My SideStix Quest Continues

Since I first tried walking with SideStix this past March, I’ve learned some things about myself. I’ve also learned that I have much to be thankful for. The crutches are tools that allow those who might not otherwise be able, to explore places and see things that would not be possible with the use of conventional medical equipment.

I instantly became excited about SideStix even before I attempted to use them. Just learning of their existence was enough of a spark to start the fires of inspiration in my mind. During my initial test run, I realized I had to obtain a set of these for myself.

In the early stages of my journey, I started out contacting my insurance provider and my primary care physician to come up with a strategy. I also called the folks at SideStix in B.C., to get as much information as I could about them before getting the details in order.

Upon first contact with Blue Cross Blue Shield of Massachusetts, I felt positive that I was going to make something happen. I enthusiastically told the operator in the frontline call center about these amazing new crutches that have the potential to change my life.

After waiting on hold, I was told, based on the rules of my particular coverage plan I would not be able to receive insurance coverage for SideStix unless they came from a local distribution point. Even then, it would still be questionable.

I quickly set out on a mission to contact medical supply outlets and organizations like Mass. Rehab Commission and Easter Seals in my city and beyond to find out if any of them were able to acquire these crutches for me. Almost as quickly as I began calling, I found out that medical equipment distributors are reluctant to add a new vendor for the potential of what they may perceive to be a single transaction. Each person I spoke to wished me luck in my uphill climb.

This only pushed me to work harder. Throughout this process, I have not stopped communicating my progress to everyone involved. I sent electronic media kits to friends who work in the healthcare field. I enlisted the assistance of people within the company I work for. I figured that they must have different contacts within the Blue Cross Blue Shield organization. Matters such as these sometimes require one to approach a problem from several different angles.

I performed further testing with SideStix for the Mass.DCR and made sure video was taken. I also wrote about my experiences and was interviewed by the Massachusetts Department of Conservation and Recreation. My input was used to help them determine if SideStix should be used in their Universal Access hiking program (I used them on June 9th.to take my daughter on a scavenger hunt). It was great fun.

After a few weeks of waiting, I was informed by the Human Resources Department at TJX that BCBSMA Member Services considered these crutches to be as follows:

“I spoke to our clinical area and based on the HCPCS code (E1399- miscellaneous code which is never covered by BCBSMA) and the fact that these items appear to be specifically designed to allow for recreational participation in sports these would not be covered DME items.”

When I heard this news, I decided not to take this message as one of defeat. I escalated this issue to another level. Out of frustration, I bypassed the appeal process and sent an e-mail to Senator Scott Brown’s office. I must admit I didn’t expect to hear back. I just wanted to spread my story to as many people that would listen.

In the meantime, family and friends began taking up collections in my name. I am humbled and astounded by the funds that people have given to assist me.

I addition, I have recently learned that a representative from Senator Brown’s office has contacted Blue Cross on my behalf. The result has proven positive. Blue Cross has decided to allow an “administrative exception” in my case. They are going to reimburse me $200.00 after the initial purchase is made.

They may not be covering the full cost, Nonetheless, I feel empowered by this experience. I was told “No” on multiple fronts and I refused to take that as a final answer. It is my sincere hope that my story can help another person in a similar situation. Through the kindness of loved ones and strangers alike, I will soon have my own pair of SideStix.

THANK YOU to everyone involved you have contributed to something that has already changed my life!

Journal Comments

  • Elspeth  McClanahan
  • Dwayne Boyd