Insurance Fairness for Amputees
Our Mission
To reach out to and empower people affected by limb loss to achieve their full potential through education, support and advocacy, and to promote limb loss prevention.
Insurance Fairness is legislation that helps ensure that there is “fair coverage for devices necessary for treatment, rehabilitation and engagement in activities of daily living for people with limb loss and limb difference.” Insurance Fairness addresses the need for access to healthcare and fits into the advocacy element of the Amputee Coalition’s mission. To make Insurance Fairness a reality in your state (and federally), this website serves as a good starting point and a hub for information and updates.
Get Involved in Your State
Select a state from the drop menu or click on the map to view detailed information and resources for each state. Orange states indicate states that have already passed insurance fairness laws for amputees.
We’re powering up at the state level to assess the status of insurance fairness and what comes next. If you’re interested in getting involved, let us know by clicking on the button below.
Insurance Fairness for Amputees Draft Bill Language
A Bill:
To provide fair coverage for devices necessary for treatment, rehabilitation and engagement in activities of daily living for limb loss and limb difference patients under group health plans and group health insurance coverage in the provision of benefits for prosthetic devices and components and benefits for other medical and surgical services.
Coverage for prosthetic devices and components:
The Purpose of this Bill is to require that each insurer proposing to issue individual or group accident and sickness insurance policies providing hospital, medical and surgical, or major medical coverage on an expense-incurred basis; each corporation providing individual or group accident and sickness subscription contracts; and each health maintenance organization providing a health care plan for health care services shall offer and make available coverage for medically necessary prosthetic devices, their repair, fitting, replacement, and components, and/or custom orthotic devices as defined as follows:
“Component” means the materials and equipment needed to ensure the comfort and functioning of a prosthetic device.
“Limb” means an arm, a hand, a leg, a foot, or any portion of an arm, a hand, a leg, or a foot.
“Prosthetic device” means an artificial device to replace, in whole or in part, a limb.
(1) Such benefits for prosthetic and custom orthotic devices and components under the plan (or coverage) shall be provided under terms and conditions that are no less favorable than the terms and conditions applicable to substantially all medical and surgical benefits provided under the plan (or coverage);
(2) Such benefits for prosthetic and custom orthotic devices and components under the plan (or coverage) may not be subject to separate financial requirements (as defined in subsection (d)(4)) that are applicable only with respect to such benefits, and any financial requirements applicable to such benefits may be no more restrictive than the financial requirements applicable to substantially all medical and surgical services.
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