Check Prosthetic Benefits Before Insurance Switch
Staff Writer
This morning I have come across another heartbreaking and all-too-common situation. A prosthetic user that I have known for years has come in and needs a new prosthesis. This person just recently switched insurance companies through a job. I'm not sure why this person switched, maybe it was by choice, maybe not. The new insurance not only imposes a deductible and a co-insurance, but after all this the plan only covers $2,500.00 per year for prosthetic devices.
How does this happen? I'm sure there are many scenarios. Maybe the employer's human resource representative misunderstood and then misrepresented the benefits for prosthetic devices. Many people assume that prosthetic devices are covered under durable medical equipment (DME) benefits, but usually prosthetic benefits are completely separate. Did the prosthetic user just assume the benefits would be adequate for prosthetics? If the prosthetic user did do some investigating and found out about this issue beforehand, what next? Not every employer offers employees a wide selection of benefit plans... you get what you get in many cases.