Recumbent - Getting a new 'bent covered by insurance?

Last week I fell on my DF and injured my shoulder (again). Today I went to the doctor and he told me that with my arthritis in my knees, back, elbows, etc. combined with the impingement of my left shoulder that was aggravated by the fall last week, he would suggest that I switch to a recumbent. He wants me to continue to ride, as it's better for my overall health and it keeps my diabetes in check without having to use medications. I commute 14 miles each way, 5 days a week.

The doctor gave me a prescription for a recumbent bike. I phoned the insurance company and they said that the only way they thought it would be covered is if I purchased the bike through a durable medical equipment company so they could have a procedure code. I've phoned around to a bunch of them around here and none seem to know or want to know anything about bikes at all, much less 'bents.

What I would really like to do is buy a Giro 20 that a friend of mine bought for his wife, but she doesn't use. He'd give me a pretty good deal on it and I'd actually save the insurance company some money.

Has anyone else had any luck getting insurance to pay for a 'bent? Does anyone know of a DME that deals with 'bents?

A bicycle as Durable Medical Equipment?
Durable? Yes. Equipment? Yes. Medical? I don't think so.
Does your insurance company define DME differently than Medicare does?
If you buy a recumbent (and ride it) your overall health will continue to benefit from cycling and you will save money on health care costs.

Actually, the reason she gave me a prescription is because I have arthritis and diabetes. By riding, I keep the diabetes under control. By riding a 'bent, I slow the progression of the arthritis. So yes, it is medical.

...What I would really like to do is buy a Giro 20 that a friend of mine bought for his wife, but she doesn't use. He'd give me a pretty good deal on it and I'd actually save the insurance company some money....

Is there any way you could buy the bike out of your own funds? It sounds like you want it (and would benefit from it enough) to make it worthwhile even if you can't get the insurance company to buy it for you.

Yes, I can and probably will buy it for myself if the insurance company doesn't step up. I'll have to wait a bit longer, though. I did talk to a couple of DME suppliers that sell the stationary recumbent trainers, and many that sell those scooter things. As far as I'm concerned, this is in the same category.

You might be able to explain your situation to the owner of the DME store, especially if it's locally owned. Have them order what you want, and have them sell it to you. I assume they can't carry every DME made in thier store, but can order, this might just have to be ordered differently for them. Doesn't hurt to ask.

How we understand the process is you will need a "pro forma" letter from your doctor and then work with a company like http://bike-on.com to order a bike. You will have to pay up front then "work" with your insurance company to claim back the expense. Bike On will have examples of some pro forma letters your doctor can use.

Ultimately all this depends on the quality of your insurance company and your employer who you can use to advocate on your behalf.

I'd seriously doubt if you could ever get an insurance company to cover the cost of a bent for medical reasons, even though I firmly believe that in my case anyway, a bent is the single best treatment I've ever had for my severe back problems.
Having said that though, I know a fellow who wrote off the cost of his bent on his income taxes as a medical expense when his doctor wrote a letter specifically prescribing a recumbent for him. Apparently the IRS didn't challenge him on it.
I spoke with my accountant regarding this and he told me it was possible as long as a physician wrote a note justifying it as a legitimate medcal expense. I think I'll do that in another month or so.

Just hope you don't get audited :). IRS can be 2-3yrs behind on items that come up flagged,
if it does get flagged. You never know until the letter comes. To the OP I would suggest
looking for a bent that is fairly close to the ground (under 22") and that SWB are a bit more
stable than LWB. Bents are not particularly knee friendly, but you can learn to spin to get
around this. Elbows tend to be more comfortable extended than flexed, but be aware there
are two general handlebar positions: the more common is chipmunk, with the elbows relatively
flexed, and the superman, with the elbows relatively extended. The Giro is the
latter.

I'll ask my mom or dad how they did it. My dad has various health problems and his doctor wrote a priscription for him to get a stationary bike as a medical device. He didn't have to go through a medical company either he went to a bike shop that dealt with stationary equipment.

Ok my mom said that my dad went to a couple of bike shops and told them about the priscription and the second one said they could help him with it. No big deal really.
Good Luck