Advocacy groups in the United States said many health insurance policies fail to cover the basic needs of people who have lost limbs.
Many face crippling medical bills and can’t access critical specialist care.
As CGTN’s Giles Gibson reports, community leaders are pushing for what they call “insurance fairness” in every U.S. state.
Six-year-old Nathan Simm’s prosthetic leg lets him play like any other child. Born with a rare condition, he became an amputee when he was just a year old.
His mother Shannon said his prosthetic leg costs around $20,000.
“When he has pants on, you have no idea he has a prosthetic limb. He’s active, he’s fine, there’s no pain, he’s not getting calluses or sores or wrinkles or anything,” said Shannon Simm Nathan’s mom.
She adds that it’s a constant battle to get insurance coverage for everything Nathan needs.
Nathan is currently on his seventh prosthetic. As he keeps growing, he’ll soon need another, as poorly-fitting prosthetics make him less mobile and more likely to be in pain. But amputee advocacy groups said health insurance plans often limit coverage to as little as a thousand dollars a year.
Nathan’s family is also just one of thousands across the U.S. that’s dealing with the everyday challenges of limb loss. The Amputee Coalition said there are approximately 185,000 new amputees every single year.
Twenty-one U.S. states have now passed what advocates call fair insurance legislation. The laws strip away arbitrary price caps and treat prosthetics like internal medical devices such as pacemakers, instead of wheelchairs or crutches.
“What we have available is much more advanced than it was 30 years ago. We compare it, and we said insurance companies are willing to pay for the other technologies, why is prosthetics carved out as being something they don’t want to reimburse many times,” said Jack Richmond the CEO of Amputee Coalition.
America’s Health Insurance Plans, a group that represents healthcare insurers, told us in a statement: “It would not be accurate to say that this critical treatment and device is considered a “luxury”. Health insurance providers do cover prosthetics, including repairs or replacements, when medically necessary, which is typically to replace a missing or non-functional limb or organ.”
Meanwhile the Amputee Coalition said its goal is to get “Insurance Fairness” in every state, meaning two million amputees across the U.S., including Nathan, can get the coverage they need to live a full life.