I have been using wheelchair assistance for about 2 years now. all with AA and it has been very good except for Reagan in DC. I went through Miami 2 years ago and it was confusing, but effective. There may be several segments, some in electric carts. The attendants in Miami are Hispanic and their accents made it difficult to understand. After C & I you will be deposited in a holding area near baggage claim. They will retrieve your baggage and then transport you to your gate. I did not understand the process, but it worked out fine. I am also hard of hearing. I usually carry several $5 bills to use as tips. Depending on the segment length the choice is yours. This past year in PHL connection was tight. I told attendant I had $20 bill in my pocket and if I made it, it was his. He got the $20. In Charlotte and PHL one attendant takes you all the way through to your gate. Leaving SXM I found the service excellent.