United Brachial Plexus Network, Inc.

I'm wondering if our child is going to have a hard time getting insurance once they are no longer a dependent. Did any of you have your new insurance carries deny claims because of a pre-existing condition? Thanks for any help/advice.

I haven't had any problems with our insurance covering my BPI other than that the Drs. are out of network, so I fight them to cover it under specialty care.

I've never encountered any problems either. Just the usual appeal when something was denied that everyone faces these days. And I have always won the appeal.

Nancy

I've never had any difficulty with insurance coverage either ,BUT, any I recieved was called "congenital birth defect" or "neurological disorder" and NOT Erb's Palsy. NObody I encounter now knows the term BPI so I am educating everyone including my MD.
Have a Happy Thanksgiving everyone.
Carolyn J(age 66 & proud of it!)

Same with me, I've never encountered any difficulties with insurance coverage. But I haven't had a major claim such as a surgery either.

John P.

To all of you who have not run into any issues....were you basically always covered under a group plan? Has anyone had to purchase their own individual insurance plan or as a self-employed individual, with the knownn preexisting condition of Erb's Palsy or a Brachial Plexus injury that has required ongoing treatment?

We have already run into some problems and my little guy is only 3 1/2. My mom worked for Blue Cross/Blue Shield for years and preexisting conditions can cause some problems when trying to get individual coverage. I only hope our children are all as fortunate as you all have been. It is sure encouraging to hear!

Thanks,
Lisa

My insurance when dealing with my BPI was a group plan through my employer. Now as a retired individual I'm on Medicare but I haven't had any occasion to make a claim for my BPI.

John P.

I have insurance through my work and in February I applied for individual insurance because my doctor and hospital of choice are not covered under my work insurance. I did choose BCBS and I had to tell them that I had Erbs Palsey in my left arm. I also informed them that there were no treatments for me as it was a birth injury. They accepted and I now have insurance. However at the time of applying I did not think there was anything that could be done, and it was after I applied that I started researching my options. I have been to see a few PT's and physicians and everything from August is still pending with BCBS as they are probably investigating why all of a sudden they are getting billed for Erbs Palsy (OBPI) items. So I don't know what BCBS will do. There were no original ryders on my condition and so I believe they will have to cover it whether they like it or not. I think the thing that helped me was I never had any interventions, and so for 15 years there were no charges/appointments that the insurance could go back and look at and put a ryder on. I believe getting an individual policy is very difficult. I have a ryder on 3 other conditions for 2 years that BCBS will not cover, but they left the Erb's Palsey alone-like I said I think it was from not having any records about my visits for quite some time. Good Luck and check all your options...

Thanks so much for the responses! I live in a state with a very low cap on med mal cases, I wanted to know if getting coverage for our child once he is no longer our dependent will be a problem and if so I want to be able to present that to the courts. Thanks again for the insight

An insurance broker actually shopped around for us and wrote a letter about how much more it would cost to insure our child due to this lifelong pre-existing condition. We knew her which is why she offered to shop the market and write a letter regarding her findings. In the end I don't think it mattered in the least regarding the settlement amount. It did serve as an eye-opener for us though, as the rates on individual or personal plans were much higher because of the pre-existing condition and to obtain decent rates they would exclude any treatment for bpi from the policy and that would be useless. I hope your case goes well.