.

[Windjammer]

thank-you Corey, I would appreciate that very much.

[dretto]

Cory
My provider sent in an order for a XLQ6000 today 7-30-08 how long will I have to wait before I get it?

[Windjammer]

Originally Posted by Corey Lewis

Windjammer,

I'm going to have one of our Medicare folks here have a look at your questions and help get you some answers.

Corey, I know you did not forget. The more I have been looking into this Ever Care people I am finding poor review. Not only to their performance in helping poeple but with not covering many simple script filling. It does not seem to be the company the represenative that came to my house is saying. When I had called medicare on them, they confirmed that this company is not on the up and up.

Has any one at Pride dealt with them yet and what was the out come. I am looking at a DME purchase.

[Paul Komishock]

Depending on the type of plan it is (Medicare Advantage, Medicare HMO, etc.) there are only a few basic rules they'd have to follow. If it's a private insurance not associated with medicare at all, they can determine their own policies. While I'm not familiar with this particular insurer, any Medicare plan that's not original Medicare has to at least offer similar coverage that original Medicare would offer. So a Group 3 chair would be covered if you had a qualifying diagnosis, but a Group 4 chair wouldn't necessarily have to be covered (unless that was part of the advantage to joining that insurer's program).

[jerryatric]

Hi to you guys I have just been reading your comments re insurance and funding. I was very lucky as my GO GO was purchased for me by my ex service association and my home insurance covers it for accidents and theft. Ex service persons in the U.K can get assistance with all types of aids through our Royal British Legion and SSAFA . do your ex service persons get helplike that over there?

[Windjammer]

jerryatric, my chairs were purchased by medicare (federal) medicaid (state). They picked up the hole bill. I think I am very lucky to have this kind of health insurance from the fed and state. They cover pretty much all my needs if I show a justification for the iteams. There has been new changes to medicare guidelines and they can be confusing. I will stick to my primary insurance as medicare, secondary insuance medicaid. I was put on them from SSDI and SSI.

I think the VA does cover purchases for DME for our vets. but one of those guys will have to answer that for you.

[akrvvers]

The Veterans Administration purchased my Q600. I'm not sure, but I think the dissability must be service conected before they do.

[gamel]

Evercare®, one of the nation's largest health care coordination programs, today announced it has received approval from the Centers for Medicare and Medicaid Services (CMS) to offer the first Medicare Advantage Special Needs Plan for people with Alzheimer's disease and chronic dementia. The Company also announced it will expand its portfolio of Chronic Illness Special Needs Plans, designed for people with a high burden of illness due to complex health conditions such as heart disease, diabetes and chronic obstructive pulmonary disease (COPD).Evercare continues its legacy of providing innovative approaches to health care coordination by offering the first Medicare Advantage Special Needs Plan designed exclusively for Medicare beneficiaries with Alzheimer's disease and chronic dementia.

[dretto]

Gamel
How does a person sign up for Evercare?

[jayidian]

thanks for information!

[dretto]

Where are you from? I'm from northern Mn. & I have a great provider. They bend over backwards to help.I hope you find a good one.