Cathedral City man fights SCAN Health Plan over coverage for power wheelchair

UPDATE:

A representative for SCAN Health Plan provided this written statement in response to News Channel 3’s request for comment:

“SCAN Health Plan is committed to providing our members access to quality care and service. Unfortunately, due to patient confidentiality regulations, we can’t be more specific in our response. However, we encourage any members who have questions or concerns about their coverage to contact us directly for assistance and we will work to ensure they receive all benefits to which they are entitled.”

INITIAL REPORT:

Alan Rosenfeld looked at the latest denial letter from Scan Health Plan, a not-for-profit “Medicare Advantage” health maintenance organization headquartered in Long Beach.

He says for two years, based on his doctor’s recommendation, he has been trying to get Scan to cover the cost of a new power wheelchair.

“I feel very angry, sure I do,” said Rosenfeld.

The retired landscaper and longtime valley resident is now borrowing an old powered wheelchair, lent by an acquaintance, who Rosenfeld says wants to be paid for the chair, or have it returned.

Living alone, he says his need for the power chair became even more pressing last year when he suffered a broken hip.

Saying he has a heart condition, and arthritis in his hands, he says he can walk upwards of 20 to 50 steps at the most, on a good day, before falling.

“I need the chair more than I ever did because of the heart,” said Rosenfeld.

The reasons given for the denials have included Scan, asserting in writing, that Rosenfeld is capable of walking further than what he says he can.

In another instance, Rosenfeld says it was blamed on a doorway in the home he was living in at the time being “too narrow”.

He also says he has appealed Scan’s denials multiple times.

Rosenfeld says after receiving the fifth denial letter, he pretty much felt as though he was out of options, and that is when he decided to contact News Channel 3 to ask us to help him find a resolution.

On Rosenfeld’s behalf, we called Scan’s corporate office, and left a voice message for a media relations representative, describing Rosenfeld’s situation, detailing his complaint, and asking for a response.

“I want the power chair, that’s right. I want them to live up to what they advertise,” said the 75-year-old.

Rosenfeld and any Medicare recipient, who feel they are wrongly denied, do have a right to file an appeal with Medicare when they believe they are not getting receiving coverage for an item or service they feel they should be getting.

We have not yet received a response from Scan and will let you know what they say, if and when we receive a callback.

We are also working to contact a representative at the Center for Medicare Advocacy in Washington, D.C, to find out how they might be able to help Rosenfeld find a resolution.

News Channel 3 will continue to follow the story.