PROSTHETIC LIMBS. Prosthetic limb devices include artificial arms, hands, legs, and feet, and are covered up to a maximum of thirty thousand dollars (US$30,000) per insured, per policy year, with a lifetime maximum of one hundred twenty thou- sand dollars (US$120,000). The benefit includes all the costs associated with the procedure, including any therapy related to the usage of the new limb. Prosthetic limbs will be covered when the individual is capable of achieving indepen- dent functionality or ambulation with the use of the prosthesis and/or prosthetic limb device, and the individual does not have a significant cardiovascular, neuro- muscular, or musculoskeletal condition which would be expected to adversely affect or be affected by the use of the prosthetic device (i.e., a condition that may prohibit a normal walking pace). Repair of the prosthetic limb is covered only when anatomical or functional change or reasonable wear and tear renders the item nonfunctional and the repair will make the equipment usable. Replacement of the prosthetic limb is cov- ered only when anatomical or functional change or reasonable wear and tear renders the item nonfunctional and non-reparable. Initial coverage, repair, and/or replacement of prosthetic limbs must be pre-approved by USA Medical Services.
PROSTHETIC LIMBS. Prosthetic limb devices include artificial arms, hands, legs, and feet, and are covered up to a maximum of thirty thousand dollars (US$30,000) per insured, per policy year, with a lifetime maximum of one hundred twenty thousand dollars (US$120,000). The benefit includes all the costs associated with the procedure, including any therapy related to the usage of the new limb. Prosthetic limbs will be covered when the individual is capable of achieving independent functionality or ambulation with the use of the prosthesis and/or prosthetic limb device, and the individual does not have a significant cardio- vascular, neuromuscular, or musculoskeletal condition which would be expected to adversely affect or be affected by the use of the prosthetic device (i.e., a condition that may prohibit a normal walking pace). Repair of the prosthetic limb is covered only when anatomical or functional change or reasonable wear and tear renders the item nonfunctional and the repair will make the equipment usable. Replacement of the prosthetic limb is covered only when anatomical or functional change or reasonable wear and tear renders the item nonfunctional and non-rep- arable. Initial coverage, repair, and/or replacement of prosthetic limbs must be pre-approved by USA Medical Services.
PROSTHETIC LIMBS. Prosthetic limb devices include artificial arms, hands, legs, and feet, and are covered up to a maximum of thirty thousand dollars (US$30,000) per insured, per policy year, with a lifetime maximum of one hundred twenty thou- sand dollars (US$120,000). The benefit includes all the costs associated with the procedure, including any therapy related to the usage of the new limb. Prosthetic limbs will be covered when the individual is capable of achieving indepen- dent functionality or ambulation with the use of the prosthesis and/or prosthetic limb device, and the individual does not have a significant cardiovascular, neuro- muscular, or musculoskeletal condition which would be expected to adversely affect or be affected by the use of the prosthetic device (i.e., a condition that may prohibit a normal walking pace). Repair of the prosthetic limb is covered only when anatomical or functional change or reasonable wear and tear renders the item nonfunctional and the repair will make the equipment usable.
