Delaware is now the 20th state to make it easier for patients who need prosthetics to afford them.
Gov. Jack Markell signed legislation Monday that requires private insurance companies to reimburse patients for artificial limbs and associated care at the same rates offered by Medicaid and Medicare–about 80 percent.
Advocates for amputees in Delaware fought for the new legislation, which takes effect Jan. 1, 2012.
John Horne lost his lower right leg to bone cancer when he was a teenager. He says most private plans cap coverage for prosthetics at very low levels and have 50 percent co-pays. Some limit prosthetic devices to one per life time.
Horne said those limitations catch people by surprise should they find themselves needing this type of care.
“Most people would never consider that if you had gotten injured and had lost a limb, that insurance wouldn’t be there to make sure that you are provided with the necessary tools and equipment in order to get rehabilitation and move on with your life,” he said.
Horne, the president of Independence Prosthetics-Orthotics in Newark, said artificial limbs need to be replaced every five years, and can cost up to $60,000. The new law will make proper prosthetic care more affordable, allowing people to remain in the work force, he said.
The efforts in Delaware were part of a national campaign to get prosthetic parity on the books in all states; New Jersey enacted similar legislation in 2008. Pennsylvania has no prosthetic parity laws.