How to Get Reimbursed for Medical Equipment Purchased Out-Of-Pocket

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