Healthcare Innovation January 8, 2025
Plans may deny coverage for prosthetic limbs, stating they aren’t medically necessary
On January 6, KFF Health News’ Michelle Andrews reported on coverage limitations for prosthetic limbs. Health insurers may deny coverage for these devices by claiming they aren’t medically necessary or are experimental.
An estimated 2.3 million people are living with limb loss in the U.S., according to an analysis by Avalere, a healthcare consulting company, Andrews writes. That number is expected to as much as double in the coming years as people age and a growing number lose limbs to diabetes, trauma, and other medical problems. According to a report by the AHRQ, the federal Agency for Healthcare Research and Quality, fewer than half of people with limb...
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