Will My Insurance Cover a Spinal Cord Injury?

Most people never think about how they would pay for the costs associated with a serious personal trauma such as a spinal cord injury.  After all, if you have health insurance and vehicle insurance, you should be covered–right?  Unfortunately, all too often, insurance policies fall short of covering all of the costs associated with serious injuries, and the more serious and life-changing the trauma, the less likely the insurance policy is to cover the expenses completely.

How Much Do Traumatic Spinal Cord Injuries Cost?

On average, a spinal cord injury victim will spend 15 days in the hospital with a follow-up of rehabilitation period of about 45 days.  After this, the victim’s limitations, medical needs and lifestyle will be determined by the degree of trauma and recovery possible.  The more severe the initial injury, the more expensive the lifelong injury will be.  Therefore, the average first-year costs associated with a spinal cord injury can range from $150,000 for a paraplegic accident to $415,000 for a quadriplegic injury.  In some cases, first-year costs can exceed $1 million.

Only about half of all victims of spinal cord injuries are covered by private health insurance at the time of their injuries.  Others are covered by Medicaid, which is a program for people who cannot afford private insurance, or Medicare, which is a program that covers the health costs of elderly people.  Some have no insurance coverage at all.

Unless a victim is covered by a low-income program, it is very likely that he or she will have a deductible, co-pay, or both.  These costs can add up significantly over a lifetime.  For example, a typical private insurance policy, even if it covers every medical procedure, drug, and rehabilitation therapy available to the victim, will only pay 80 percent of the costs after meeting a deductible of several thousand dollars.  Therefore, with a $3,000 deductible and 20 percent co-pay cost, the first year of a victim’s treatment could easily wind up costing more than $80,000 in out-of-pocket expenses.

In reality, the costs are often much greater.  Most insurance companies will not pay for every possible treatment and insist on covering only those that are “medically necessary.”  This is defined by the insurance company itself, so it is easy for an insurer to deny payment for any treatment beyond the most basic care.  Similarly, those who receive Social Security disability payments or Medicaid may be limited in the types of treatment available to them.

How Can I Protect Myself After A Spinal Cord Accident?

Clearly, the victims of spinal cord injuries need help paying for treatments, drugs and therapy not covered by insurers.  In these cases, a personal injury attorney may be able to help the victim recover compensation to pay for these expenses.

At Barber & Associates, we have been working with the victims of spinal cord injuries and helping them recover compensation to pay for treatment for decades.  We have the experience to navigate the confusing world of insurance companies and help victims recover enough money to pay for proper treatment for SCIs.  Give us a call today to learn more about how we can help you.

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