Note: This column is for information purposes only and is not intended as a substitute for professional medical advice.

Q: Thank you for your help in overturning the HMO and Medicare denials of my power wheelchair. But there is something I never thought of. The powerchair won't fit in my car. I now have to buy a wheelchair accessible van that costs nearly $50,000! What good is the power wheelchair if I can't get it out of my house?

A: It is impossible to get a power wheelchair into a car even with help. There are platforms that attach to a heavy-duty trailer hitch on the back of larger cars that can carry a powerchair. But you have to be able to tie down the chair, cover it in the rain and walk back to your car. Powerchair users need a van so the chair can ride inside. A lift-arm costing less than $2,000 can haul your chair into the van. But again you have to be able to walk and hike yourself up into the van's driver's seat, which is higher than a car seat. Your best bet is a lowered floor van with a motorized ramp that deploys out the side door. You drive your powerchair inside, transfer to the driver's seat, or drive from the wheelchair itself, which can be locked down behind the steering wheel.

Expensive? Yes. Medical insurance and Medicare typically pay 80 percent of a power wheelchair. But neither pays for a van-about $25,000-or a platform, a lift-arm, or adding a dropped floor and ramp that can cost more than $15,000. But there are options. Most car companies will give you $1,000 toward accessibility equipment when you buy a new van. But that's a drop in the bucket when you add up all the modifications. Some van dealers might give you a five-year loan for the van and modifications. However, your loan payment could be as much as $900 per month for a new, modified van. With interest rates low right now, you may be able to get a longer term home equity loan with lower monthly payments. And the cost of any accessibility modification-to a car, van or your home-is considered a medical deduction by the IRS and can take about 25 percent off the price. Another option is to look for a "preowned" accessible van. The National Multiple Sclerosis Society, Easter Seals, local independent living centers and van dealers who do accessibility modifications often sell used vans. If you need the van to work, vocational rehabilitation will often pay for all or part of your van modifications (but not the van), depending on your income.

If you haven't passed out yet from sticker shock, financial help may be on the horizon. New Jersey Congressman Steve Rothman is working with the International Post-Polio Task Force to investigate the possibility of the federal government creating long term, no-interest loans to pay for power wheelchairs and wheelchair accessible vans. These loans would likely be administered by local agencies or municipalities, like HUD loans for making accessibility modifications to your home. E-mail Congressman Rothman (c/o rob.zucker@mail.house.gov) and help him by explaining how important a power wheelchair and van would be for your PPS and your life. Then write your own congresspersons and senators (addresses at www.congress.org) and ask them to work with Congressman Rothman to quickly create federal long-term, no-interest loans for power wheelchairs and vans.

Does this mean you have to sit around your house until the bucks start flowing from D.C.? New Jersey polio survivor Anngene Anthony didn't wait. In 1996 Anngene was diagnosed with PPS. She could only walk short distances even with a new short leg brace and crutches. We recommended a power wheelchair that her insurance paid for, but she had no way of transporting it. Anngene began writing to local stores, asking them to buy scooters to help their customers with disabilities. When a local supermarket agreed to buy scooters, she asked larger stores and malls to follow suit.

In 1998 she created the National Scooter Shopping Initiative, a campaign to make motorized scooters available in stores nationwide. Anngene's NSSI has now succeeded in convincing several northern New Jersey malls to buy scooters. Weight Watchers has agreed to become the NSSI national sponsor and will spread her campaign to other states. But Anngene needs your help. The only way retailers will provide scooters is if many people with disabilities write letters. E-mail scooterangels@aol.com and Anngene will forward a letter that you can send to your local stores and malls asking them to get scooters-now, before you start your holiday shopping.