Quote:
Originally Posted by QuadSquad
Very sage advice to heed...As it was offered
"Isn't there a way to work around that insurance thing? How 'bout the doc prescribes a motorized wheelchair or a 3/4-wheel scooter. Then you pick up the device and promptly sell it and put that money toward the cost of a Segway."
I would be unable to view it as anything but fraud.
Call your Insurance provider and explain to them your intent. I'm certain they'll give you a very clear answer.
That of course doesn't mean you can't sell an old scooter or wheelchair and apply those funds to something else.
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I understand where you're coming from here, but:
1) insurance companies will of course give you the answer they want to give you. That doesn't mean it's the right answer. If you care enough to be considering such measures, you're better off with an advocate who has your best interests at heart, and that is definitely NOT the insurance company.
2) Docs game the system on behalf of their patients all the time. It is a perpetual ethical quandary for them. (And we should also raise the question not just of fraud -- a legal concept -- but also ethics, in both medical and moral senses). Docs are forever choosing ICD-9 codes on the basis of what they believe will lead the insurance pay for the procedure or test or treatment that they believe are what the patient needs.
Insurance companies are not "the good guys". Long gone are the days when Blue Cross was a mutual insurance company looking out for its members -- and even then, insurance inherently pits the recipient vs everyone else, when it comes time to pay claims.
I DO believe there is a line here. But I don't know where it lies, legally, ethically, morally, and even if I thought I did, I wouldn't know how to describe it in a way that would let anyone apply it to their specific circumstance.
Hence, my advice -- talk to a lawyer, either way. The line may not be where you think it is. It probably varies by jurisdiction. It may vary by insurance contract terms.
BUT -- along the lines of what you're pointing out -- if you get the device, sell it, buy a Segway, and end up with more money than you put in -- I don't know about the legal situation, but I'll raise moral objections to that.
Even though it's the insurance company's fault.
But if you refund them the difference?