Doctors often recommend cognitive rehabilitation — a set of therapies to retrain patients’ brains and restore lost brainpower — beyond what insurance companies are willing to cover. Getting rehab right is crucial: A traumatic brain injury can rob patients of memory, thinking skills, emotional regulation and even motor control of their arms and legs. High-profile successes, such as former U.S. Rep. Gabrielle Giffords, draw attention to the potential of cognitive rehabilitation, but also to the fact that most people can’t afford the level of care she received.
A 2011 U.S. Institute of Medicine report concluded that rehab is often “incomplete” for those with severe brain injuries and that “many patients may not receive prescribed treatments due to limitations in payer plans.” What can you do? Although it’s not possible to expand health coverage for rehab services after a TBI, it is possible to consult with a specialized neuro-rehab facility such as Centre for Neuroskills, and find out from them how much coverage you actually have.
Although some insurance companies are reliable sources of information on how much coverage you have for rehab services under their policy, don’t count on every insurance company to be upfront and honest about it. How an insurer interprets ambiguities in your health policy can make a substantial difference in whether you get rehab paid for or not. Specialty providers of neuro-rehab services have insurance procurement experts on their staff who will act as your advocate if you select them to help you.
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