|
"When my son Chase was 1 year old, he was diagnosed with bone cancer. We made the difficult decision to amputate his right leg to save his life. Much to my surprise, getting the proper insurance coverage for the cost of his prosthesis was nearly impossible. All I could think of was, 'How can this be?! I chose to amputate my son's leg to give him the best chance for a quality life, and an insurance company can take that away?!'" |
"I was born without the lower portion of my right arm. Even though I've always worked and had insurance, I have not had coverage for my arm since I left my parents’ Blue Cross. I am 40 years old. My last prosthesis was more than 20 years ago; it no longer fits or works properly. I really would like to have a new arm, but I can’t afford the cost without insurance." |
"Without a leg, it’s extremely difficult for me to work to pay bills and help provide for my family. And without a leg, I can’t go out and play or go hiking in the woods with my children. This is both a financial issue in terms of lost wages and a personal issue in terms of the impact on my ability to lead a full life." "I called our insurance company to determine if this $7,000 lifetime cap is a policy-specific limit set by my wife’s employer or if the insurance company uses this as an across-the-board policy. The insurance company was reluctant to give me answers at first, but I was finally told that limiting orthotic/prosthetic (O&P) coverage to $7,000 lifetime is a companywide policy. I pay them for a service, and I expect adequate care under that service; it’s only fair." |
 |
People who need either prosthetic or orthotic care have been subject to the same unfortunate efforts by some insurers to profoundly limit coverage availability.
Without appropriate prosthetic and orthotic care, many people with complex, disabling conditions are at risk of developing dangerous and costly secondary complications. Furthermore, the delay in appropriate care has a profound impact on the ability of individuals to maintain and enhance function, become and remain independent and to reach their full potential. The subsequent cost to the healthcare system far exceeds that of providing prosthetic care.
-
For children with spina bifida, access to custom orthotic devices impacts both their short- and long-term mobility, their muscle strength and overall quality of life. As they mature, the orthotic devices allow them to maintain their maximum level of functionality.
-
The purpose of a custom orthotic device for people with cerebral palsy is to protect, such as stabilizing a fracture during healing; to prevent deformity, such as stretching braces worn while the person sleeps, to help prevent muscle contractures; and to improve function. This can help children with cerebral palsy achieve maximum potential in growth and development.
-
Those with limb loss can and want to regain the quality of their lives. Prosthetic devices and related services enable amputees to continue working and attain levels of function that were not possible in years past.
Prosthetic coverage has financial and social benefits. A number of reports have been released related to the low cost and potential savings of prosthetic provision. But the strongest demonstration of the need for this legislation are the stories of real people fighting to get the care they need to remain contributing members of society.
The Prosthetic and Customized Orthotic Parity Act will help ensure that those Americans facing limb loss and disabling conditions are not denied the needed services and devices that keep them mobile and productive in their communities and homes.
