John-Edward Heath, from Annapolis, may have lost one leg, but now he has six. Each specialized for a different sport.
“This one is specifically for distance running,” Heath said as he showed us one of his prosthetic limbs.
“I use this for olympic weightlifting, snowboarding, and surfing,” he said as he showed us another.
“This is a very stiff one. You cannot run long distance in this. You’re gonna jam your residual limb,” as he picked up a third.
This technology has allowed heath to become a professional adaptive athlete, and quickly.
In 2016, he was hit by a drunk driver. After five years of doctors trying to reconstruct his leg, he finally opted to amputate in 2021.
He's now a top qualifier for the 2024 Paralympics in track and field, the 2026 Paralympics in snowboarding, and the Adaptive CrossFit games. He travels around the world to compete, and has trained alongside NFL players.
He has exceptional athletic prowess, no doubt. But even someone with the same disability who matches him in strength, might not match him in means. After serving in the marines for 10 years, his prosthetics are covered by the Department of Veterans Affairs.
“To realize that the average person I was competing with, especially in the international level, they only had one. Here I am coming in with a suitcase full of prosthetics. I started to realize that it's not as common," Heath said.
But he believes it should be. He's fighting for legislative change at the state level, alongside a clinician at Linthicum-based prosthetic company.
“So in Maryland, insurance companies are required to pay for baseline prosthetic and orthotic devices for patients,” explained Sheryl Sachs, clinician at Dankmeyer Inc.
But after that, you're on your own. Want a back-up in case you rip the sleeve of your prosthetic on the playground? Want one made that will allow you to ride a bike? Do yoga? Swim? It's not "medically necessary," so insurance most likely won't cover it.
"Prosthetic devices and some orthoses are not designed to do all of those things at once. So that's why it's medically necessary for a lot of patients to have more than one type of prosthesis or orthosis. But insurance doesn't necessarily recognize that, all they see is - 'we've already paid for something, now we need to pay for something else.' And the way that billing and coding works in our field, devices that function very differently, are reimbursed for in the same way. So insurance that doesn't necessarily recognize that a certain prosthetic foot or prosthetic arm can only do one thing versus the other, they're not recognizing that nuance," explained Sachs.
And we're talking about costs that will make your head spin.
“I just got back from Florida.” Heath goes to Florida to get his prosthetics. "They gave me all brand new sockets. I got a brand new walking foot. I got a brand new blade because I broke it. In the five days that I was there, $35,000. And that's just sockets and sleeves. So if you're talking these numbers, why would you want to be actively fit if you don't have the coverage?"
A change to state law would require insurance companies to cover things like an additional prosthetic device for physical activity. Heath and Sachs have received support from Senator Sarah Elfreth, Senator Pamela Beidle, and Delagate Ashanti Martinez. The bill was introduced in the Senate today.
“We're very optimistic that this will move forward. Because not only is it the right thing, but we've also found through research, that the fiscal impact on the state and on insurance companies is so minimal compared to a lot of other other efforts that are out there already,” Sachs said.
For the disabled community, the technology is out there. The inspiration is out there. Now they just need the law to catch up.
“I think it’s important for me to fight for this, because I know what it is to have all these resources,” Heath said.
