For Immediate Release

April 2, 2008

Media Contact:  Vince Matthews 973-509-0388 
 

HEALTH INSURANCE COVERAGE EXPANDED FOR AMPUTEES  
 

      MONTCLAIR – Senate Bill 502 sponsored by Senator Nia Gill, which expands health insurance coverage for orthotic and prosthetic devices, was recently signed into law by Governor Corzine.  This law goes into effect on April 13, 2008.

            “It is important that health insurance provides amputees with access to prosthetic and orthotic devises in the same manner as other basic, essential healthcare,” said Senator Gill (D-Essex & Passaic).  “Additionally, the costs are minimal, and both the public and private sector experience savings in the long run.”

            Everyday New Jersey citizens have to battle discouraging obstacles when trying to obtain prosthetic and orthotic care.  While no one expects to ever need these items, illness, accidents, and birth defects are factors that constantly increase the numbers that do.  Currently, insurance companies can place unrealistic restrictions such as a limitation of one prosthesis per lifetime, or even a $2,500 cap per year for related care.

            “The restrictions in many insurance policies crush the hope for an independent, productive future and lead in many cases to a reliance on State and Federal programs,” said Dennis O’Donnell, a member of Amps In Action.  “This bill will help ensure that people are given the opportunity to lead a full and productive life.” Amps in Action is an advocacy and support organization for amputees, their families, and friends. In addition to monthly meetings, they answer questions and provide guidance to resources that will help amputees quickly return to a full and active life.

            Under this new law health insurers are required to provide health benefits coverage for expenses incurred in obtaining an orthotic or prosthetic appliance as determined medically necessary by the covered person's physician.  Health insurers and the State Health Benefits Program are also required to reimburse for the orthotic and prosthetic appliances at the same rate as reimbursement under the federal Medicare reimbursement schedule.  New Jersey’s law is one of the strongest in the nation.

            “The passage of this bill not only results in financial benefits, but it also enhances the quality of lives of those affected,” added Senator Gill.  “Secondary medical complications caused by a sedentary lifestyle are reduced, and many social benefits are gained.  Simply put, this is the right thing to do.” 

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