How to Get the Insurance Coverage You Need
Amputees and their caregivers are often faced with the realization that their insurance carrier does not cover prosthetics and supplies. This can be a very scary and confusing time but can be avoided with a few simple steps:
Be Proactive - Make certain you know what's covered in your insurance policy PRIOR TO arriving at your prosthetist's office. Certain keywords to look for are pre-existing condition, mobility aid/mobility device, quality of life, medical necessity, and prosthetics/prosthesis/prostheses. Find out what's covered and what isn't. Some policies cover only ONE prosthesis FOR LIFE. Make sure this isn't the case for you. Do your research ahead of time so you're not surprised when something isn't covered and you're left footing the bill.
Ask Questions - Check directly with your healthcare provider or with your Benefits Director at your place of employment. They should be able to answer your questions or point you in the right direction to have them answered. If something remains unclear, ask again. And again. Be sure to know what your policy will and will not cover and don't be afraid to ask why or why not regarding a specific item or coverage.
Shop Carriers - Just as you shop for auto or homeowners insurance carriers, you can also shop for different health insurance companies - or ask your employer to do so. Discuss your concerns with your employer or benefits director - they can work to find coverage that will best suit your needs. If they're unable to, you can shop for coverage on your own. Opting out and choosing stand-alone coverage may not always be the most cost-effective approach, but it may be the best solution for you. Remember - you always have options!
YOU ARE YOUR BEST ADVOCATE. Speak up and take action on your behalf and work to get the coverage that you deserve and is the best fit for your unique situation. Your prosthetist may be able to shed some light on carriers that provide more inclusive coverage. It may take a little leg work (no pun intended!) in the beginning, but the time and effort will be worthwhile when you need the coverage.