Utah family fights for coverage of daughter's vital prosthetic arm

In Utah, Remy Bateman, a 9-year-old girl born without a hand below the elbow, is at the center of an ongoing struggle involving her health insurance company, Select Health. The family is advocating for coverage of a new advanced prosthetic arm, known as the HeroArm, which they believe is essential for enhancing Remy's quality of life. This new device has potential life-changing capabilities that include improved dexterity and functionality, as exhibited during a recent trial in Colorado, where Remy was able to perform activities such as using a fork and knife to cut through Play-Doh. Despite being approved for three previous prosthetics, Select Health has deemed the HeroArm to be 'not medically necessary,' leading to confusion and frustration for the Bateman family. The family's repeated appeals to Select Health have been unsuccessful. Each time they have tried to overturn the denial, their requests have been met with affirmation of the original decision to reject coverage. Jami Bateman, Remy's mother, has argued that medical documentation from doctors supports the necessity of the HeroArm, which they assert can provide significant improvement to Remy's everyday life. The insurance provider, when contacted, cited privacy laws, avoiding direct commentary on the family's specific situation. Remy’s father noted the seamless integration of the prosthetic with her natural movements during the trial, highlighting its importance in her day-to-day activities. Without coverage, the Batemans face a daunting out-of-pocket expense of $24,000 for the HeroArm. They hope their story brings attention not only to their plight but also to the challenges faced by others who find themselves in similar situations regarding insurance coverage for medical devices. The family's ongoing advocacy aims to effect change, both for Remy and for others encountering similar roadblocks with their insurance providers. They emphasize that this prosthetic is not merely a luxury but a critical tool for enhancing the quality of life. The Batemans continue their campaign for reconsideration from Select Health while drawing attention to the broader implications of insurance policies on medical device coverage for children. This case illustrates the complexities of health insurance policies and the often arbitrary distinctions made between what is deemed medically necessary versus not, especially concerning advanced technology in prosthetics. Conversations surrounding this topic are crucial as families like the Batemans fight for the rights and needs of their children, standing firm against the denials that could greatly hinder their growth and abilities.