Jessica's New Prosthetic Leg
Donation protected
It has been 8 years since I’ve gotten a new prosthetic. The only reason I am looking to get a new one now is because my old socket is too big. Since January 2020, I have lost about 25-30 pounds. I sought a diagnosis for constant nausea and stomach pain for months before finally learning of a new chronic condition I possess in late July. The chances of me getting back to the weight I was at the beginning of the year seems unlikely. So, given the age of my previous prosthesis and the inability to shrink the socket down enough to fit the new circumference of my leg, it was determined that I would need an entire new limb.
As a child, I do not recall ever facing any challenges when I needed a new prosthetic. Part of this is definitely because I went to Shriner’s hospital and they helped my family financially with the prosthetics until I was 18. But, in general, I have noticed that many organizations and healthcare providers tend to be more willing to help children with their medical bills than adults. It seems that some people have forgotten that disabled children grow up too.
At my second appointment, after some discussion between myself and my prosthetist, we decided that I should change my knee joint away from the one I was currently using and trade it for a computerized version. You see, back in 2018, I had a massive fall because the knee joint in my prosthetic gave out. Now, this was definitely not my first fall, but it was my worst. I hit my head on the concrete and suffered a concussion.
This new knee joint would quickly learn my gait and provide more assurance and stability as I walk, essentially ensuring fewer falls in the future. Not to mention, it’s the recommended joint these days across the board as it offers many people a more natural-looking walk. I was sold, and so the request was sent off to my insurance company, UnitedHealthcare.
In mid-October, I was informed that my request for the knee joint had been denied. This caused me to stop dead in my tracks. How could it have been denied??? It didn’t make sense to me at all. My prosthetist took immediate action and sent off an expedited appeal, explaining why this product was particularly important for my case.
On Monday, November 2nd, 2020, I was told that the appeal was once again denied because the device “exceeded my basic needs.” Cue a colossal explosion from every person in my family that lasted for hours. As I type this, my throat still hurts from my initial outburst. Not only was I denied, but UnitedHealthcare also said that I could not fight the matter further internally and that their answer was final. They would NOT be covering my new knee. Now, they have approved the other parts of the prosthetic (the socket, ankle, foot, etc), just not the knee, which is arguably one of the most important parts.
I am currently in the process of filing an external appeal, but I am not confident that the end result will land in my favor. This GoFundMe page is, therefore, a fallback option. I cannot afford this new device on my own and, while I don't find joy in asking others for financial assistance, I truly don't know what other route to take.
IF insurance does save the day, ALL donations will be refunded. Thank you in advance for any and all help.
As a child, I do not recall ever facing any challenges when I needed a new prosthetic. Part of this is definitely because I went to Shriner’s hospital and they helped my family financially with the prosthetics until I was 18. But, in general, I have noticed that many organizations and healthcare providers tend to be more willing to help children with their medical bills than adults. It seems that some people have forgotten that disabled children grow up too.
At my second appointment, after some discussion between myself and my prosthetist, we decided that I should change my knee joint away from the one I was currently using and trade it for a computerized version. You see, back in 2018, I had a massive fall because the knee joint in my prosthetic gave out. Now, this was definitely not my first fall, but it was my worst. I hit my head on the concrete and suffered a concussion.
This new knee joint would quickly learn my gait and provide more assurance and stability as I walk, essentially ensuring fewer falls in the future. Not to mention, it’s the recommended joint these days across the board as it offers many people a more natural-looking walk. I was sold, and so the request was sent off to my insurance company, UnitedHealthcare.
In mid-October, I was informed that my request for the knee joint had been denied. This caused me to stop dead in my tracks. How could it have been denied??? It didn’t make sense to me at all. My prosthetist took immediate action and sent off an expedited appeal, explaining why this product was particularly important for my case.
On Monday, November 2nd, 2020, I was told that the appeal was once again denied because the device “exceeded my basic needs.” Cue a colossal explosion from every person in my family that lasted for hours. As I type this, my throat still hurts from my initial outburst. Not only was I denied, but UnitedHealthcare also said that I could not fight the matter further internally and that their answer was final. They would NOT be covering my new knee. Now, they have approved the other parts of the prosthetic (the socket, ankle, foot, etc), just not the knee, which is arguably one of the most important parts.
I am currently in the process of filing an external appeal, but I am not confident that the end result will land in my favor. This GoFundMe page is, therefore, a fallback option. I cannot afford this new device on my own and, while I don't find joy in asking others for financial assistance, I truly don't know what other route to take.
IF insurance does save the day, ALL donations will be refunded. Thank you in advance for any and all help.
Organizer
Jessica Ping-Wild
Organizer
Pontiac, IL