Private Health Insurance Policies could be Subject to Circumstantial Revisions after Brain Injury Diagnosis, According to US Research Group

Private Health Insurance Policies could be Subject to Circumstantial Revisions after Brain Injury Diagnosis, According to US Research Group

- in Health Insurance, News

Recent research over in America has concluded that those private health insurance policyholders who are diagnosed with a traumatic brain injury are at increased risk of changing (or indeed, losing) their existing coverage at the juncture they arguably would need it most.

A study group scrutinised data which detailed private health insurance accounts over a three year period, with its findings establishing that the more severe the brain injury suffered by the individual, the more rapidly they observed revisions to their hitherto health coverage, or worse still, had their entitlement comprehensively compromised as a result of the diagnosis/subsequent change in their personal situation.

Of those individuals the survey focussed on, a significant percentage had originally arranged their health policies via their employers, which impinged on their coverage if and when changes in their employment status was noted; or at least so say the authors of the research letter in JAMA Surgery.

One of the co-authors behind the research (who were granted access to data from MarketScan, a national commercial database of people with private health insurance and their insurance claims), Eric Schneider of Brigham and Women’s Hospital and Harvard Medical School in Boston, confided with Reuters that the upshot was; “Individuals who were the primary policy holder might have lost coverage because they were unable to continue in their job and became unemployed/uninsured.”

American Study Finds that Traumatic Brain Injuries Might be Linked to Compromised Health Insurance Cover Thereafter

In the US TBI’s are said to account for some 2.5 million visits to A&E annually, with 280,000 of those who attended emergency departments consequently admitted to the hospitals in question thereafter. That’s exactly what the team of researchers discovered when sifting through the documentation at their disposal, further citing that in the region of 40% of traumatic brain injury survivors go on to develop a disability which in turn can have a devastating effect on their ability to return to work/hold down a variety of roles.

Permission to peruse diagnostic data was also approved, so that the team of researchers could determine degrees of injuries and contrast these findings with any revisions to health insurance practices or existing arrangements/accepted exclusions.

This information revealed that individuals with the most severe brain injuries acknowledged the shortest time between sustaining the physical trauma and experiencing a shift in insurance coverage, at just under five months. People without TBI averaged around 8.5 months before their insurance situation witnessed any change.

For the purposes of their study the researchers examined data relating to 13,558 under-65’s who had received treatment for traumatic brain injuries between January 2010 and December 2012, and sough to draw comparisons with another group of people with no count of TBI during that same passage of time.

Reuters reported that the academics leading the study discovered that 30.7% of people who suffered TBI had changes in their insurance coverage, compared to 27.6% of their counterparts without TBI. Keen to point out the diverse spectrum of patients whose experiences were put under the microscope, Dartmouth Institute for Health Policy neurosurgeon and Clinical instructor, Dr. Kimon Bekelis expressed his professional opinion by saying; “Some of these patients receive prolonged rehabilitation, whereas others require frequent hospitalizations and multiple re-operations.”

He went on to describe how a number of patients may experience seizures and are subsequently prescribed costly long-term medications, which private health insurers would quickly wise up to, but added a serious footnote by saying; “A potential interruption of insurance coverage for these patients and their dependents can have catastrophic consequences.”

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