Will Health Insurance Cover Cerebral Palsy Care?

If your child has received a diagnosis of cerebral palsy, you are probably concerned about the long-term treatment costs. Your future will likely include attending many different doctors’ appointments, taking numerous different medications, and experiencing several hospital stays while your child receives surgeries. You might also need to purchase and install accommodations in your home. It is likely that you will need to invest in a wheelchair, as well as a specialty adaptive van to transport the wheelchair to and from doctors’ visits. You may even need to hire a caregiver to come to your house, or live with you, to assist in caring for your child.

Depending on the severity of their cerebral palsy, you might need to take your child to physical therapy, speech therapy, and occupational therapy. In addition, your child could also need orthopedic surgery. Children with cerebral palsy are often monitored by neurologists. All of these treatments can add up and create a serious financial burden.

Many parents of children with chronic medical conditions end up in debt, or even filing for bankruptcy. Paying out of pocket for all of these medical interventions is not possible for most families. However, insurance companies do cover some of the financial costs associated with cerebral palsy treatment. Unfortunately, many private insurance companies require an extremely high deductible and they do not cover all of the cost of treatments.

Even when insurance companies do cover most of a medical expense, parents often spend a significant amount of money out-of-pocket. Insurance companies are for-profit businesses that can put making a profit above the welfare of their customers. For example, an insurance company might only cover one occupational therapy appointment per month, while your child’s occupational therapist recommends one appointment per week.

Many children with a cerebral palsy diagnosis suffer severe symptoms and negative effects throughout their life, including some or all of the following challenges:

• Difficulty talking or walking
• Difficulty chewing
• Difficulty swallowing
• Difficulty speaking
• Difficulty walking
• Difficulty getting dressed
• Painful muscle spasms
• Seizures
• Chronic pain
• Weak muscle tone

Each child with cerebral palsy is unique and needs a unique treatment plan. In severe cases, children with cerebral palsy need multiple surgeries to correct extremely tight muscles and protect their joints. Sometimes, children with cerebral palsy need complex surgeries to correct their misaligned spines or to stop muscle spasms.

Children with cerebral palsy often benefit from taking prescription medication to help them control spasms, seizures, muscle tone, and more. Your child can greatly benefit from physical, occupational, and speech therapies to help him or her engage with the world and increase his or her adaptive skills.

Unfortunately, these treatments can cost thousands, if not hundreds of thousands of dollars without insurance. When you consider the cost of treatment for a child with severe cerebral palsy, the costs without insurance could come in at over a million dollars for the child’s lifetime.

Finding health insurance that is affordable for children with cerebral palsy is often challenging. It can be incredibly difficult to find insurance coverage for your child with cerebral palsy, due to a preexisting condition. However, even if an insurance company does not deny coverage based on a pre-existing condition, they can charge you extremely high monthly premiums that can become difficult to pay. It might be possible for you to receive care through a government healthcare program if you are unable to find a private provider.

Medicaid is a government-provided health insurance program that is available for low-income Americans. If you receive Social Security Income for your child’s disability, you automatically qualify for Medicaid. The Medicaid program only covers health care needs, including inpatient and outpatient care, medications, in-home nursing care, medical supplies, and communication devices.

North Carolina offers low-cost comprehensive health coverage to children, and for families that earn too much money to qualify for Medicaid called CHIP. Those who qualify will receive sick benefits, checkups, hospital care, counseling, prescriptions, and other related services. You will need to check the guidelines to see if you qualify based on your maximum income level and your household size.

If a doctor’s negligence caused your child’s cerebral palsy, you could be entitled to compensation through a medical malpractice lawsuit. Contact the experienced birth injury lawyers at Arnold & Smith, PLLC today to schedule your initial consultation with one of our experienced lawyers today. Call our office at (704) 370-2828 to evaluate your options or fill out our contact form. Now taking cases throughout North Carolina with offices in Uptown Charlotte, Mooresville, and Monroe.