Expanding Insurance Coverage for Pediatric Upper Extremity Recreational Prosthetic Devices

TL;DR

This paper discusses the need to expand insurance coverage for recreational prosthetics for children with limb differences to improve their physical and mental health.

Contribution

The paper advocates for policy changes to cover activity-specific prosthetics, highlighting their long-term cost savings and benefits.

Findings

Activity-specific prosthetics offer physical and psychological benefits like increased strength and self-esteem.

Insurance coverage for these prosthetics is currently limited, causing financial strain for families.

Expanding coverage is cost-saving in the long-term and improves quality of life for pediatric patients.

Abstract

Pediatric limb differences often necessitate prosthesis use to assist with activities of daily living. Daily prosthetics are not designed for creative or skill- and strength-based physical activities, which has prompted the use of activity-based or “recreational” prosthetics. Pediatric activity-specific prosthetics are expensive but provide considerable physical and psychological benefits, such as increased strength, weight loss, better self-esteem, social inclusion, and higher quality of life. Currently, activity-specific prostheses are generally not covered by insurance, posing considerable financial burden in conjunction with ongoing prosthetic replacements and additional medical care. Many states are introducing and adopting policies about expanding insurance coverage for activity-specific prostheses, which are cost-saving in the long-term. To best serve our patients with limb differences, hand surgeons should advocate for expanded coverage of activity-specific prostheses for pediatric patients at local, state, and national levels.

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