Apologies if this has already been said!
Manual vs Electric
First off, a manual chair will fit into small cars the best. A rigid frame will allow you to be seated in the car while you put the frame and wheels in your backseat or front seat. A folding chair, you generally have to stand to put it in your car. Chairs without wheels are around 10lbs at lightest, so think of how many times you will be lifting the chair in and out of your car and whether it would be easier to sit down or stand up. A bonus of a folding frame with a small car is that you can get an overhead compartment that picks up your folding chair for you and puts it on top of the car. Downside is that they’re not as comfortable or customized to your body.
A manual chair requires decent arm strength and/or some core strength. Or it requires push handles and someone to push you around. Flip down push handles are a good option if you want to give someone the option to push you but also be able to keep strangers from pushing you.
If you get a manual chair, you do NOT want a basic hospital style chair. It will be almost impossible to push, far too big, and completely uncomfortable. The best thing for a manual chair is to get one that is customizable. Brands like TiLite, Quickie, and Ki Mobility are all ones that have custom options. I personally highly recommend Ki Mobility. I’ve had their Tsunami chair (paid out of pocket for $2500) for almost six years now. Their customer service and reps are absolutely phenomenal and I’ve gotten a ton of freebies from them for my chair.
You want the chair measured to your size. I would try to have a frame that’s 14lbs or less and a suitable cushion. I like Ottobock cushions and foam cushions for myself but i know a lot of people find RoHo cushions fantastic. Even if you don’t think you’ll need back support, please get back support. I’ve been using a tension adjustable back and it is literally terrible. I have no support for my core and the back digs in fiercely. I recommend getting a hard shell back, it doesn’t have to be to tall, it just has to give you support. If you use insurance, you have to remember that insurance will only cover a new chair every five years, so you need to be prepared for not only what you need today, but what you would need should your disabilities progress.
Since you mentioned having a small car, a power chair is probably not optimal. There are lifts that you can put on the back of your car to carry a power chair or scooter but they leave your chair exposed to the elements. And if you do have a tarp with you for coverage, you’ll have to put it on and off every time you want go somewhere and that’s in addition to walking from the back of your car to the front of your car.
There are however some other options. One is that you can get a wheelchair accessible van should you need a power chair. Of course that will cost more money and there is not a whole lot of financial help for getting a wheelchair van. Although some you can find used for 10K or under.
There is the smart drive. It fits onto both manual and folding chairs and gives you power assist. You do one push and it continues that push forward for you.
There are e-motion wheels. Down side is that they weigh about 25lbs each making them very heavy to transfer in and out of your car. Upside is that you barely need to touch the wheels to have them move you forward.
There’s also the Spinergy ZX-1. Downside, you’ll need an accessible van if you want to take it any place. Upside, it turns your small manual chair into a power chair and it comes on and off your chair with the press of a button.
And that’s about as much as I know on that particular subject.
As for insurance and rx, what you want to do first is go to your doctor. Explain to them that you want more ability to go out and do things and that you thing this is the best way for that. Also tell them that you would like to be able to save your energy so you can exercise, cook food, and maybe work and things like that. If your doctor agrees that a wheelchair will be suitable for you, they should set you up with a physical therapist that will do your measurements and fitting a long with your chosen vendor. Also make sure that the doctor writes what specifically you need in a wheelchair (for an instance, I had my dr write out a script for an ultra lightweight wheelchair rigid frame with power assist). The more specific the better everyone will listen to you. After that, the vendor and your PT should work together with you to find what will suit you best, the therapist will write a “letter of justification” explaining why you need what you need, they’ll send it to your dr to sign off on it, and then send it to the insurance company, who will then approve or deny it. If they deny it, you have every right to fight back. After they approve it, it’ll then take a few months for everything to be built and set up.
If you don’t go through insurance, it is MUCH faster. It is more expensive, but some companies will let you do payment plans to slowly pay it off. A bonus of paying out of pocket is that you don’t have to worry about insurance denial, and that since the wheelchair vendor will not be charging to the insurance company, the price of the chair will retail lower for you. You’ll still need a detailed script and a wheelchair fitting, but you can do it without insurance approval.
Also medicaid will cover the cost of a wheelchair if justified.
If you need anything else, feel free to PM me! (I paid out of pocket for my first chair and am now going through insurance for my second chair so I got at least a good chunk of knowledge about this)