Mark Poss lost his legs in an accident in 2017 when he was hit by a driver who was drunk on a highway in Sacramento, where he lives.
He was trying to help a couple whose car had broken down by another vehicle which led to a crash that severed his legs. He was rushed to the ICU.
After the incident, he is recovering slowly. But his insurance company has made things more difficult for him.
The UnitedHealthcare refused him a wheelchair for the second time. He criticized the company on Facebook, over what he called “the last straw.”
“I just don’t understand how anyone could contest that I need a wheelchair,” he wrote. “Yet, here we are. The fact that I have prosthetic legs means I do not need a wheelchair.”
Poss is a training specialist at a biotech firm, he told BuzzFeed News he was told by UnitedHealthcare that his insurance plan, which he said was otherwise “stellar”, “doesn’t cover this type of equipment for somebody with my needs.”
“It doesn’t make any sense,” he said. “I don’t have legs. I need a wheelchair to function.”
Poss said he’s not demanding the company for any special or expensive electric wheelchair, he just wants is a manual “everyday wheelchair.” The cost of the wheelchair $2,000, which is about the standard price.
BuzzFeed News has seen a copy of the Oct. 20, 2019, rejection letter. According to the website, Poss’s “doctor has requested a special wheelchair…which appears to exceed your needs and therefore, your coverage.” Elsewhere in the letter, the device is referred to only as an “ultralightweight wheelchair.”
A spokesperson for UnitedHealthcare told BuzzFeed News via email, “UnitedHealthcare provides coverage for wheelchairs based on the individual’s benefits. While we cannot provide detailed comments due to privacy, we will work with Mr. Poss to address coverage of his care needs under his plan.”
Poss said that he is fighting with the insurance company for a long time, and he submitted a claim for a wheelchair over a year ago. He also said that the company denied every time based on administrative reasons.
“I was told [the first denial] wasn’t based on anything besides the way the claim was submitted,” he said. “This was the second time I’ve gone through this process, and they denied me again.”
Poss said he faced similar difficulties with the insurance company that he faced after losing his legs in the accident.
A coworker started a GoFundMe to help in his treatment, which ultimately raised more than $160,000 for his family.
The company also refused his claim for a socket, that can help him in moving easily, Poss said, “I’m not able to walk as well, and I need the wheelchair even more.”
Poss spoke to five UnitedHealthcare representatives and left furious, “every single one of them expressed shock that I was denied.”
“All of them said this should be covered,” he added. “I just don’t understand who’s making the denial.”
UnitedHealthcare denied his claim for a wheelchair once again and it makes him believe that the company doesn’t want to help and wants patients to fight for themselves.
“I do believe that they’re just denying them and hopefully [patients] will go away and stop making claims, and maybe make fewer claims in the future because it’s not worth the fight,” Poss added. “And it’s been a fight. It’s been upsetting, it’s been discouraging. My wife is furious. And I’m really sad about it.”
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