For 12-Year-Old Without an Arm, Insurance Has Run Out

[one...two...tree 2,762]

By Danielle Ivory,

Benjamin French was born with his right arm missing below the elbow. In his 12 years, he has been fitted with seven prostheses. His most recent replacement will cost nearly $30,000 and his doctor says he will soon grow out of it.

But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit.

Benjamin's family happens to live in Michigan, one of 33 states where insurance companies are allowed to set annual and lifetime caps on prosthetic coverage. The family's policy with Blue Cross Blue Shield of Michigan covers a maximum of $30,000 per lifetime for prosthetics, plus $1,000 per year for repairs. In states such as Colorado and Maryland, the law says there can be no such cap on prosthetics.

"It seems really unfair," said Benjamin's mother, Kristen French. "The insurance company can do this in one state, but not in another? It's ridiculous."

The French family represents one small part of a for-profit health care system rife with inequities and inconsistencies: Some people have insurance, some do not. For those who are insured, individual policies operate under different rules than group policies. Each insurance company and every individual policy has different requirements, exclusions, and benefits.

more...

http://www.alternet.org/workplace/144012/f...nce_has_run_out

[mawilson 2,133]

It's just another example of how the insurance-based health care system is ill-suited for routine care.

Imagine what would happen to food prices if one needed "food insurance" to buy food.

"Hey, does your policy cover lobster? No, but mine covers filet mignon."

[Hilarious Clinton 452]

Vision correction and plastic surgery. Two things that are not normally covered by insurance but have dropped in price. Funny how the free market works.

[scandal 951]

Benjamin French was born with his right arm missing below the elbow. In his 12 years, he has been fitted with seven prostheses. His most recent replacement will cost nearly $30,000 and his doctor says he will soon grow out of it.

But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit.

In other words ... the insurance company has rationed his care.

Funny... America has health care rationing?

I thought that's the devilish practice we've been warned by the right will happen to us if we adopt universal coverage? Hmm...

[Niels Bohr 72]

Yep. Wait. Why is it happening right now? The Health Care Bill didn't finalize or even approved.

Benjamin French was born with his right arm missing below the elbow. In his 12 years, he has been fitted with seven prostheses. His most recent replacement will cost nearly $30,000 and his doctor says he will soon grow out of it.

But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit.

In other words ... the insurance company has rationed his care.

Funny... America has health care rationing?

I thought that's the devilish practice we've been warned by the right will happen to us if we adopt universal coverage? Hmm...

Edited November 18, 2009 by Niels Bohr

[Mr. Big Dog 10,747]

Benjamin French was born with his right arm missing below the elbow. In his 12 years, he has been fitted with seven prostheses. His most recent replacement will cost nearly $30,000 and his doctor says he will soon grow out of it.

But, according to his insurance company, the boy is ineligible for further coverage of prosthetic devices because he has already spent his lifetime maximum benefit.

In other words ... the insurance company has rationed his care.

Funny... America has health care rationing?

I thought that's the devilish practice we've been warned by the right will happen to us if we adopt universal coverage? Hmm...

The opposite would be the case. No way would this scenario be found in comparable countries with universal coverage. Only in America...

[one...two...tree 2,762]

Vision correction and plastic surgery. Two things that are not normally covered by insurance but have dropped in price. Funny how the free market works.

So basically, you are telling this 12 year old to shut up and be thankful for the insurance he used up.

[Susita 175]

We knew this system was screwed up years ago

[rika60607 215]

Perhaps he is saying that if health insurance was banned for all in the whole USA,

(and I sorta like this fresh idea despite it's very republican spirit)

then medical care costs would have to drop down significantly.

Because very few people would be able to afford medical care and the one's who need it but can't pay - would die off. Hence, laws of market - cheap helathcare!

That is except that nobody is willing to provide goods below the costs and doctors are no exception. They have to pay off those student loans somehow.

Vision correction and plastic surgery. Two things that are not normally covered by insurance but have dropped in price. Funny how the free market works.

So basically, you are telling this 12 year old to shut up and be thankful for the insurance he used up.