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Arms and Legs are Not a Luxury!

Posted Sep 22 2009 12:00am

Insurance companies in almost every state set unfair limits on reimbursement for prosthetics. While technology has advanced dramatically in the past decade insurance reimbursements have not. Current microprocessor-controlled knees for full leg prosthetics drive the cost of a prosthetic leg up to $50,000. The result of these huge technological advances is that while amputees used to fall an average of once per week, the microprocessor virtually eliminates the risk of falling due to stepping down when the knee is flexed and not perfectly straight. In my case, I went from falling once per month when my heel accidentally came down on a rock, twig, or the junction between hardwood and carpeted floor to zero falls in five years. Furthermore, microprocessor control of knees reduces energy consumption from normal walking by 75% compared to the old style knees. This is just the beginning as the next wave of powered ankles is about to arrive. This will drive the cost even more out of reach of most people needed a prosthesis.

At this point 17 states currently have laws requiring insurance companies treat prosthetics the same way they treat a home oxygen machine or doctor-prescribed home hospital bed. Yet in most states, these companies have woefully insufficient caps like $5,000 and some even mandate one prosthesis for life (even for growing children). Finally, at the national level a new bill HR 2575 has been introduced into the House of Representatives that will ensure equal health insurance for amputees.

Please let Congress know that you want them to support HR 2479, which will assure quality of treatment and replacement limbs amputees receive, and HR 2575, the bill that lets amputees get the limbs they need without unfair limitations imposed by their insurance companies. For much more, see the Amputee Coalition's advocacy site here.

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