A front-page USA Today article, titled “For brain injuries, a treatment gap,” from March 1 provides an extensive overview of issues that individuals encounter with their insurance plans when attempting to rehabilitate from traumatic brain injuries.
While most insurance plans, both public and private, insure against catastrophic coverage, at least two-thirds of traumatic brain injury patients receive no further treatment after a typical stay of 16 days in a rehabilitation hospital, according to data from the National Institute for Disability and Rehabilitation Research cited in the article.
“The lack of coverage means that thousands of patients are discharged each year from hospitals to nursing homes or to languish in their beds during the critical early months when their brains are most receptive to healing,” according to the article.
Medicare and Medicaid have no national policy for rehabilitation programs, which can cost anywhere from $600 to $8,000 a day, though the amount of federal financing for research projects looking at traumatic brain injury has increased in recent years. Private insurance plans often contain arbitrary time and visit limits. Certain plans don’t cover rehabilitation programs at all, arguing that many of these programs have not proven to be effective.
Texas is the only state that requires major insures to cover brain-injury rehab, though the program is facing a 75 percent budget cut.
According to statistics from Center for Disease Control and Prevention cited in the article, more than three million people nationwide are affected with TBI, costing the American people $10 billion in medical care costs and $50 billion in lost productivity.