Guide to getting financial assistance for Amputees
It may happen from an accident or from a disease; the loss of a limb can be a very emotional experience and a financial headache. There are a lot of different costs that are related to amputation which may include surgery, the cost of medical and prosthetic equipment, medication, hospitalization and doctors’ visits.
The costs involved can be overwhelming for most patients, however, help is available from private as well as public sector programs that are especially designed to help with financial assistance.
Below mentioned are a few steps that may help amputees secure some additional funding for their condition:
How to prepare for applying for financial assistance
Before an individual can apply to find the right kind of financial assistance, it is extremely important to look into the below mentioned three steps. These three steps are critical in understanding what you need and to properly prepare yourself in planning and selecting the right kind of financial assistance for your needs. It’s important to understand that not all financial assistance would suit your needs or provide you with enough assistance to cover the entire cost.
1. Knowing what kind of device you require.
Depending on your disability it is extremely important to find out which kind of device may suit you best. Ideally this information should include the model, manufacturer and make of the device.
It can also mean knowing whether or not you are seeking to replace a device or equipment that you have been using such as wheelchairs, crutches or other assistive equipment. Make sure you know what model, manufacture and the costs for the new device. This entails speaking with your health professional as well as doing online research.
Often financial assistance programs may have set guidelines and rules on the types or models that are permitted when receiving financial assistance. It’s important to speak with your health professional to find the best device that suits your needs and to have valid reasons why this device will be best suited for you.
For individuals who are newly disabled, consultation your health professional is the a great way to get an assessment on your current needs and what devices or equipment would be useful for you.
2. Getting a doctor’s or surgeon’s signed prescription for the device.
Keep in mind that no financial assistance program may give out funds on verbal communication and every program might have their own requirements to get the funds approved. Approval of financial assistance often requires individuals to meet face to face as well as provide proof from a health professional you are currently working with for your treatment plan and care.
To avoid medical negligence, a health professional must often provide a signed prescription or referral for the device you plan to seek financial assistance for. This ensures that you as the patient have been examined by a professional who approves of the use of the device for the benefit of your health and well-being. Therefore it is always important to have a signed prescription for the device from either your doctor or surgeon as verification.
Also keep in mind that this may also be known as a justification statement. A justification statement is a signed statement from either the beneficiary, physician, therapist or other health professional to confirm the need for the specific medical device or equipment. This is commonly requested by public or private health insurance companies who require the beneficiary to provide proof and a description of why the specific device or equipment is needed.
Therefore, patients will need to demonstrate why the need and how the equipment or device will enhance the individual’s independence, employment and overall health.
3. Always gather documented information.
Amputees may need all kinds of documentation while applying for financial assistance. Each program or service that provides financial assistance will have their own set of requirements for documentation. There will likely be a lot of different criteria and you might not know when and where documented proof may be required for getting the funds for financial assistance approved. Below mentioned are the following documentations that should always be updated and with you all time:
– Reason and time of disability
– Employment history
– Total family gross income
– Full name age and the relationship with the patient
– Any kind of health insurance you might have and all its information
– Expenses such as house rent, mortgages, utility bills, loans (if any) and medical expenses.
These are common documents that have been commonly requested when seeking financial assistance for amputees. Once all the above mentioned steps are fulfilled, take time on how you may need to justify the financial assistance request. It should also be kept in mind that most of these financial assistance programs, especially publicly run programs, need a “justification statement” before funds may be approved.
State run rehabilitation centers may require the applicant to demonstrate how the services and devices may actually be able to improve in keeping their job or getting a new one. If there are no job requirements for the patient, then a justification statement may have to show on how the services or devices may be able to improve the patient’s independence.
Where to get financial assistance for amputees
Once all the above mentioned requirements are fulfilled then the next step would be to look for financial assistance options that are required for the amputee. The level of success in acquiring funds would depend on their ability to fulfill all of the important requirements needed by each funding agency.
There are a lot of different agencies both private and public that may be able to financially help the applicant in providing funds, all depending on how the applicant fulfills their requirements and their genuine need for assistance. Some of these agencies that might be able to help with financial assistance may include:
Medicare offers amputees financial assistance to cover devices as well as prosthetic limbs, wheelchairs (both manual and power), walkers, and crutches. Keep in mind that Medicare does not cover ramps, adaptive driving devices, and other non-medical devices, which are commonly deemed as unnecessary or not needed.
