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Private Insurance

Overview

Many people who are covered under private insurance would assume that their health plan would cover the equipment they might need in the event they were disabled. Surely, private insurance would cover artificial limbs, wheelchairs or walkers, for example.

A private insurance plan may not cover such equipment, called durable medical equipment (DME), by insurance companies. Even if one's employee booklet states that its plan covers DME, that coverage may be limited. Individuals with pre-existing conditions may be excluded from coverage for DME. This means a child who uses an artificial limb may not be able to get reimbursement for another, when she outgrows the first. The same is true if that child is a wheelchair user.

Should the DME be covered under private insurance, it often takes months to obtain authorization to purchase the equipment. Some people give up on the process, which for many, causes a loss of independence, loss of work or decrease in work productivity, and a loss in ability to participate effectively in community and family activities. For those individuals who are able to ultimately prevail and obtain their equipment these losses were temporary.

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