United Brachial Plexus Network, Inc.

As an adult do any of you have problems with the insurance not covering treatment because it's a pre-existing condition? Did any of your mother's sue to get your medical bills covered? How much in medical bills is spent per year? The reason i'm asking is because i am contemplating sueing on behalf of my 8 month old son for future medical bills. thanks.
Breonna, Jospeh's mother, lobpi

I have not had a problem getting PT/OT covered by insurance for my BPI arm. I recently had surgery to clear scar tissure from my brachial plexus and did not have a problem getting that covered.

I never had the tendon/muscle transfer surgeries that kids get these days so can't comment on that.

I know sometimes as an adult some insurances will make you wait a year(maybe less) to get coverage on pre-existing conditions but ya still get coverage in time.
Becky

I have not had a problem getting coverage.
My parents did not believe in suing and knew it was the doctors fault.
Of course, I am 67 and people just did not sue.
I personally wish they had but they made the choice and it was best at the time.
No one realized that due to compensation I would have to face so many secondary problems.
They, of course, had no idea of the cost of medical care in the future.
I still have to go to PT at least once or twice a year to either loosen my arm or straighten my spine.
So the cost in the future is important.
I guess it all depends on the extend of an injury how much medical care a person will need in the future.

Recently, I was told if Erbs Palsy was on my referral I would not be covered because it was not curable.
I fought and won on that point.

Some state do not allow refusal for pre-existing conditions.
I know NJ is one of the states, I guess you could look that up somewhere.

Kath robpi/adult

I have had an insurance company put ryders on anything that had to do with my arm because it was pre-existing. Because of that I had no medical care for my bpi outside of the wonderful care I recieved through Shriners!

Now though if I keep any insurance at all they cant say its pre-existing unless there is a break in my coverage, then it could be starting all over again. So I am still under my parents plan until I can find a job that I can get insurance and still go to school.

I hope you dont run into those road blocks!
Good luck!
Amy 20 years old ROBPI from MN

This is what I have experienced....my son is 8 1/2 years old. We were told that lapse of coverage doesn't apply in Illinois until they are five, as long as they are born with the condition, which of course he was. We just watched very carefully and now as long as we are not without insurance for 63 days, his BPI is NOT pre-existing. I don't know if it is different from state to state, but I know that we have no pre exisiting conditions, and I also have pre-existing also, but pay nothing additional because we have never had a lapse.

Last year, when my hubby lost his job, we jumped on STATE MEDICAID and didn't even have a one day lapse, we were very fortunate. Check with someone in your state, but I have had no problems. !!! GAYLE