My brother-in-law claims that he not has to pay more for his prosthetic leg adjustments under Obamacare. He said his knee adjustment will not be paid for now. The doctor said the reason is Obamacare. He is on disability and I was wondering if it is because of NC not fully funding Medicaid expansion?
Where can he go to find the answers?
Prosthetics are covered on most ACA plans, but replacements and adjustments aren't considered an "essential health benefit", thus services can be limited. There is no specific provision in the law that limits prosthetic coverage.
In states that didn't expand Medicaid prosthetic leg adjustments may not be covered and coverage of adjustments and replacements may be limited on other plans.
The best bet is always to check with the insurer before picking a plan, in the case of Medicaid, the best bet is to contact the state Medicaid department to better understand what plan a person is on. (In state's that don't expand coverage some adults can still get limited benefit Medicaid coverage).
Every day, there are more than 500 amputations performed in America, adding up to more than 180,000 amputations each year, according to the Amputee Coalition. Nationwide, some 2 million Americans are amputees.
If you have specific Medicaid questions you should contact NC's state Medicaid department. The phone number to call the North Carolina Medicaid office is 800-662-7030 or in state call 919-855-4100.