Amputee Coalition of America / National Limb Loss Information Center Fact Sheet
Financial Assistance for Prosthetic Services, Durable Medical Equipment, and Other Assistive Devices
|by NLLIC Staff (Revised 2008)|
Some of the questions most frequently asked by amputees who contact the National Limb Loss Information Center relate to the payment coverage for costs related to prosthetic fitting and associated services, and durable medical equipment (DME) such as wheelchairs, ramps, and other adaptive equipment. The prosthetic fitting process can be very costly depending on the difficulty of the case, pathology, and analogous components used - foot, ankle, knee, hip, hand, elbow, etc. Many durable medical devices such as sophisticated electronic wheelchairs are also very costly, and many people can experience financial hardship when trying to obtain these and other equipment needed to maintain their independence. Before attempting to find a funding source, two basic steps should be taken to lay the groundwork:
1. Determine what assistive device(s) you need — Those seeking to replace old or outdated equipment such as wheelchairs or crutches need to determine the specific item needed (make, model, manufacturer, etc.) and from where it will be purchased, and then get a prescription for the device. If there are changes in disability or ability levels, consult a therapist, physician, or rehabilitation professional to determine necessary features to accommodate them. For those who are newly disabled or in need of new prostheses, consulting with medical and rehabilitation professionals is the essential first step in the process.
2. Gather information — No matter where you seek assistance, organized information is important. Keeping the following documentation handy will help avoid frustration and unnecessary delays:
Preparing a Justification Statement
Some funding sources, particularly government programs, require the applicant to prepare a justification statement before funds are actually appropriated. Public or private insurance companies usually require the expected beneficiary, a physician, or a therapist to submit a statement of medical necessity for the purchase. State vocational rehabilitation agencies normally require that applicants demonstrate that the service or technology will enhance their ability to prepare for, get, or keep a job. If employment is not an expected outcome, then the justification statement must show that the device will enhance the individual’s independence.
Other funding sources will have their own specific requirements. Success in securing funding frequently depends on the applicant’s ability to address each agency’s unique requirements. Sources of financial assistance range from Medicare and other insurance to national and local nonprofit organizations. The following is an overview of some of the available resources.
|Last updated: 09/17/2008|
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