Thursday, May 12, 2022

Braces vs orthotics

James Fenton

To U.S. Listservers:


I just received my United Healthcare insureds manual.  In reviewing my coverages I came across this gem.  Maybe it has some meaning to you.  I found it amusing and disgusting at the same time.  This is straight from the manual:


Examples of Durable Medical Equipment include:


   Braces, including necessary adjustments to shoes to accomodate braces.  Braces that

   stabilize an Injured (sic) body part and braces to treat curvature of the spine are considered

   Durable Medical Equipment and are a (sic) covered service.  Braces that straighten or 

   change the shape of a body part are orthotic devices, and are excluded from coverage.

   (I added the italics)


Not only have they made up their own definitions but they don’t seem to know that a brace that treats curvature of the spine is either covered or not covered, depending on whether you use the first part of the paragraph or the last part as your reference. 


I’m certain we’ll get the answer on an individual basis; at their descretion. 


Let me know if you understand this any better than I do.


Jim Fenton, LPO, CPO

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