Wednesday, March 12, 2008

Insurers Pressed to Pay More for Prostheses

A Wall Street Journal article forwarded by Meredith.

Many private health plans cap prosthesis coverage at $2,500 or $5,000 a year, or pay for just one device per limb in a lifetime, sometimes even for a growing child. The most basic devices can cost between $3,000 and $15,000, while mechanically advanced or computer-assisted models can cost up to $40,000.

Now, amputees and prosthetic-device makers are pushing state legislatures around the country to pass laws that mandate prosthesis coverage. The goal is to force private health plans to offer coverage comparable to that provided by Medicare, which pays at least 80% of the cost of prostheses and allows regular replacement of artificial limbs.

So far eight states have passed laws which require coverage of prostheses which is comparable to Medicare. 27 other states are considering the same kind of legislation.

The Amputee Coalition of America, an advocacy group backed by both prosthesis makers and individual amputees, has launched a campaign to introduce a bill in Congress. A big backer of the effort is Hanger Orthopedic Group Inc., the biggest player in the $2.5 billion U.S. prosthetics market. The coalition plans to enlist amputated Iraq war veterans -- many of whom have state-of-the-art prostheses through veterans' benefits -- to help make the case.
via Wall Street Journal Online

To read more about how the high cost of these devices affects families and people with disabilities, see the article. As one father of an amputee put it, you'd think they'd be willing to pay for an arm or a leg when you need one.

{Update: I found this story on CNN about a wounded Iraqi man whose wife is caring for him. He's unable to get prosthetic legs and she has to carry him . It highlights the lack of independence that mobility issues present. I'd like to add that there are people in our country as well who do without mobility equipment as well, behind closed doors and that when we read these stories, it's good to remember that rather than leaving it up to chance to solve one by one, we need to find solutions so that people can have the equipment they need.]

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