Adaptive strollers are a specialized type of equipment designed for children with physical disabilities. These strollers provide the necessary support, positioning, and comfort, enabling the child and their caregivers to engage in community life more readily.
While adaptive strollers are an essential tool for many families, the high cost can make them difficult to afford. Therefore, it’s often necessary for a healthcare provider to write a letter of medical necessity to the child’s insurance company, requesting coverage for the adaptive stroller.
These letters should provide detailed information about the child’s medical condition, how the condition affects their mobility, and why an adaptive stroller is the most appropriate solution.
Sample Letters of Medical Necessity for Adaptive Stroller
The following are 15 samples of such letters, which you may use as a guide or template to help justify the medical necessity for an adaptive stroller.
Sample 1: Letter for a Child with Cerebral Palsy
Subject: Medical Necessity for Adaptive Stroller – Cerebral Palsy
Dear [Recipient’s Name],
I am the primary care physician for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with cerebral palsy. Due to their condition, [Patient’s Name] has significant motor impairments that hinder their ability to walk or maintain balance.
While a wheelchair could provide mobility, it lacks the flexibility needed for [Patient’s Name]’s daily activities, and is impractical given their age. An adaptive stroller, with its ability to be easily transported, maneuvered, and adjusted, would significantly improve [Patient’s Name]’s mobility, providing them with the ability to engage more fully with their environment.
I trust you will acknowledge the necessity of this equipment for [Patient’s Name] and agree to cover the costs associated with the adaptive stroller.
Yours Sincerely, Dr. [Your Name]
Sample 2: Letter for a Child with Spina Bifida
Subject: Medical Necessity of Adaptive Stroller for Spina Bifida
Dear [Recipient’s Name],
I am the neurologist for [Patient’s Name], a [Patient’s Age]-year-old child with spina bifida. This condition has significantly impacted [Patient’s Name]’s mobility, making it extremely difficult for them to walk without support.
An adaptive stroller would greatly benefit [Patient’s Name] by providing the necessary support and stability, while allowing them to participate more fully in family and community activities. It would also facilitate care for their caregivers, who currently struggle with the weight and bulk of a traditional wheelchair.
Therefore, I kindly request your consideration to provide coverage for an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
Sample 3: Letter for a Child with Muscular Dystrophy
Subject: Medical Need for Adaptive Stroller in Muscular Dystrophy
Dear [Recipient’s Name],
I am the pediatric neurologist for [Patient’s Name], who has been diagnosed with muscular dystrophy. As a result of this condition, [Patient’s Name] has increasing difficulties with mobility and maintaining balance.
Given the progressive nature of muscular dystrophy, it is essential for [Patient’s Name] to have an adaptive stroller. This equipment will provide [Patient’s Name] with the necessary support, help preserve their remaining strength, and allow them to engage more with their peers and surroundings.
With this in mind, I strongly recommend the approval for coverage of an adaptive stroller for [Patient’s Name].
Yours Sincerely, Dr. [Your Name]
Sample 4: Letter for a Child with Down Syndrome
Subject: Urgent Need for Adaptive Stroller – Down Syndrome
Dear [Recipient’s Name],
As the developmental pediatrician treating [Patient’s Name], I am writing to highlight the necessity of an adaptive stroller for [Patient’s Name], a [Patient’s Age]-year-old child with Down syndrome. Due to the nature of their condition, [Patient’s Name] struggles with motor skills, especially walking and maintaining balance for extended periods.
The use of an adaptive stroller, with its supportive design and flexibility, would provide [Patient’s Name] with the necessary stability and comfort, allowing them to participate more fully in daily activities.
I kindly request you to consider this and approve the coverage of an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
Sample 5: Letter for a Child with Autism
Subject: Medical Necessity of Adaptive Stroller for Autism Management
Dear [Recipient’s Name],
I am the child psychologist for [Patient’s Name], a [Patient’s Age]-year-old diagnosed with autism spectrum disorder. While [Patient’s Name]’s cognitive abilities are preserved, they have considerable difficulties with motor coordination and are prone to wandering.
An adaptive stroller, with its secure and supportive design, would significantly improve [Patient’s Name]’s safety during community outings and provide a measure of independence. It would also help [Patient’s Name]’s caregivers manage their behavior more effectively.
I trust you will acknowledge the importance of this equipment and agree to cover the costs associated with the adaptive stroller.
Yours Sincerely, Dr. [Your Name]
Sample 6: Letter for a Child with Rett Syndrome
Subject: Medical Necessity for Adaptive Stroller – Rett Syndrome
Dear [Recipient’s Name],
I am the neurologist for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with Rett syndrome. This condition has caused severe motor impairments, rendering [Patient’s Name] unable to walk unassisted.
Considering this, an adaptive stroller is crucial to improve [Patient’s Name]’s mobility and allow them to participate more fully in social activities. The stroller’s support features would also greatly benefit [Patient’s Name]’s caregivers, who currently struggle with managing [Patient’s Name]’s mobility.
I kindly request your consideration and approval for coverage of an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
Sample 7: Letter for a Child with Williams Syndrome
Subject: Need for Adaptive Stroller in Williams Syndrome Management
Dear [Recipient’s Name],
I am the pediatrician for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with Williams syndrome. Due to their condition, [Patient’s Name] experiences significant motor development delays.
An adaptive stroller, with its supportive features, would greatly enhance [Patient’s Name]’s mobility, participation in activities, and overall quality of life. Furthermore, it would provide their caregivers with a more practical and manageable solution compared to a traditional wheelchair.
