PITTSBURGH (KDKA) – A local man who is quadriplegic can't use his bathroom because of health insurance red tape -- and he's not alone.
In this simple bathroom, you don't have to look hard to find a complex problem – it's the empty shower.
The truth is, it hasn't been used in months.
Dave Cubarney hasn't taken a shower in six months.
Cubarney is a quadriplegic, born with Cerebral Palsy.
He is fiercely independent, loves the Steelers, the Penguins and can't stand the bureaucracy – the battle to be able to take a shower.
"According to them, I don't need a shower chair," he said.
According to Medicare and Medicaid, as well as a significant number of insurance companies, a shower chair is a luxury. In fact, nothing in the bathroom is covered.
"It's about the money," said Joe Ponsi.
Ponsi knows the game. His family has been in the medical supply business for 70 years.
And we've been down this road before, kind of.
Roger Madden had to crawl up and down his stairs. Medicare offers no coverage for chairlifts, also no coverage for hand rails in his bathroom.
So, thousands of disabled veterans, even more seniors, have to go without. In Roger's case, the Ponsi family stepped up.
In Cubarney's case, Ponsi stepped up again, providing him with a nearly $1,000 shower chair free of charge.
"This is wonderful," Cubarney said. "I'll be taking a shower every night."
Insurance calls this a luxury.
"Why they don't cover some of these items we need for day-to-day living, I can't tell you," said Ponsi.
So the solution?
Cubarney has UPMC insurance. His caseworkers, who can't talk specifics, say there is now a process – albeit painstaking and four steps – that would get Cubarney his chair and other so-called luxury items in the bathroom.
Also, Sen. Bob Casey's people are alarmed by this. They're looking at taking on the policy nationwide.
If you'd like Marty to help you solve your problem, email him at GetMarty@kdka.com.
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