BY SHANNON MULLENSTAFF WRITER
He's got a $15 co-pay for doctor's visits and medications. He's got 100 percent coverage for hospital visits.
He had no complaints, really — that is, until he needed a prosthetic leg and learned the maximum lifetime allowance was $1,000, with a $200 co-pay.
A thousand dollars? A basic prosthesis costs 10 times that much. You can't buy a wooden peg for $1,000 today.
Hansen, 50, of Keyport, a diabetic since childhood, lost his job as a hazardous materials training technician after he tore off a toenail and developed a dangerous infection that led to the amputation of his toe. Subsequent amputations of his other toes, half his foot and finally his left leg, above his knee, had wiped out his life savings and driven him into debt. He and his wife, Fran, didn't know how they'd come up with $10,000, even if that was his only shot at ever walking again.
But Tuesday he did walk. Just a few, tentative steps — but after all he's been through, it felt like reaching the surface of a very deep, dark sea after a long time underwater, and seeing the sun again.
"It's amazing," an ecstatic Hansen said afterward. "It felt great to be standing and to put weight on my two legs again. I haven't done that in two years."
At Hansen's side was Robert Manfredi Sr., look-ing equally pleased. It was Manfredi's charity, Angels with Limbs, that made the moment possible.
Manfredi, 70, of Rumson, is the co-founder of Manfredi Orthotic & Prosthetic, a company that's been a fixture in downtown Long Branch for the past 50 years. Three years ago, in an ironic twist, Manfredi himself wound up needing a prosthetic leg after a diabetic-related amputation; he says he's one of only 10 people in the world right now with a computerized ankle joint.
Manfredi retired at the time, handing the business over to his son, Robert Manfredi Jr. Eager to remain active, the elder Manfredi founded Angels with Limbs, a nonprofit organization that uses parts of donated prostheses to fabricate new limbs for New Jersey residents who are underinsured or don't have health insurance.
The charity helps about a dozen people per year. Among its recent projects was fitting an Ocean County man with a state-of-the-art, $50,000 computerized prosthetic knee that the previous owner had bequeathed to the charity. The man has returned to work and participated this summer in the Manfredi company's annual tennis clinic for its prosthesis-wearing clients.
The Hansens' insurance problems aren't unusual, according to the Amputee Coalition of America.
The advocacy organization says coverage for limb loss varies widely among insurance companies, which sometimes evaluate coverage on a case-by-case basis. For example, the ACA found at least eight different companies in New York that are restricting or eliminating coverage for prosthetics. The restrictions vary from financial caps of $1,000 or $2,500 to excluding repairs or even limiting a person's benefit to one prosthesis per lifetime.
The organization is leading a national campaign in support of state legislation that would bar such practices and create parity among insurance providers. Seven states have adopted such laws, and bills are pending in another 24 states, including New Jersey.
In the meantime, Angels with Limbs has provided the Hansens with a lifeline they desperately needed.
Brian Hansen's toenail injury in 2005 sent them on a two-year downward spiral. Despite the amputations of his toes and foot, and heavy doses of OxyContin, Hansen was in excruciating pain because of recurrent infections and circulatory problems.
"All I did was sleep, wake up in pain, sleep, wake up in pain. It was no way to live," Hansen said. "I sat there at night screaming, I was in so much pain. . . . It was rough on my daughter (Isabella), a 12-year-old, seeing all that."
"They gave me my life back the day they amputated my leg," Hansen said.
Next step: rehab
Hansen said he erred in not checking his coverage for a prosthesis before he had the amputation. After his wife found out about the $1,000 maximum, she called around and discovered the prosthesis her husband needed would cost between $10,000 and $12,000. Her last call was to Manfredi Orthotic & Prosthetic. At the other end of the line, Jean Manfredi, who is Robert Jr.'s wife and an employee of the company, assured Fran that the company and her father-in-law's charity would do whatever they could to help.
On Tuesday, they made good on that promise, fitting Hansen with a moderately sophisticated prosthesis with a titanium pylon and a socket that will allow him to pivot on his foot, once he learns how.
"It's just been a nightmare, and now we're finally seeing a light at the end of the tunnel," Fran Hansen said after watching her husband take his first steps. "Thank God for Angels with Limbs."
Hansen's HMO will pay for a week's stay at Riverview Medical Center's rehabilitation hospital in Red Bank so he can learn how to use the very prosthesis that the company wouldn't cover in the first place. Hansen is too grateful right now to dwell on the irony of that.
"It's like a whole new beginning for me," said Hansen, who is hoping to return to work, eventually. "I'm looking forward to walking out of the hospital."
Shannon Mullen: (732) 643-4278 or firstname.lastname@example.org