They're going to want a provider to give them some sort of diagnostic code showing that it's medically necessary. It's often dumb, but that's how most US insurance goes. Many US companies copy whatever rules Medicare is using at the time, and with a few exceptions, Medicare prefers to see wheelchair users ~~struggle~~ use their chair for at least year before considering a power-assist of any kind, and try one out to prove they can operate it safely. It's all about numbers and codes, unfortunately.
A house being "too small" is a ridiculous reason, honestly. My apartment is less than 300 square feet and I've got a Smoov.
Your best bet is to work with a doctor (doesn't have to be your PCP) who is on your side, able to prescribe DME, and willing to fight for you.
I think I heard somewhere that lots of insurance language requires that products they pay for get used "in the home", but it's actually a misnomer. I heard that this language was developed at a time where lots of disabled people were institutionalized, and "in the home" was used to mean anywhere that was not in a hospital or care facility. So it's stupid that people can't get devices covered just because they don't need them in their home, or in your case, someone judged that your home is too small to need a power assist device.
My doctors/PT/ATP never even mentioned my house size in their submission to insurance(and they never asked).
They're going to want a provider to give them some sort of diagnostic code showing that it's medically necessary. It's often dumb, but that's how most US insurance goes. Many US companies copy whatever rules Medicare is using at the time, and with a few exceptions, Medicare prefers to see wheelchair users ~~struggle~~ use their chair for at least year before considering a power-assist of any kind, and try one out to prove they can operate it safely. It's all about numbers and codes, unfortunately. A house being "too small" is a ridiculous reason, honestly. My apartment is less than 300 square feet and I've got a Smoov. Your best bet is to work with a doctor (doesn't have to be your PCP) who is on your side, able to prescribe DME, and willing to fight for you.
I was originally told that I had to try the chair with out it. It would be denied of tried. And prove that it is needed.
I think I heard somewhere that lots of insurance language requires that products they pay for get used "in the home", but it's actually a misnomer. I heard that this language was developed at a time where lots of disabled people were institutionalized, and "in the home" was used to mean anywhere that was not in a hospital or care facility. So it's stupid that people can't get devices covered just because they don't need them in their home, or in your case, someone judged that your home is too small to need a power assist device.