Suitland Teenager Seeks Help With Continuing Costs of Prosthesis - Southern Maryland Headline News

Suitland Teenager Seeks Help With Continuing Costs of Prosthesis


By ERIKA WOODWARD

ANNAPOLIS (Feb. 11, 2009)—Lorenzo Smith never thought he'd be penalized for growing taller, but his HMO insurance plan says he has to pay.

The 15-year-old was charged more than $20,000 for growing 5 inches in 4 years, and he dares to keep growing.

"I'll be 16 (on) Feb. 25," he said. "I'm near 5-foot-8."

Because Smith stands tall with the aid of a prosthetic leg, the price of his height is taxing his family, as his insurance restricts coverage for his prosthetic device, including adjustments made for his height.

Smith's right leg was amputated from the knee down three years ago after he was struck by a car while walking home from school.

"There's several people out here who have lost a limb and they need this certain object just to do their everyday life and it's sad for you to go to your insurance that you've been paying for years and they tell you, `no, you can't get this,'" he said. "I don't understand why they can't help you when you're in need."

Smith is taking his fight for affordable prosthetics all the way from his row home in Suitland, to legislators in Annapolis, where he is slated to testify Thursday in favor of the Prosthetic Parity Act. This will be the second time he testifies for the bill, which would mandate state-regulated insurance companies provide more comprehensive coverage for prosthetic devices.

The bill was held over last session for a Maryland Healthcare Commission report, which analyzed the cost to insurance companies. The commission found the mandate would add zero to 31 cents per policy per month, said Sen. Catherine Pugh, D- Baltimore, who introduced the bill in the Senate.

"We just feel that when we talk about prosthetics that those who are in need should be able to have," she said. "We've done our homework. We've done our research and I hope the General Assembly will follow through and pass this bill."

But a spokesman for UnitedHealthcare, the parent company for the Smith's insurance policy, said the General Assembly may need to do more homework. While 31 cents sounds cheap, Debora Spano said the real test is to add it to existing mandates and multiply it by the number of people insured.

It would be a significant cost to taxpayers, she said.

"Maryland is at the top of the list (for states with the highest number of mandates) and that's a cost to everybody who's paying health insurance," she said. "While we see the need for everybody to have a prosthesis, the question becomes how much can we afford?"

The Smith family asks the same question.

Since being fitted for the artificial leg at age 12, Smith has outgrown two legs and two whole sockets, the part of the prosthesis that helps lock everything in place.

Under his mother's insurance plan, only 50 percent of the costs associated with the prosthesis are covered and Smith is limited to 50 doctor visits per year, his mother Albertha Jackson-Smith said.

Trips to the doctor add up quickly for an active young man who is a point guard in pick-up basketball games and a wide-receiver in football games.

"I'm too good for (wheelchair) basketball," Smith said of his active lifestyle, which helped prompt two doctor's visits in January and one in February.

"If my thigh gets too big for the (liner), I have to get that changed. As far as me growing, I have to get an extension," Smith said.

"All that takes time to get fixed and it costs money, too," he said.

It costs $500 for the liner Smith must replace every five months. The liner is a slip-like sleeve he hand washes daily, which is used to suction his thigh to the prosthesis.

It's also one of the many costs that have driven Smith's mother, a government employee, and her husband, a contractor, to get creative with fundraising.

They hosted a benefit dinner in 2007 and held the Lorenzo Smith Fund Walk-a-thon that same year and the year after.

But they spent more money on the benefit dinner then they made, and while they're proud of the walk-a-thons, last year's only raised enough money for one liner.

"It was a good turnout, but not like it was for the first year," said Albertha Jackson-Smith, when people had more money to give.

The Smiths are counting on the General Assembly to help them afford the prosthetic that gave their son a new life. He's just not himself without it.

"I'm not moving, basically," he said. "I won't do anything outside this house. I still don't understand why I don't like to go anywhere without walking."

The Senate Finance Committee with hold the hearing at 1 p.m. Thursday.

Capital News Service contributed to this report.

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