An Open Letter From Tom Andrews: The Maine Coalition for Working Amputees

October 2002

Dear friend,

Something tragic is happening to growing numbers of working Maine amputees and their families. Recovering from the traumatic loss of a limb, many are being told that their health insurance covers only a very small portion of the cost of a prosthesis, or none at all.

What do they do? Some go deeply into credit card debt. Some mortgage their homes. Some dip into college or retirement savings. Others simply go without. Or, they are forced to purge their assets and become eligible for Medicaid - the state health care program for the poor that pays for medically necessary prosthetic care.

The problem is that over the last few years certain insurance companies in Maine have decided to severely reduce coverage of prosthetics to working Maine families. Classifying prosthetic care as "Durable Medical Equipment", they are capping benefits so low that most, and sometimes all, of the cost of a prosthesis is not covered. Maine families who have been regularly paying their medical insurance premiums, with the belief that they will receive reasonable medical coverage if it becomes necessary, suddenly find themselves facing a double catastrophe - the tragic loss of a limb and a severe and sometimes insurmountable financial hardship. Other working Maine amputees suddenly find that they can't fill a medical prescription for the repair or replacement of a prosthesis because their insurance will not longer provide adequate coverage.

I'm writing to you and other Maine people who use a prosthesis, or who know someone who does, because we all have a stake in this serious problem. I'm also writing because I believe that if we work together, we can solve it.

I'd like you to consider joining the Maine Coalition for Working Amputees. We are a grass-roots network of Maine people who want to make certain that working Maine amputees who are covered under medical insurance plans do not face unnecessary financial burdens and hardships in order to secure or maintain a prosthesis that meets their needs. We want to make sure that working amputees in Maine are able to continue working and supporting their families. We want to eliminate any possibility that a child who has lost a limb is not forced to spend his or her childhood - or any more time than is necessary - in a wheelchair when a prosthesis is readily available.

Our goal is simple: to change Maine law so that all group health insurance in Maine covers prosthetic care equal to the Medicare benefit level.

The cost to an insurance company and its subscribers is minimal. It has been estimated that this change may increase premiums by .0008% or just twelve cents per month per subscriber! The benefit to all working Mainers - particularly working amputees and those who have a family member who has lost a limb - will be enormous. This includes reaping the savings that a prosthesis provides including decreasing the need for:

• Unnecessary hospitalizations and emergency room visits;
• Treatment of pressure sores, infections, back problems, hip replacements or the deterioration of joints and muscles;
• The unnecessary use of durable medical equipment;
• Unnecessary medication;
• And, the benefit of allowing Maine amputees to return to work as soon as possible.

We need your help to get our coalition up and running. We are asking every concerned Mainer - including amputees, their friends and families, health care and service providers - to join this effort. Our goal is to demonstrate that concerned Mainers from throughout our state support this important protection for working Maine families. Your willingness to sign up now will make a real difference.

Please e-mail us at mcwa@drcme.org or call at 1-800-452-1948. You will be put on our membership contact list and provided complete information on this important effort, including regular updates on our progress. We will also provide you with simple but powerful ways that you can help to win passage of this legislation. If you can, a financial contribution to this grass-roots effort - large or small - will also be greatly appreciated and put to work right away.

Together, we CAN make a difference. By joining us today, we WILL.

We look forward to hearing from you.

Sincerely,

Tom Andrews
Maine Coalition for Working Amputees

PS. Please take a moment to respond to us today - it really takes only a few minutes and it will make a tremendous difference to amputees and their families throughout Maine. Thanks in advance for joining us!

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