Health - Resources and discussion for everything health-related

Experts say it’s not uncommon for patients who need prostheses to be denied by insurance. “It’s not a matter of if, but when,” one advocate said.

Insurance denials for prosthetic devices are not uncommon.

“The amount of denials that our community faces is prolific, and it’s not a matter of if you’ll be denied, but when,” said Nicole Ver Kuilen, the director of impact campaigns for the Amputee Coalition and the national lead for the So Every BODY Can Move campaign. Ver Kuilen lost a limb due to bone cancer as a child and said she has personally dealt with insurance denials.

Insurance coverage for prostheses varies from state to state and depends on the type of plan, Ver Kuilin said. At least 25 states have passed legislation requiring state-regulated insurance plans to offer the same prosthetic coverage as Medicare, which generally covers devices that replace a body part or function and requires a 20% copay.