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Family of nine-year-old girl born without her left arm are told new prosthetic 'not medically necessary'
Daily Mail UK ^ | December 13, 2024 | Emma Richter

Posted on 12/13/2024 10:52:56 AM PST by Morgana

The family of a nine-year-old girl who was born without her left arm has been told a new prosthetic is 'not medically necessary' by their insurance company.

Remy Bateman, from Utah, has lived her whole life with the use of just one arm 'due to an amniotic band in the womb' caused her to lose the limb at birth, according to her mother Jami Batemen.

The school girl has always relied on prosthetics, but after recently outgrowing them, her family set their sights on upgrading her to a robotic arm.

They traveled to Colorado where Remy got to test out the Hero Arm, quickly feeling a sense of joy because of how functional it made her.

But her happiness was torn away when Select Health sent a denial letter to her mother, stating the new prosthetic is 'not medically necessary.'

Jami immediately appealed the company's decision as she was left confused why they refused to cover the costs.

'They’ve approved three prosthetics before in her lifetime, so I can’t figure out why they refuse to deny this one,' Jami told KUTV.

Despite sending an appeal letter back to Select Health, Jami said she yet again received a letter denying coverage for Remy's new arm, which costs $24,000 without insurance.

During their time in Colorado, Jami said her daughter was visibly thriving wearing the robotic arm.

'This is 100 percent needed,' her mother said, adding that they saw with their own eyes what their daughter is capable of with the advanced prosthetic.

'We have seen what she can do being over in Colorado for three days.

(Excerpt) Read more at dailymail.co.uk ...


TOPICS: Health/Medicine
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To: Chickensoup

Nevertheless, this is something our health care companies need to work on.
If the industry has a standard for these instruments, then be patient should be able to apply the cost to any higher cost instrument that they believe will do them more good. This is simple. Also, the problem of outgrowing a device is known and can be priced in too.


21 posted on 12/13/2024 11:39:33 AM PST by KC_for_Freedom (retired aerospace engineer and CSP who also taught)
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To: Morgana

Technically, insurance is to cover you for loss.

If you did not have something, there is a great argument that you can’t get something.

This definitely should hold true for all sex change operations, too.


22 posted on 12/13/2024 11:44:19 AM PST by ConservativeMind (Trump: Befuddling Democrats, Republicans, and the Media for the benefit of the US and all mankind.)
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To: Morgana

If she wanted a sex change though???


23 posted on 12/13/2024 11:45:08 AM PST by Karliner (Heb 4:12 Rom 8:28 Rev 3, "...This is the end of the beginning." Churchill)
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To: KC_for_Freedom

The standard is the prosthetic arm.

A robot arm is beyond standard.

Perhaps over time like so many other kinds of medical equipment it will become standard.

But not now


24 posted on 12/13/2024 11:48:26 AM PST by Chickensoup
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To: Responsibility2nd

So, you’re saying they’re denying her the super deluxe fancy prosthetic arm but that you did get a prosthetic arm from the insurance company?


25 posted on 12/13/2024 11:57:09 AM PST by dangus
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To: Morgana

I gather from what was posted that the insurance company is not outright denying all prosthetics but this robotic model. The insurance company likely reasons that she had not needed that type before and that she will outgrow it fairly quickly.

It may be that the robotic arm is not suitable for her at this age. I also do not understand why she was allowed to test the arm before getting a clearance from the insurance company. That would have saved her a lot of heart ache.


26 posted on 12/13/2024 11:59:20 AM PST by lastchance (Cognovit Dominus qui sunt eius.)
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To: Revel

OMGosh. You get it! Thanks.


27 posted on 12/13/2024 12:00:42 PM PST by lastchance (Cognovit Dominus qui sunt eius.)
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To: Responsibility2nd

It’s not fake news. It’s Agony Aunt news.


