Insurance coverage for prosthetic limbs would be mandatory in MI under new bill | Michigan Radio
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Insurance coverage for prosthetic limbs would be mandatory in MI under new bill

Jun 22, 2018

Rep. Beau LaFave was born with a congenital defect. When he was 18 months old, doctors amputated his left leg at the knee. He’s worn a prosthetic device for most of his life. 

For amputees, a prosthetic device can be life changing, but prosthetics are expensive -- LeFave (R-Iron Mountain) says his latest has a price tag of $70,000 -- and they’re not always covered by health insurance.

That's why LaFave introduced a bill in the Michigan legislature that would require all health insurance companies to cover prosthetic devices more like they do hip replacements and other implanted devices. Right now, some insurance companies cover prosthetics as "durable medical equipment," the same category as wheelchairs. LaFave says that often means a separate line item in an insurance policy and a higher cost to the customer because it doesn't fall under the typical deductible system used for common procedures.

The costs add up even more quickly for children who are growing.

"When you're a young kid, you're looking at a new [prosthetic] ... at least every 18 months," LaFave told Michigan Radio Morning Edition host Doug Tribou.

The legislature is currently on its summer recess. LaFave hopes the bill will move forward in the House this fall.

Another priority

LaFave represents the 108th district in the Upper Peninsula. The district includes Menominee County, one of two counties where Gov. Rick Snyder declared a state of disaster after severe flooding over the weekend.

Lafave described some of the cleanup efforts. 

"The National Guard has been deployed," he said. "They have 15 dump trucks, four front-end loaders, two bulldozers, two excavators, and the personnel to operate it."

LaFave says the residents of the U.P. have the spirit to start over.

"We will rebuild and we're gonna build it stronger than it was before."