Cost of Traumatic Brain Injury

 No insurance…now what?

People of all walks of life go about their days, months and years believing that they are living the “normal” life. Budgets are put into place to reflect their lifestyle. Homes are purchased. Vehicles are bought. Recreational activities are planned and vacations are taken. Life is life. It is full of emotions and experiences. But most of all, we strive to make life better.

What about the very unexpected? What about a situation where life does not go back to “normal”? Life is changed. Finances are different. Bills are a reality!

Life changes in an instant

When someone experiences a traumatic brain injury (TBI) the first thoughts are focused on the person and their survival. Statistics are built on these pieces of information. The focus is on helping the person recover as much as possible and for as long as possible. But with treatment comes costs.

Just off the top, are loss of wages for the working injured and loss of wages for their loved one who may stay with them at the hospital? All the while home expenses remain the same as life goes on.

“Difficulties can occur immediately as families struggle to pay medical bills, in the medium-term as lost income impairs the ability to service debt, and into the long-term if cognitive problems from the injury affect financial management.”[1]

Medical expenses are climbing while wages are drastically altered. The patient and family quickly can find themselves in a financial struggle.

“The cost of treatment and rehabilitation for patients with traumatic brain injury (TBI) are staggering. In the year 2000, the costs and productivity losses attributable to TBI in the US totaled $60 billion”[2]

As these costs rapidly mount, the patient may remain in the hospital in a very critical condition. Unknowingly, to them or the family, the costs are incurring at a rate they cannot control or may not even know until much later. The hope is insurance will cover the bills. But too often, insurance has deductibles, co-pays, restrictions and cap on the covered services. This leaves the non covered fees to the individual or the family to pay.

“…financial problems after TBI often play a key role in a negative spiral of events. Injury depletes income and wealth, which represents additional obstacles to accessing needed health care, further reducing health and wealth.”[3]

In some cases, the individual with a brain injury or the family will find themselves making the devastating decision to file bankruptcy.

“Bankruptcy represents just the tip of the iceberg of financial problems following injury. Many injured patients struggle to repay medical debts or maintain income without filing bankruptcy.”[4]

 In the current economy with jobs being scarce, layoffs occurring every week and businesses closing, it is not uncommon for the average person to already be in financial difficulty prior to an injury. When the home budget is under financial strain, it is not surprising that the costs of treatment for a brain injury can easily tip a family into bankruptcy.

“Home equity loans and house price decreases mean that some individuals are unable to sell their homes to repay the whole debt. For patients with TBI, it is not uncommon for the value of the secured asset to be destroyed in the incident that caused the TBI. Many patients also have

How much?

How much?

pre-existing unsecured debts and obligations such as student loans, credit card debt, store charge cards, alimony, child support payments and unpaid income tax. Some of these unsecured debts are taken on in the expectation that future income will be sufficient to repay them, a hope that may have to be revised after TBI.”[5]

It has been said that our percentage of disposable income has decreased statistically since the 80’s. Meaning our debts are increasing faster than our actual income. With less money in our pockets for saving or purchase as you go theory, this statistic will only continue to increase.

“Therefore, TBI often affects those least prepared to deal with the economical consequences.”[6]

No insurance…now what?

What about the uninsured patient? What happens to them financially when there is an injury?

“It is estimated that approximately 46.5 million Americans aged less than 65 do not have medical care insurance. At 31%, the probability of having no insurance is highest among young adults.”[7]

We are finding more and more people have little to no insurance. Someone has to take on the burden. The state’s Medicaid program and the federal Medicare and Social Security Disability programs are discovering that they compensate for these individuals.

“…some of the burden is shared by the tax payer (through programs such as Medicare and Social Security Disability Insurance ), employers…a substantial proportions falls upon the patient and their family.”[8]

The costs are many and can continue over a lifetime

As the average family saves less and spends more, there is little money available for them when an emergency arises.

“…79% of parents of children with severe TBI reported financial problems 1 month after the injury.”[9]

“…from the 1980’s, interviewing spouses of individuals with head injury, found that 48% had to borrow money, 26% lost possessions or sold a house and 9% declared bankruptcy”[10]

With so many variables and little research, it is difficult to determine a cost in traumatic brain injury. Except to say that TBI is costly and very much affects the patient and family financially causing some to fall into poverty. Work may or may not be an option post-injury further damaging the financial outcome. Medical expenses may be required for the duration of the person’s life post injury creating a further spiral in finances.

Be prepared. Know your insurance policy by reviewing it annually. If you hear the words “It’s not covered”, don’t panic. Verify that with an attorney and an insurance expert to receive all the benefits due. Be aggressive! Do all you can do to help and protect yourself financially. The unexpected can happen at any time.

Recommended reading

This Fact Sheet is based on a special issue on Hidden Issues in Brain Injury of the Brain Injury/Professional (vol. 5, issue 2, 2008). 

 

7 responses to “Cost of Traumatic Brain Injury”

  1. TJ Peoria says:

    Good article. I am currently referencing it for a letter I am writing to senators and representatives concerning health care. I wonder if you wouldn’t mind posting those sources that you cited so that I can use them as well. Thanks!

  2. This a nice post, very well written, and it also contains a lot of useful facts. I appreciated your professional manner of writing this post. Thanks, you have made it easy for me to understand, fantastic job

  3. Thanks for finding the time to go over this, Personally i think strongly about this and love learning read more about this topic. If possible, when you gain expertise, does one mind updating your blog with more information? It is rather helpful personally.

  4. Aubrey Morak says:

    Just the facts I was looking for. I should examination our expenses soon.

  5. Cool site, love the info.

  6. Tonya says:

    Thanks Boston Bob! This was my first submitted article for the blog! T

  7. Boston Bob says:

    Nice article…
    Nice blog…
    Great website for books and free information on brain injury.

    Keep up the good work.

    Bob

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