As many of you know, I am an OT providing prosthetic rehabilitation services to consumers. This story just came to my attention.... Please read on and be sure to check out the link:
"This 6 yr old boy was born without part of his arm. He told Santa that he wanted an XBox and fingers to play it. A family friend started fundraising for a prosthetic arm for him because the parents' insurance will not cover a prosthetic arm for the little boy because it is not medically necessary. A little boy doesn't need an arm?Anyway, I thought, well, it is Christmas time. Miracles happen. Maybe someone can help... somehow...Thank you. xo"
http://www.myfoxny.com/story/24198927/long-island-boy-asks-santa-for-prosthetic-arm-and-xbox
Shame on the insurance companies.... and the reviewer who relays this sentiment. How despicable. The argument of the reviewer is that the responsibility of the provider is to prove that the (prosthetic) device(s) requested are medically necessary and that they did not likely submit such necessary evidence. -It is always the fault or the responsibility of someone else. It does not matter that the parents of this child, or any other consumer paying into an insurance policy for that matter; have been paying/contributing to that policy as stakeholders. Talk about being held hostage! We are required to have insurance, to pay into it; yet it provides little to nothing relative to our prosthetic needs. And what has happened to the basics of common sense, not to mention compassion for fellow human beings???? Are we so stupid or so callous that we cannot see the benefits of assistive technology... we have to prove the medical necessity, when the beneficial functional necessity is apparent?
Please tell me that someone is going to come to their senses and assist ALL of the Christophers of the world...
"This 6 yr old boy was born without part of his arm. He told Santa that he wanted an XBox and fingers to play it. A family friend started fundraising for a prosthetic arm for him because the parents' insurance will not cover a prosthetic arm for the little boy because it is not medically necessary. A little boy doesn't need an arm?Anyway, I thought, well, it is Christmas time. Miracles happen. Maybe someone can help... somehow...Thank you. xo"
http://www.myfoxny.com/story/24198927/long-island-boy-asks-santa-for-prosthetic-arm-and-xbox
Shame on the insurance companies.... and the reviewer who relays this sentiment. How despicable. The argument of the reviewer is that the responsibility of the provider is to prove that the (prosthetic) device(s) requested are medically necessary and that they did not likely submit such necessary evidence. -It is always the fault or the responsibility of someone else. It does not matter that the parents of this child, or any other consumer paying into an insurance policy for that matter; have been paying/contributing to that policy as stakeholders. Talk about being held hostage! We are required to have insurance, to pay into it; yet it provides little to nothing relative to our prosthetic needs. And what has happened to the basics of common sense, not to mention compassion for fellow human beings???? Are we so stupid or so callous that we cannot see the benefits of assistive technology... we have to prove the medical necessity, when the beneficial functional necessity is apparent?
Please tell me that someone is going to come to their senses and assist ALL of the Christophers of the world...