A prosthetics industry group has pledged to provide artificial limbs at no cost to Boston bombing victims who may require prosthetics in the future but lack sufficient insurance coverage.
The American Orthotic & Prosthetic Association said it is working with its member companies to supply necessary devices for its “Coalition to Run and Walk Again” program.
More than a dozen Boston bombing victims have lost their limbs, according to news reports.
The association added that amputees can face severe limits in some health insurance coverage, such as a cap of $1,000 per prostheses or coverage for only one artificial limb over the course of an individual’s lifetime, for example. In practice, the association said, the care and cost of an initial prosthetic device could add up to $30,000 or more and that artificial limbs often need be replaced every five-to-seven years.
Prosthetics manufacturer Freedom Innovations is one of the member companies that plan to participate in the program. The company’s product manager Meghan Seus told Insurance Journal that if an individual has insurance, these devices are usually covered — but the coverage varies widely by each insurance plan.
Good insurance plans, including those in Medicare and good private insurance plans, will provide coverage of about 80 percent of the cost, leaving a 20 percent co-pay for the user. But she said some private plans put unrealistic annual or lifetime benefit caps on insurance coverage.
Benefit caps can be lumped in with Durable Medical Equipment (DME) which may have a cap of $1,500 or $2,500 a year, Seus said. “This doesn’t even cover the cost of a prosthetic socket (the part the residual limb clips into), and leaves no funding for componentry like a foot, knee, suspension sleeves, liners, etc. There is legislation underway in many states trying to mandate prosthetic coverage on par with typical medical benefits,” she said.
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