Advocacy Help for AT

By Aimee Sterk, LMSW, MATP Staff

My friend contacted me last week asking about the process for working with a nursing home to get his father, a resident in the home, a new wheelchair. It seems the nursing home suggested a very specialized wheelchair to meet his father’s needs, but when the home was told they had to provide the wheelchair out of their regular per diem rate, they were now suggesting a far cheaper, inferior option. That made me think it was time for another blog about advocating for AT needs.

There are a couple options to help you advocate for your needs for assistive technology (AT) or durable medical equipment (DME) in Michigan.

If you have a MI Health Link Plan (a combination of Medicare and Medicaid) the MI Health Link Ombudsman Program is here to help you access the DME you need if you have been denied coverage or are having trouble getting what you need. Call them directly—lawyers answer all the calls and are ready to help—at 888-746-6456. It is also possible to contact the Nursing Home Ombudsman program if the nursing facility is not providing needed AT at 866-485-9393 or 517-827-8040 for the State Long Term Care Ombudsman.

If you need help getting AT or DME through your school system, community mental health, the MiChoice Waiver, Medicare, Medicaid (or Medicaid funded nursing facility), or Michigan Rehabilitation Services (if employment related), contact Michigan Protection and Advocacy Services’ AT team at 800-288-5923. Michigan Protection and Advocacy Services receives direct federal funding to help people with disabilities of all ages access the AT they need.

The following is from Justice In Aging:

“Consumers with both Medicare and Medicaid face recurring problems getting approval for Durable Medical Equipment (DME), getting repairs, and finding reliable suppliers. DME includes many vital items, such as wheelchairs, walkers, hospital beds, home oxygen equipment, and even diabetes test strips used with a glucose monitor. ”

Some of the obstacles in getting access to DME include:

• Conflicting DME approval processes for Medicare and Medicaid
• DME access problems for people who have Medicaid first and then become eligible for Medicare
• Getting coverage for repairs, particularly getting Medicare coverage for an item originally obtained through Medicaid
• Differences between Medicare and Medicaid approved suppliers (many providers are approved for one program, but not the other)”

It is so important that people access the equipment they need to live in the setting of their choosing. Please, use the advocacy services to get the AT/DME you or someone you care about needs.

Have you contacted Michigan Protection and Advocacy Services for help with getting AT? Have you used an ombudsman program? What was your experience? What other advocacy tools have you used?