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Decision Means Mobility for Thousands of New Yorkers

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Friday, May 29, 2015   

NEW YORK - None of us wants to ponder what life would be like if we lost a limb; but a new change in policy for the New York State of Health marketplace just made life more manageable for thousands.

At issue was how often and how many prosthetic limbs could be replaced for New Yorkers who rely on what is commonly known as "Obamacare." Heidi Siegfried, project director for New Yorkers for Accessible Health Coverage, said New Yorkers now will be covered if they outgrow prosthetic limbs or if the limbs simply wear out over time.

"So, this means that people will not have to pay out of pocket anywhere from $5,000 to $80,000 to replace a limb," she said, "which they do need replacement, like, every three to five years."

Siegfried said New York lawmakers also are debating a long-term fix this session that would make coverage for these prosthetic devices a matter of law in New York.

Solomon Wolde is a Type 1 diabetic from the Bronx who has two prosthetic devices from leg amputations. The loss of a kidney qualified him for Medicaid and, as a result, his limb replacements are covered. Still, he said he is concerned about other uninsured fellow New Yorkers who need state lawmakers to take action.

"If you don't have insurance, that means I couldn't leave my house. I couldn't go to the hospital or to visit a friend. I cannot do anything," he said. "That means it's very important for people who lose their limbs, so they have to fix the policy."

Siegfried said the replacement issue is important, considering the number of New Yorkers who lose a limb each year.

"In New York in 2012 there were hundreds of people getting upper-limb amputations and thousands of people that needed below-the-knee and above-the-knee amputations each year," she said, "and then, of course, they are going to need repair and replacement."

Siegfried said this is one positive sign as to how Obamacare rules can be improved to meet the changing needs and gaps in coverage for New Yorkers.


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