Late last year, three lawsuits were filed against three separate health insurance companies for their failures to pay for microprocessor-controlled prosthetic limbs. The three health insurance companies that were sued are Anthem, Blue Shield of California, and United Healthcare.
All three insurance companies have denied coverage for microprocessor-controlled limbs for their customers. The insurance companies typically claim that they are investigational, not medically necessary, or that the insurance company is not obligated to pay for those limbs when cheaper limbs are available.
Microprocessor-controlled limbs use microprocessors to power the artificial limbs. Manufacturers have developed lower leg devices that are much more similar to the movements of real legs, which can minimize falls, allow walking on uneven terrain, and can result in much less pain for the user. Microprocessor-controlled upper limbs have much better comfort and functionality. They are essential for anyone who needs to move their hands with dexterity, grasp objects, or perform other necessary tasks of daily living.
However, microprocessor-controlled limbs are much more expensive than more basic limbs. Therefore, many insurance companies deny coverage for them. If you have had an insurance company deny coverage for a microprocessor-controlled limb, you may be eligible to join one of these lawsuits or file your own. Call me, Conal Doyle, amputation attorney, at 310-385-0567. I am working on these lawsuits and my team can help. Call today to learn more.