Here is a step by step guide to get a reimbursement from an insurance company for medical equipment that was purchased out of pocket. A wheelchair purchase is being used in this example.
Get an itemized receipt from the store your purchased from
- Your name
- Date of purchase
- Wheelchair description and HCPCS code (K0001–K0007 for most manual chairs)
- Amount paid
- Store name, address, and tax ID
Get a prescription from your doctor
- Must state “manual wheelchair”
- Must include your diagnosis (ICD-10 code)
Get a Letter of Medical Necessity (LMN)
- Completed and signed by your doctor
- Explains why you need the wheelchair, your mobility limitations, how you will use it at home, and why cheaper alternatives aren’t enough
Get your doctor’s clinical notes
- Typically from the last 6–12 months
- Must show the mobility issue and failed alternatives (cane, walker, etc.)
Download your insurance company’s “Member Claim Form”
- Most insurers have this on their website
- Fill it out completely
- Add the store’s information (even though it’s retail, you still list them as the supplier)
Assemble your packetAttach:
- Member Claim Form
- Itemized receipt
- Prescription
- LMN
- Clinical notes
Submit to your insurance company
- Use the address on the back of your card or upload through their member portal
- Keep copies of everything
Wait 30–90 days for processing
- They may request more information
- Respond quickly to avoid delays
If denied
- File an appeal
- Your doctor may need to clarify medical necessity
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