Health Insurance
Spinal Cord Injury care depends a lot on medical and social insurance. If you don’t have insurance, the first hospital that helped you signed you up for Medicaid. It’s important to understand what your insurance covers, if it will keep covering you after the SCI, and if it will pay for services at a specialty SCI center.
You may be able to ask for out-of-network services if specialty services are not available within your insurance plan. You might want to apply for a Medicaid and Medicaid Home and Community based services waiver to get better help for living in the community.
How Does Health Insurance Affect Recovery?
The complex U.S. health insurance and welfare systems are made up of public and private plans and can impact access to healthcare and rehabilitation after SCI.
Medicare
This is for people who are 65 years old or older. It's also for younger people who have certain health problems including a spinal cord injury.
Medicaid
This is a program run by both the government and the states. It helps people with economically disadvantaged get healthcare.
Private Health Insurance
Private Health Insurance is insurance from your job, your parent's job, or if you buy it yourself from an insurance company. Sometimes, private insurance can also get public benefits. For example, if you get insurance through your job, the government doesn't charge taxes on the money used to buy it.
About one out of every four people in America get their health insurance from Medicaid or from plans they buy themselves, like those offered through the Patient Protection and the Affordable Care Act (PPACA).
Other Kinds of Health Insurance includes Workers' Compensation Benefits for when you get hurt at your job and Veterans Health Benefits for those who were in the military and meet certain rules.
Social Insurance
Besides regular Medicaid health insurance, there are special Medicaid waiver programs that help people get homes and communities based services. There are over 300 of these programs all across the country! They can help with things like case management, personal care assistance, home modifications and equipment, and respite care. There are also other ways to receive money. Social Security Disability Income (SSDI) is a benefit you get if you've worked for a certain amount of time and paid taxes into the Social Security system. Supplemental Security Income (SSI) is a program that gives a basic amount of money to people who don't have a lot of income. It's for people who haven't worked much or haven't worked long enough to get SSDI. Programs like Medicaid and SSI have strict income eligibility restrictions.
Financial Changes After SCI
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Single person who works, private insurance, transition to Medicaid
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Person who transfers to spouse’s insurance
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Person already on Medicaid
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Others and possible options