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Funding Adaptive Bicycles

How to Find Funding for a Buddy Bike

Many families have obtained funding to purchase the Buddy Bike as therapeutic equipment for children with physical and/or cognitive disabilities such as autism, Down Syndrome, sight impairment, cerebral palsy, epilepsy and hypotonia. Below you will find a list of ideas for seeking medical funds to purchase the Buddy Bike as therapeutic equipment. Many families have found success through their Department of Developmental Disabilities or their county's Department of Health & Human Services or other similar organization and have used a variety of medical waivers. If you do not qualify for state or county funds, we offer alternative funding suggestions based on the successful fundraising efforts of other families. According to Laura in Lakewood, CO, she was initially denied and filed several appeals but she eventually obtained the support she needed through a local organization.

Buddy Bike is not a Medicare provider and does not offer funding programs but we are happy to work with your funding sources to help make your dream of having a Buddy Bike become a reality! We may not be able to process medical funding for Trade-In and used bike models.

Please note that Buddy Bike nor any of the organizations listed below can guarantee that you will qualify for funding.

Durable Medical Equipment - DME Code

The Buddy Bike may qualify as HCPCS Code E1399 DME Miscellaneous and has also been covered as HCPCS T2029 Assistive Technology - Tandem Bicycle.

"In cases where a more specific HCPCS code is not available, a product may be billed using E1399, durable medical equipment, miscellaneous. In order for durable medical equipment to be covered or reimbursed in the home, many third-party payers require the equipment to be: (1) prescribed by a physician (2) durable (3) medically reasonable and necessary."

 

Problems that may arise - a denial letter sample.

Medical Waiver Programs

Many times, an adaptive bicycle can be purchased through waiver programs. Each state is different in their coverage and the process for accessing waiver funds. Some states require a denial from the primary insurer first prior to covering with waiver funds, others require a physician’s prescription with a therapist’s letter of medical necessity and evaluation for the equipment.

Many families have found success through their Department of Developmental Disabilities or their county's Department of Health & Human Services or other similar organization and have used a variety of medical waivers.

  • Caseworker: You should begin by speaking with your caseworker or family support counselor for specifics in your state on coverage and to see if assistance is available through county or state funding and grants. Another good starting place would be to contact your Community Center Boards (CCB).

  • Medical Professional: Request a prescription or "Letter of Medical Necessity" of your doctor or therapist. Some states may have laws requiring funding to be provided if a doctor writes a note requiring the equipment for therapeutic purposes.

  • DME Provider: The Buddy Bike is classified as Durable Medical Equipment (DME). You may contact the organization in your state that provides DME. See DME Code above.

SAMPLE FUNDING REQUEST LETTERS
These sample letters may be helpful in submitting your funding applications.

  • BUDDY BIKE MEDICAL SUBMISSION DOCUMENT

  • LETTER 1  Courtesy of Laura, Lakewood, CO

  • LETTER 2  Courtesy of Christine, San Francisco, CA

USEFUL WEB PAGES
You may find these web pages to be useful in your search for funding.

Insurance Coverage

To our knowledge, the Buddy Bike has been partially covered by 1a couple insurance policies through BCBS. Here are some notes from the customer to help you navigate your own insurance claim.

  • Customer covers cost then seeks reimbursement.

  • Insurance doesn't pay for anything prior to service or delivery.

  • Approximately 80% was covered according to the customer's plan (Federal Employee BCBS plan). This reimbursement rate may vary from plan to plan.

SUBMIT A CLAIM, step-by-step process:

  1. Letter of Medical Necessity filled out by Doctor and PT and OT, coded as Durable Medical Equipment (DME). See DME Code above.

  2. Get a price quote for the bike, but do not purchase yet. Contact shelley@bikesforeverybody.com

  3. Submit Letters of necessity and quote for Insurance company eligibility review.

  4. After approval is received then you can order and pay for the bike.

  5. After receiving the bike then submit bill along with approval letter for reimbursement.

 

A bike shop will not be on their approved providers list and it is unreasonable to ask the bike shop to navigate the medical billing and coding system to seek payment from insurance.

Grants & Charitable Organizations

Search for local agencies that provide assistance for special needs children. Most of the agencies that have provided funding operate by county so start looking locally. Seek local or state chapters of national groups such as Variety Club, Easter Seals, and Make-a-Wish Foundation.

 

GRANTS FOR ADAPTIVE BIKES
There are a number of grants available from organizations that focus on helping children with disabilities. These organizations may provide grants or other funding assistance for adaptive bikes.

CHARITABLE ORGANIZATIONS
These organizations may also offer funding assistance. Use the links to search for chapters in your area.

 

FOR EDUCATORS AND STATE/LOCAL EDUCATION AGENCIES

Fundraising

Holding a benefit or fundraiser for a child is a great way to get the community to help out. Set a goal of raising the funds necessary for the bike, shipping, assembly and maybe even a helmet. Reach out to your community through letters, the news and local television or radio, and fundraising events.

 

WARNING! It is imperative that a family contact a special needs attorney prior to holding the fundraiser to establish a proper trust for the funds earned. If it is not set up properly, the money can be viewed as income for the child potentially making them ineligible for state health plans and waiver programs.

FUNDRAISING IN YOUR COMMUNITY

  • Schools and universities: Many sororities, fraternities, Girl/Boy Scout groups or other school groups will take the community project of raising funds to purchase equipment such as the Buddy Bike for a special needs child.

  • Family: Hold a birthday party but tell your guests that instead of gifts, you would prefer donations toward the purchase of a Buddy Bike.

  • Church or other community groups

 

FUNDRAISING ONLINE
One of the most efficient ways to fund raise for a Buddy Bike is through online fundraising. You can set up a fundraising page using one of the services below (fees may apply) then promote your page through e-mail, social media and word-of-mouth!

 

CREATE A WEB PAGE
Create a web page page to raise awareness of your child's disability and to raise funds. There are many sources in the web for creating free web pages. Add a section talking about the Buddy Bike and how it would benefit your child. Then add a PayPal button to request donations online.

Buddy Bike Vendor Registration

Funding may be available through various associations to purchase the Buddy Bike as therapeutic equipment. Buddy Bike has worked with several organizations and authorized dealers who have funded Buddy Bikes or who may be able to assist you in utilizing medical waivers and funds to purchase the Buddy Bikes as therapeutic equipment.

If you do not see a program below that applies to you, you should check with your family support counselor, case worker, therapist or other medical professional to find out if funding is available through county or state funding and grants.

This list is provided as a courtesy. Buddy Bike nor any of the organizations listed below can guarantee that you will qualify for funding. Contact the organization for their criteria and program requirements. Some programs are state-specific.

NO ORGANIZATIONS LISTED AT THIS TIME

Let us know about your county and state programs, we will be happy to apply for vendor status.

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