DREDF seeks individuals or organizations who have faced exclusions, monetary caps, or high cost-sharing on the coverage of needed medical equipment (e.g., wheelchairs, ventilators, or transfer lifts) in an individual or small group Kaiser health insurance plan.
DREDF is intimately aware that most private health plans in California fail to meet the durable medical equipment (“DME”) needs of people with disabilities. Many plans completely exclude coverage of costly DME items such as wheelchairs or CPAP machines. Other plans place $2,000 annual limits on DME coverage, even when a necessary item is far more expensive. Still other plans say they cover DME, but then require the individual to pay 100% of its cost as a “coinsurance” rate. These barriers to coverage are particularly prevalent among Kaiser health plans.
DREDF has worked on legislative and policy approaches to improving DME coverage. We would like to gather more personal experiences from individuals and/or organizations who have been medically or financially disadvantaged or otherwise harmed by these discriminatory private insurance policies. For example, DREDF experiences harm through the impact on our valued employees for whom DME is a medical necessity. If the health insurance that we provide to our employees excludes DME coverage, employees we rely on could literally not be able to come into work if their wheelchairs broke down, and they are looking at being out-of-pocket thousands of dollars to get needed repairs or a new chair.
Are you or your organization similarly affected by DME coverage limitations in a Kaiser health plan? If so, contact Hongyu Min at info@dredf.org or (510) 644-2555 for more information.