Insurer Denies New Wheelchair For Chicago Child

By Consumers For Quality Care, on December 19, 2018

Insurer Denies New Wheelchair For Chicago Child

Keisheya Spencer says she never expected to have to fight her insurance company to cover a wheelchair for her son with Cerebral palsy, Keyshawn Griffin. Spencer says that her insurer, Blue Cross Blue Shield, used to cover most of what Keyshawn needed. Then a few months ago, it began to push back, CBS reports.

Since his current wheelchair needed to be fixed, Griffin has been relying on a donated scooter to get to and from school. While the scooter helps, it limits his mobility more than a functional wheelchair would. He says his wheelchair is “basically his life,” because his disease means he can’t walk on his own.

Spencer feels like the company is giving her the run around on why they will not cover the wheelchair.

“This is private insurance—this is something I pay for,” she said. “So it really upsets me that he can’t get what he needs. And I pay my money to them every two weeks.”

 Blue Cross Blue Shield first denied the wheelchair and claimed it needed a price comparison for repair or replacement. Spencer submitted comparisons and the chair was again denied. In another letter, Blue Cross Blue Shield said it needed additional information from Griffin’s doctors. A BCBS rep tried to call Griffin’s doctor’s office but hung-up after 2 minutes, calling the wait time “excessive.”

Now, the family must go through a 60-90 day appeal process.

Spencer’s emotions took over when she thought about her son’s struggles, which could worsen when snow covers the ground.

 “Just trying to make sure he has what he needs so that he can do what he needs for himself,” she said. “Those are his legs, and he can’t get around without them, and I think it’s so unfair,” Spencer said as she fought back tears.

BCBS would not comment on the case, despite having the family’s consent to do so.