I trust you will acknowledge the necessity of this equipment and agree to cover the costs associated with the adaptive stroller.
Yours Sincerely, Dr. [Your Name]
Sample 8: Letter for a Child with Developmental Delay
Subject: Medical Necessity for Adaptive Stroller – Developmental Delay
Dear [Recipient’s Name],
I am the developmental pediatrician for [Patient’s Name], a [Patient’s Age]-year-old child with a significant developmental delay. As a result, [Patient’s Name] struggles with motor skills and mobility.
An adaptive stroller would significantly improve [Patient’s Name]’s ability to engage in family and community outings. It offers necessary support, comfort, and safety that a traditional stroller or wheelchair cannot provide.
I kindly request your consideration and approval for the coverage of an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
Sample 9: Letter for a Child with Prader-Willi Syndrome
Subject: Urgent Requirement of Adaptive Stroller – Prader-Willi Syndrome
Dear [Recipient’s Name],
I am the pediatric endocrinologist for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with Prader-Willi syndrome. The symptoms of this genetic disorder include low muscle tone, which has resulted in [Patient’s Name] having difficulty with mobility.
Given these challenges, it is medically necessary for [Patient’s Name] to have an adaptive stroller. This equipment would provide [Patient’s Name] with the necessary support for mobility, allow them to participate more fully in family and community activities, and improve their overall quality of life.
I trust you will acknowledge this need and agree to cover the costs associated with the adaptive stroller.
Yours Sincerely, Dr. [Your Name]
Sample 10: Letter for a Child with Fragile X Syndrome
Subject: Medical Necessity for Adaptive Stroller – Fragile X Syndrome
Dear [Recipient’s Name],
I am the pediatrician for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with Fragile X syndrome. As part of their condition, [Patient’s Name] struggles with motor coordination and balance, affecting their mobility.
An adaptive stroller would provide [Patient’s Name] with the necessary support and stability, thereby enhancing their mobility and allowing them to participate more fully in everyday activities.
I kindly request your understanding and approval for the coverage of an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
Sample 11: Letter for a Child with Angelman Syndrome
Subject: Medical Necessity for Adaptive Stroller – Angelman Syndrome
Dear [Recipient’s Name],
I am the pediatric neurologist for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with Angelman syndrome. This condition has significantly affected [Patient’s Name]’s motor skills, leading to difficulties with walking and balance.
Considering these challenges, an adaptive stroller is crucial for [Patient’s Name]. It would provide them with the necessary support, improve their mobility, and enable them to engage more fully in family and community activities.
I trust you will acknowledge the necessity of this equipment and agree to cover the costs associated with the adaptive stroller.
Yours Sincerely, Dr. [Your Name]
Sample 12: Letter for a Child with Duchenne Muscular Dystrophy
Subject: Urgent Requirement for Adaptive Stroller – Duchenne Muscular Dystrophy
Dear [Recipient’s Name],
I am the pediatric neurologist for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with Duchenne muscular dystrophy. As a result of this condition, [Patient’s Name] has significant difficulties with mobility and maintaining balance.
An adaptive stroller, with its supportive design and ease of use, would provide [Patient’s Name] with the necessary stability and comfort, enabling them to participate more fully in daily activities.
I kindly request you to consider this and approve the coverage of an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
Sample 13: Letter for a Child with Pervasive Developmental Disorder
Subject: Medical Necessity for Adaptive Stroller – Pervasive Developmental Disorder
Dear [Recipient’s Name],
I am the developmental pediatrician for [Patient’s Name], a [Patient’s Age]-year-old child with a pervasive developmental disorder. Due to their condition, [Patient’s Name] struggles with motor coordination and is prone to wandering.
An adaptive stroller would be a great help in managing [Patient’s Name]’s mobility and behavior in the community. It would provide necessary support and containment, greatly improving [Patient’s Name]’s safety and quality of life.
I trust you will acknowledge the importance of this equipment and agree to cover the costs associated with the adaptive stroller.
Yours Sincerely, Dr. [Your Name]
Sample 14: Letter for a Child with Mitochondrial Disease
Subject: Medical Necessity for Adaptive Stroller – Mitochondrial Disease
Dear [Recipient’s Name],
I am the pediatric neurologist for [Patient’s Name], a [Patient’s Age]-year-old child with mitochondrial disease. This condition has caused [Patient’s Name] significant fatigue and weakness, making mobility a considerable challenge.
An adaptive stroller would greatly benefit [Patient’s Name] by providing necessary support and comfort, and allowing them to conserve energy for other activities. It would also facilitate mobility in different settings, from home to school and in the community.
I kindly request your consideration and approval for coverage of an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
Sample 15: Letter for a Child with Ehlers-Danlos Syndrome
Subject: Urgent Need for Adaptive Stroller – Ehlers-Danlos Syndrome
Dear [Recipient’s Name],
As the pediatrician for [Patient’s Name], I am writing to highlight the necessity of an adaptive stroller for [Patient’s Name], a [Patient’s Age]-year-old child diagnosed with Ehlers-Danlos Syndrome. Their condition makes it difficult for them to walk for extended periods due to joint instability and fatigue.
An adaptive stroller, designed to provide enhanced support and stability, would be invaluable to [Patient’s Name]’s mobility and quality of life. It would provide [Patient’s Name] with the means to participate in daily activities and interact with peers without risk of injury or exhaustion.
I kindly request you to consider this and approve the coverage of an adaptive stroller.
Yours Faithfully, Dr. [Your Name]
