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Lymphedema sufferers fight for better insurance coverage

Lymphedema is a disease many don’t know much about.

An estimated three to five million people in the United States live with the illness.

Lymphedema is an incurable but treatable medical condition caused by injury, trauma or congenital defects in the lymphatic system.

Many patients are cancer survivors. Many patients also struggle to afford the medically prescribed compression garments needed every day to manage the disease.

Those garments can cost hundreds of dollars, need to be worn everyday, and therefor, change out regularly. Medical insurance often does not cover the cost.

Many diagnosed with the medical condition across the country want to change that with the Lymphedema Treatment Act.

Kansas City area resident Bill McCann has also been diagnosed with lymphedema.

“In my early 20s I had a cancer in my leg. That spread to my lymphatic system, so they had to take lymph nodes out,” he said.

The majority of lymphedema patients are cancer survivors, and every day, these garments help promote circulation in limbs that otherwise would show the lymph fluid building up, leading to even more serious health problems,” McCann explained.

McCann is part of the nationwide effort to change the law and the lack of insurance coverage.

He’s been to Capitol Hill multiple times lobbying members of Congress to change that.

The Lymphedema Treatment Act (LTA) has been introduced in both the House and Senate and supporters say they should now have enough co-sponsors in both the House and Senate to pass legislation if there is a vote.

There is no set timeline for a vote at this point. You can read the bill here and see which members of Congress are co-sponsoring the legislation.

Without insurance, patients can end up with serious medical complications including cellulitis sepsis, and septic shock. In some cases, medical complications can be fatal.

 

“What happens is they end up using the garment for too long because financially they can’t afford it. They’re playing this game of chicken basically. What happens is they end up getting an infection. I have friends who are in and out of the hospital constantly because they’re playing that game,” McCann said.

Supporters of the LTA say insurance coverage for compression garments could be a cost savings, eliminating many hospital visits that end with thousands of dollars in charges for multiple-day stays.

The LTA website includes the following explanation of the bill:

The Lymphedema Treatment Act (LTA) will improve coverage for the treatment of lymphedema from any cause by amending Medicare statute to allow for coverage of compression supplies. Although this legislation relates specifically to a change in Medicare law, it would set a precedent for Medicaid and private insurers to follow.

McCann points to studies showing insurance coverage of compression garments result in fewer hospitalizations and lower medical costs.

For more information on the LTA, research on lymphedema, compression garments, insurance coverage and contact information for members of Congress, click here.






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