Insurance & Financial Assistance
Both Medicare and private health insurance plans pay for a large portion — or sometimes even all costs — associated with many types of medical equipment used in the home, including prosthetics/orthotics devices. Most health insurance plans have similar rules to Medicare, but you should know that all private health insurance plans vary and the specific rules of your plan may differ from these Medicare guidelines.
Progressive O&P accepts most major health insurance plans, including Medicare. We will work with you and your insurance company so that there is maximal coverage for the device you need to retain locomotion and/or mobility.
Problem: the insurance denies the prosthetist’s request for approval to provide you with the high-tech prosthesis you need.
Many insurance companies routinely deny all requests for high-tech advanced prosthetic devices or components, such as the Otto Bock C-Leg™ microprocessor hydraulic knee-shin system or the Össur Rheo™ microprocessor magnetorheologic knee, in the hopes that the patient will simply take “no” for an answer and agree to be fitted with cheaper, less-than-optimal prosthetic components. This is done simply to save the insurance company money, not to look out for the patient’s best interests and needs.
Progressive O&P understands that not all insurers comprehend the magnitude of being an amputee or an orthosis wearer and how much the right prosthetic componentry can make a difference in our patients’ lives. To that end, our highly trained insurance Appeals Team vigorously fights all attempts by insurers to deny needed products or services to our patients.
Progressive O&P’s Appeals Team specializes in taking on these insurance giants and will be your advocate if your insurance carrier attempts to deny you a product or service that you need. Our mission is to provide our patients with the highest quality prosthetic and orthotic devices to help restore as much of your independence as possible, not to take “no” for an answer from some insurer bent on cutting costs instead of serving their members.
At Progressive O&P, your insurance appeal will be handled by an ABC-certified prosthetist who is intimately familiar with both your situation and the function of the device that is denied. We’ve read the research; we know when an advanced-technology prosthesis is the only solution that will help a patient achieve their goals. Our Appeals Team knows how to fight for your right to be fitted with the right prosthesis/orthosis for you, and we won’t let cost-cutting insurance companies push you around. If you need a particular orthosis, prosthesis or prosthetic component, and it could make your life better or more independent, then we will fight for you to be provided with it.
Please don’t hesitate to call us at 516-338-8585 and schedule an appointment to consult with a member of our Appeals Team if you have found that your existing provider is either unwilling or unable to fight for your rights against your insurance’s denials, or are concerned that your insurance will deny you products and services that you need.