Funding for a prosthesis
People are often concerned about the costs involved in getting a prosthesis. During the course of your treatment the funding for your prosthesis should be discussed with you. As the majority of amputations are due to contributing medical conditions such as diabetes, vascular disease or cancer, your prosthesis is generally covered by funding from the public health system and/or if eligible, the National Disability Insurance Scheme (NDIS)
Generally speaking, the following categories apply:
- If you lost your limb due to disease or illness you will most likely be covered by the Queensland Amputee Limb Service (QALS) or the National Disability Insurance Scheme (NDIS) if you are under the age of 65.
- If you lost your limb in an accident and there is no compensating body, for example at home or during recreation, then the public health system or the National Injury Insurance Scheme (NIIS) will cover the cost of prosthetic limb/s. (Note the NIIS is still a work in progress, funding will be provided by the NDIS in the meantime).
- If your amputation was due to trauma such as: a motor vehicle accident or workplace accident, and compensation is identified as a possibility, the Insurance organisation will most likely fund your prosthesis and medical care as part of your rehabilitation needs.
- Veterans who either lost their limb as a result of injuries received while serving, or who have a Gold Card, will have their prosthesis paid for by the Department of Veterans Affairs or the Defence Force.
- Most Private Health insurance companies do not allocate funding for prosthetics, however it is worth checking with you insurer if you are uncertain as they may cover partial costs.
If you are eligible for ongoing prosthetic use and funding, all future prosthetic services ranging from your first (interim) prosthesis, replacement prosthesis, socket replacements, reasonable repair costs and supplies such as stump sock and shrinkers are included.
It is important to remember that you can trial most prosthetic devices before facing out of pocket expenses.
Most prosthetic componentry companies will allow you to have a foot, knee unit or hand/arm on loan for approximately two weeks to try before you make the final decision about which device is best for you. This will give you the chance to see if a different prosthetic component gives you better outcomes such as;
- More energy at the end of the day
- Provides you with more stability and confidence
- Enables you to be more active
- Increases your functionality
Remember to have an prosthetic maintenance check every 3 months.