New law will help pay for artificial limbs
By Ana Rivas
Salem News
BOSTON – When Juliet Bryce lost her leg in a car accident in Salem in 2001, she discovered that the amount her insurance company would pay wouldn’t cover the cost of the artificial leg that she needed.
Last year, when she had her prosthesis fixed after she lost weight from her first pregnancy, she made the same upsetting finding.
“You never fully understand the details of a policy until you have to go and make a claim,” Bryce says. “Then you discover you really didn’t have any coverage.”
But now a new law requires all health plans to provide coverage for prosthetic limbs, without annual spending limits, and it’s making a difference in the lives of real people.
“Now everyone is covered evenly,” Bryce says.
The so-called “prosthetic parity law” will ensure that Massachusetts residents who are paying for health insurance will receive the same prosthetic care provided under federal Medicare laws, said Steven Sosnoff, manager of Hanger Prosthetics & Orthotics in Worcester.
Rep. Joyce Spiliotis, D-Peabody, introduced the bill, backed by Rep. Barbara L’Italien, D-Andover, and Sen. Bruce Tarr, R-Gloucester.
When Gov. Mitt Romney signed the bill on Sept. 7, Massachusetts became the fifth state to enact such legislation. The new law will take effect in January.
“The emotional impact of losing a limb can be devastating,” Sosnoff said. But “most people do not learn of the devastating financial impact until they are in the midst of dealing with limb loss.”
Some insurance plans limited coverage to $750 or $1,500 per year, while a prosthetic limb can cost between $10,000 and $40,000, he said. And amputees need a new limb every three to four years on average, he explained.
Keith Cornell, a Salem prosthetist, was one of those who worked with the Mass. Society of Orthotists and Prosthetists to push for legislation to compel health insurance providers to cover the costs.
The need for such help is rare, he pointed out. “Approximately.0.000496 percent of the general population will yearly require new or replacement prosthesis,” Cornell said – meaning the new law will benefit just around 14 people every year.
Why is this law so important if it benefits so few? Because to those few, he said, it can be all that matters.
“We’re not talking about a car or vacation, but a very necessary part of existing normally,” said Theresa Arnold of Gloucester, who uses a prosthetic leg.
“What this bill passing means for me personally is not having to dish out $30,000 or $40,000 for my next limb, but a reasonable percentage instead.”
Arnold pays more than $1,000 a month for health insurance, but she found out it was terrible in terms of “durable medical equipment” or prosthetics.
“If people are equipped with adequate prosthetics,” Arnold said, “then they can live normal, healthy and productive lives.”
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