Navigating Medicare Together: Scott’s Story

Seventeen years after an accident that left him paralyzed from the shoulders down, musician and music producer Scott Harding is no stranger to Medicare. He has plenty of experience navigating the Medicare system and advocating for himself to get the care that allows him to live and work independently.

But Medicare becomes more complicated—and less beneficiary-friendly—every year. Rising health care costs, aggressive marketing, shifting rules, and coverage denials make it harder for people to get care.

Following a medical emergency that led to months in hospitals and nursing facilities last year, Scott developed a severe pressure wound. His doctor prescribed a specialized pressure-relief bed, which should be covered by Medicare as a piece of durable medical equipment necessary for his healing. But when Scott tried to obtain the bed through Medicare, it was denied even though he met the medical criteria. When he tried to figure out why, he received only unclear explanations and confusing documentation. He was left to pay nearly $3,900 each month out of pocket for the bed while he attempted to appeal the denial on his own.

Fortunately, he then received a referral to the Medicare Rights Center, where our volunteers and caseworkers took on his appeal and saw it through to the end. Allison, an experienced Medicare Rights caseworker, reviewed Scott’s records and identified exactly what Medicare requested for his claim. She gathered the required documentation to show that Scott was eligible for the specialized bed and that he had met all the previous requirements for coverage. Over several months, she worked directly with Medicare until the appeal was accepted and Scott was reimbursed for each month he had paid out of pocket.

“There are so many people who just get steamrolled by the system,” Scott said. “I’m a guy that’s been in the system for 17 years, and I’ve become pretty good at it, but this one had me beat. Medicare Rights kept fighting for me.”

We receive calls from people like Scott every day. Medicare beneficiaries find us when they feel like they are out of options, facing unaffordable costs and denials they don’t know how to fight. The Medicare Rights Center is both a lifeline and a watchdog for people like Scott, providing one-on-one counseling for beneficiaries, training health care professionals, and advocating for federal and state policies to expand Medicare. This past year, we:

• Responded to more than 36,000 Medicare questions on our national helpline
• Secured $11 million in essential benefits for our clients
• Reached millions through our educational website, Medicare Interactive
• Advocated for simplified Medicare enrollment and expansion of Medicare Savings Programs

We believe everyone has a right to dignity and independence, and health care is foundational to that basic right. As challenges to affordable health care mount, the Medicare Rights Center will continue to work to get Medicare right. 

If you need assistance with Medicare, call our helpline at 800-333-4114. To learn more about Medicare, visit Medicare Interactive.