Knee braces & insurance

[TooTall]

Does anyone currently use knee braces that were covered by insurance? I don't currently have a knee injury, but I've heard that some companies will cover the cost of knee braces as a preventative measure. Any comments?

TT

 

[Danman]

I would love to know as well. I would gladly were a pair, but not have money yet to buy them. I wish that I could just explain to the insurance company that it would cost them more for me to have surgery on my knee than for them to shell out now for some decent braces.

With the new insurance laws that just got passed will this even be possible? If they tell you that motorcycling is a "high risk" sport and they won't cover it. We changed insurance companies just a this month and if you upped you coverage for life insurance they made you fill out another form. One question on that form asked about "High risk activities". The question specificly mentioned racing motorcycles withing the last 2 years. IF you answered yes to that question you have to turn the form over and fill out a bunch of medical type questions. I just don't wonder if that just gives the insurance company leverage to deny your family compensation if you die or you become disabled?

 

[jeb]

My insurance company, Health Partner HMO, paid 80% of the cost of mine. I was able to choose between Cti2, Townsend Air and Don Joy all about $1100 per side.

I had tweaked my MCL the year before and it was still giving me a little pain but no instability. My other knee I hurt downhill skiing 20 years ago. After seeing the doc and getting MRI's on both knees ($1500 per knee for the MRI's!!!), he told me I had strained MCL's in both knees. He said there's not much evidence to suggest that knee braces do much good as preventatives but he gave me a prescription anyway.

There's a recent discussion on ktmtalk about the benefits of knee braces, or lack thereof. It was started by an MD and, even though it gets a bit heated at times, it's worth a read:
http://www.ktmtalk.com/messageview.cfm?catid=20&threadid=885

I like my braces. I doubt they'd do much to prevent a torsional MCL type loading or help in any kind of high load impact. I do think they help with low speed forces and they for sure help me stand much longer without knee pain. That alone is worth the price to me.

 

[Danman]

I'm slow so I might get more protection ;)

 

[hoosierf]

My insurance company paid for them after I requested that my surgeon prescribe them. He initially said they really aren't that effective, but did admit that they are effective at protecting against hyperextension (the way I tore my ACL in the first place). There are several good medical papers on the web that will support an argument for, or against braces. The attached paper supports the Donjoy Legend, which I own. They cost about $750 each by the time they are fitted and really are quite comfortable. The late '90s vintage articles I researched in the past were largely critical of braces. This article was written after my knee was repaired. I was encouraged to see the tide turning on bracing, as I am a firm believer in them. Here's the link. http://www.execulink.com/~frind/Knee-Articles/Fleming-AJSM-Nov00.htm It might help you pursuade you doc or your provider. I would be surprised if you could get your insurer to pay for the braces without a diagnosed injury.

 

[TooTall]

Thanks for the info. I think I'll mention this during my next visit to the doc. I have had surgury on my right knee a few years ago, so maybe if I complain about it bothering me once in a while....................

TT

 

[zio]

call your insurance company (800 # usually can be found on your ID card), and ask them about the coverage on your plan for Durable Medical Equipment and Orthodics. You can even ask them to mail you a new "Summary of Benefits". Don't alwasy take what your doc says about your plan. Mine said that braces weren't covered, when in fact they are. Also, if you have an HMO, ask for a referral to a specialist. An orthopedic surgeon will be more likely to prescribe them than your PCP.