Medicare is divided into two parts; part A and part B. Part A covers costs associated with inpatient and outpatient hospitalization. This includes medical expenses such as hospice care, nursing home care and home healthcare. For many individuals, there are not costs and patients who seek prosthesis through select providers will often get billed and receive payment from Medicare.
Part B on the other hand is for all professional services you might need. This includes physicians, therapies, equipment and medical devices. These services often occur outside the facility setting in which case the prosthetist will bill Medicare on your behalf.
Medicare is open to individuals who meet the following requirements:
People 65 years of age and older who are eligible to receive retirement benefits from Social Security or the Railroad Retirement Board, or their spouses.
People under 65 years of age who have received Social Security or Railroad Retirement Board disability benefits for 24 months.
People with end-stage renal disease (permanent kidney failure requiring dialysis or a transplant).
For individuals who do not fall under the requirements such as the age requirement, you will need to apply for and get approval for Social Security Disability (SSD) benefits. In this case, doctors are required to file a claim for the device for the applicant. The applicant, on the other hand, will need to provide documentation to help file a claim. This is the only way the Medicare system will be able to process your request. According to statistics, approximately 70 to 75 percent of SSD applicants are denied the first time they apply.
Prosthetic devices under Medicaid are categorized as optional benefits. But no matter what kind of disability there might be, all patients of Medicaid are eligible for all the services that are provided by Medicaid according to the Affordable Care Act.
Each state will have it’s own requirements and standards, the type, amount duration and scope of services permitted and provided as well as the rate of payment for services. This means quality of care and assistance will vary state by state and it is therefore difficult to provide further information on guidelines and requirements. It is best for the beneficiary to speak directly with your state department for further information.
Unfortunately, with major cutbacks in the Medicaid budget, there is limited funding and assistance available for amputees and as a result, providing financial assistance to the disabled is not mandated. These cuts according to the Department of Health and Human Services have effectively reduced $193,750 of budget which was allocated for financial assistance for amputees and those with a disability.
As a result, patients may experience long waiting periods for the application process, which can effectively mean delays in receiving updates or news as to whether the financial assistance has been approved.
3. Veterans Health Administration
A number of prosthetics, mobility devices as well as adaptive driving equipment is available through this program. To get prosthetic assistance from this program. The prosthetic needs to be prescribed by a prosthetic representative or a member of the VHA’s amputee clinic team.
– Vocational Rehabilitation
– Private insurance companies
– Medical discount programs
– Non-profit organizations such as Amputee Blade Runners, the Bar Foundation and many more.
– If the application is wrongly denied
For other programs the applicant can visit the Client Assistance Program where their file may be looked upon therefore protecting the rights of the people with disabilities through a legal advocacy. Two of such programs include
The Protection and Advocacy of Individual Rights Program that is designed to help to advocate and protect the human and legal rights of people suffering from any kind of disability.
The Protection and Advocacy for Assistive Technology Program is designed to assist those applicants with disabilities as well as their families or caretakers, with an authorized representative for providing the devices needed for the treatment through proper case management.
If an applicant feels that they may have not received the services that they may be entitled for under the federally funded programs, they can turn to the Client Assistance Program. That is when The Client Assistance Program will be there to provide the applicant with assistance that they may need.
4. Medical Fundraising
To meet overwhelming costs, individuals are encouraged to look to medical fundraising as an option. Medical fundraising via an online platforms is an effective way to reach a wider audience who can then contribute to the specific cause. Amputees may make the reason, treatment and funds required known through their platform, so that donors know exactly how much to contribute as well as have a target figure to aim for. There are services that offer fundraising online completely for free for the beneficiary such as PeoplePledge.
On of the major benefits of using medical fundraising is the ease of creating your fundraising page online. There are no costs involved when using PeoplePledge. Families can start raising funds on the same day after completing their fundraising page simply by sharing their unique URL link to friends and family on social networking websites like Facebook and Twitter.
Medical fundraising online has become a popular way for individuals and families to raise funds for devices and equipments that may not be covered by their health insurer or by other financial assistance programs. With the limited resources available, medical fundraising offers individual the ability to quickly raise funds directly from family and friends without long waiting periods, paperwork and restrictions.
Along with medical fundraising, it is also important to go through other financial options that are available to the individual. Although there are limited options for amputees and their families to seek assistance, these 4 options for financial assistance for amputees are the most common options available in the United States.