28 posted on 12/13/2024 12:01:33 PM PST by lastchance (Cognovit Dominus qui sunt eius.)
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To: Morgana
The Brit Socialists are quietly peddling NHS death care with this crap .
Does the Brit Death care NHS cover Robotic.
Hell No .
Does the Daily Smear state .
Hell No.
No insurance will cover robotics unless you bought a special Add on .
They are experimental and not covered by Medicare as covered .
Medicare would go bankrupt .
This robotics are 25000 and up
These insurance are villains are purposely being peddled Daily.
Wait until you are stuck with Deathcare .
The daily Smear are reckless socialists .
29 posted on 12/13/2024 12:03:28 PM PST by ncalburt ( Gop DC Globalists are the evil)
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To: dangus

Did I get a prosthetic arm??

Do you wanna try rewriting that question so that it makes sense? Thank you.


30 posted on 12/13/2024 12:03:57 PM PST by Responsibility2nd (Climate Change is Real. Winter, Spring, Summer and Fall.)
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To: MayflowerMadam

They are demanding a experimental robotic.

She is NOT denied a prosthetic which everyone covered can get .
This family is playing games here and the
Deathcare socialists at the nDaily Smear wrote up this crap .
Does the Dear NHS pay full robotics for kids .
Hell No but the daily smear wont tell anyone that.


31 posted on 12/13/2024 12:08:57 PM PST by ncalburt ( Gop DC Globalists are the evil)
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To: Morgana

I wouldn’t be surprised if they offered “euthanasia” instead.


32 posted on 12/13/2024 12:16:59 PM PST by I want the USA back (Voltaire: To learn who rules over you, simply find out who you are not allowed to criticize.)
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To: ncalburt

“They are demanding a experimental robotic.”

Could fall under “Right To Try”. But they shouldn’t be “demanding” it. Find a mediator and negotiate. Also if it’s experimental, the engineers, etc., should be thrilled to have an eager volunteer.


33 posted on 12/13/2024 12:43:06 PM PST by MayflowerMadam (It's hard not to celebrate the fall of bad people. - Bongino)
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To: Morgana
'This is 100 percent needed,' her mother said,

Apparently it really isn't. But it's for the children dontcha know......

'She recently has been asking for a robotic arm, saying it will help her feel more confident in her abilities day to day,'

If the child is functioning well with the current prosthetic, there is no sense for the insurance company to approve a new high tech prosthesis that will have to be replaced in a couple years due to the child's growth.

I hate these article that make no mention of the insurance companies or what their policies offer. Maybe the parents need to switch companies to one that is more sympathetic to their needs.

34 posted on 12/13/2024 12:45:59 PM PST by Hot Tabasco
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To: Morgana
her family set their sights on upgrading her to a robotic arm. But her happiness was torn away when Select Health sent a denial letter to her mother, stating the new prosthetic is 'not medically necessary.'

She wanted to be upgraded to a robotic arm and the insurance company denied it. I know insurance companies can be a-holes but I'm not seeing anything wrong here. Why not ask for a gold-plated arm?

35 posted on 12/13/2024 12:47:51 PM PST by Opinionated Blowhard (When the people find that they can vote themselves money, that will herald the end of the republic.)
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To: Opinionated Blowhard

Agree


36 posted on 12/13/2024 12:48:40 PM PST by Chickensoup
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To: Morgana
The very reason that Insurance Company CEO's are ASSASSINATED.


37 posted on 12/13/2024 12:53:23 PM PST by VideoDoctor
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To: brookwood

Yes indeed, any insurance company doing ACA policies should’ve been restricted to some reasonable amount around the salary paid to POTUS in order to be able to collect premiums. Most of the premiums they do get are paid by the government or employers. And then they rape the taxpayers on these premiums while screwing over their customers.


38 posted on 12/13/2024 1:06:02 PM PST by Degaston
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To: Morgana

my vote is for the person or persons who proclaimed a prosthetic arm as being medically unnecessary to each have an arm cut off, and THEN let them decide how medically necessary a prosthetic arm is ...


39 posted on 12/13/2024 1:07:19 PM PST by catnipman ((A Vote For The Lesser Of Two Evils Still Counts As A Vote For Evil))
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To: Morgana

switch insurance companies? because they cant deny your pre-existing condition...


40 posted on 12/13/2024 1:08:22 PM PST by TexasFreeper2009
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