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Insurance Coverage of Prosthetic Limbs

John Rheinstein, CP, FAAOP

October 29, 2014

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Question

Does insurance pay for more than one limb at a time?  How often are you able to get a new one?

Answer

That will vary by the insurance company.  They usually will not pay for a second limb at the same time.  The veterans who are being treated by the Department of Defense and the Veteran’s Administration are getting more than one limb, but your general civilian population is not.  The replacement is generally granted based on medical necessity.  That is determined by a consultation with the doctor and is based on the patient’s condition.  If there is a real benefit to the patient, if they cannot do something that they really need to do, then we go to bat for them and see what we can get done.  Sometimes there are creative solutions where we can make a detachable foot if they need two feet, but they cannot get two prosthetic limbs.  


john rheinstein

John Rheinstein, CP, FAAOP

John Rheinstein is a board certified prosthetist with 20 years experience practicing in New York City with Hanger Clinic. He received his board certification in prosthetics from Northwestern University Medical School’s Prosthetics & Orthotics Center at the Rehab Institute of Chicago. He is a fellow of the American Academy of Orthotists and Prosthetists and is the chair of the Lower Limb Prosthetic Society.

John has specialized experience with active, proximal level, and upper extremity amputation patients as well as immediate post-operative care.  He is the co-inventor of the patented Aircast Air-Limb post-operative prosthesis. John is active in research and patient care applications of new products.  He presents at academic and medical institutions, teaches continuing education courses to prosthetists, and trains prosthetic residents.  He recently won the Hanger Award for Pioneering Innovations.


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