Amputee Fights for Coverage of Prosthetics

Good Morning America reported this morning about a Virginia woman, Susan Bailey, who fell ill after eating an E. coli infected meal. Because of the course of the infection, doctors were forced to perform a double above-knee amputation on Susan. The GMA article does not focus on the infection or treatment, but rather the decision by her insurance company not to pay for the high-end prosthetic legs. "Anthem Blue Cross Blue Shield refused to pay for the more expensive C-Legs because they were experimental and not medically necessary. More than 25,000 C-Legs have been used by amputees." There was a "happy" ending to the story as a result of GMA contacting the Virginia Bureau of Insurance, which regulates insurers. They reviewed her case and within a few weeks, the state overruled Anthem and ordered them to pay for her new legs. There is a six minute long video at the GMA website, if you are interested.
This story highlights some of the unfortunate circumstances that occur between insurance providers and amputees. Because Suzanne has below-knee prosthetics, she has not encountered the same sort of resistance, as of yet. We hope this remains true going forward.