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Insurance company won’t cover much-needed wheelchair, double amputee says

Posted at 2:04 PM, Nov 01, 2019
and last updated 2019-11-01 14:04:06-04

SACRAMENTO, Calif. (KTXL) - A Sacramento man who lost both of his legs after pulling over to help a stranded driver said his insurance company will not cover a customized wheelchair.

On Thursday, Mark Poss smiled as he sat on a couch inside his home alongside his wife and infant son. The last two years have been a long journey for his family.

In November 2017, a drive down Highway 50 changed Poss’ life forever.

“I saw a car while being slowly pushed along the shoulder on the side of the freeway on Highway 50 and I decided to get out and help them push the car off the road,” Poss told KTXL.

He said a drunken driver slammed into him, pinning him between two cars near the 15th Street off-ramp in Sacramento.

“I lost my legs pretty much instantly,” Poss said.

Poss now walks with two prosthetic legs but there is a specialized wheelchair that would help him adapt to living life as a double amputee.

“I’ve just been using a loaner wheelchair. So, I’m using a similar one based on the one requested from UnitedHealth,” he told KTXL.

He said his insurance company, UnitedHealthcare, has twice now denied his request for the customized wheelchair, which he estimates could cost around $2,000.

“They’ve never covered a wheelchair. This company has never ... We've bought one from the hospital, one of those basic, temporary (ones),” Poss said. “It’s not a durable piece of equipment. It was worn out within two or three weeks.”

In a letter addressed to Mark, UnitedHealthcare stated his request for equipment related health care services were “not covered” under his Preferred Provider Organization plan.

“If he’s not getting what he needs, he’s not going to be given the quality of life that he deserves,” said Poss' wife, Sarah said.

In a statement, a representative with UnitedHealthcare told KTXL:

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 and his wife said they are disappointed with the decision but hope their insurance company reconsiders.

They said the specialized wheelchair will help Mark through the hardships of losing his legs.

“I would want them to consider kind of the mental health ramifications of having to fight this kind of battle," Sarah said.

Poss said he is in the process of filing an appeal with the company.