How to get a special needs seat?

NannyMom · Dec 18, 2011

My friend has a Regent for her 6 year old. It will expire in Jan 2013, so they have 1 more year. He is just even with/slightly above the 2nd from top slots (with the recline bar, if that matters). He has Aspergers, and Mom would really like to keep him in a harness. He has been diagnosed by a.... Psychologist (i think that was it). Would she need to go to somewhere like Kennedy Kreiger (that's local to us) to get a big official diagnosis? We want to get insurance to pay for a seat. Also, how does she go about getting insurance to pay? They have Blue Cross Blue Shield if it matters. How long does approval usually take?

DaniannieB · Dec 18, 2011

The first step would be to look up a SN tech near you to help you out.

Getting insurance to pay for a SN seat can take several months, so you want to get started as soon as possible.

They'll need an Rx from a physician and usually an eval by a PT/OT. Once insurance approves, the seat usually has to be purchased through a DME.

Just FYI, in a majority of cases insurance will only pay for a SN seat for positioning needs, not for safety.

If they don't have success getting insurance to pay, they might look at some other avenues. Sometimes local clubs will help out (like Kiwanis, Rotary, etc. type of clubs) or even things like hospital foundations. Most of the time you have to be denied by insurance first, though.

NannyMom · Dec 18, 2011

Well, I am a special needs tech

But I've never dealt with it, and it's been a year and a half since my training. I guess I need to hit up Shumnum.

ETA: In my conversation with Mom, she was saying that he doesn't have low tone, but he can tend to just slink down out of a seat. That's one of the reasons she won't let him ride the bus to school. Would that count as for positioning?

flipper68 · Dec 19, 2011

She'll need a letter of justification from an OT/PT and/or a doctor outlining why DC needs a 5 pt restraint vs. a booster. Many durable medical equipment websites have samples/examples of this type of letter.

Be aware also that most insurance companies deny at least once before approving. Your friend will need to make sure she has strong letters and is familiar with her policy.

If it's just slouching, I wonder if a Britax Parkway SG would provide enough support/reminder for him.

NannyMom · Dec 19, 2011

flipper68 said:
She'll need a letter of justification from an OT/PT and/or a doctor outlining why DC needs a 5 pt restraint vs. a booster. Many durable medical equipment websites have samples/examples of this type of letter.

Be aware also that most insurance companies deny at least once before approving. Your friend will need to make sure she has strong letters and is familiar with her policy.

If it's just slouching, I wonder if a Britax Parkway SG would provide enough support/reminder for him.

I did consider that. But how much growing room would there be after outgrowing a Regent?

ketchupqueen · Dec 19, 2011

It's a very tall booster.

She could also consider a Monterey with an 86-Y.

ShumNum · Dec 27, 2011

Flipper86 is right. Medical assistance will deny you all day long, but they might a fighting chance with private insurance. A letter of medical necessity would be a must. My instinct is that it will be difficult to get insurance to pay for this seat as it sounds like it's not for positioning needs, but rather more of a safety/restraint/preference. Definitely worth a try, but she should be prepared for denial.

aetj115 · Dec 27, 2011

The dx he has is official. Had he got it from the school system that would be different. Here where we live we have a family resource that pays for such things. Its with our local DD (Previously called mr/dd). Also, if insurance battles she could always comtact many of the asd orginizations. Autism speaks gave a grant to a couple local families here for iPads and seats.

How to get a special needs seat?

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