Health Care and Insurance Coverage for People with Cerebral Palsy

Choosing the right insurance provider and primary care doctor is essential for people with cerebral palsy (CP) to receive quality care at an affordable cost. The transition from child to adult health care can be a challenge for young people with CP, who have a variety of needs. To help alleviate the cost of caring for a child with CP, there are countless organizations around the world, as well as government benefits and grants available. In addition, there are steps people can take before and during pregnancy, as well as after delivery, to reduce the risk of developmental problems, including CP. In the United Kingdom, adult specialists of this type are lacking, and the criteria for referral to adult services are restrictive.

A study surveyed doctors who provide services to adolescents and recommended that there should be a multidisciplinary clinic in the adult health care setting. The Medicaid population tends to have low incomes and may have multiple and ongoing service needs, which could result in high costs without the protection of cost-sharing. When studying the health care needs of young adults with CP, it is important to consider that their situation may not be solely due to inadequate transitional care. A 3-year longitudinal study was conducted with 106 young people with CP before they were transferred from children's services. Under the Tennessee exemption, they are required to enroll in managed care by capitated and allege that they have been denied or restricted the service, putting them at risk of entering hospitals or institutions. Employment-sponsored health insurance is advantageous because the employer can fully or partially pay the premium.

By insuring a group of people, the insurance provider can distribute the risk and administration of the plan among the people enrolled, making group plans desirable. In a comprehensive literature review on health care transition services for people with CP or spina bifida (149 articles), five elements were identified that support a positive transition to adulthood (preparation, flexible schedules, coordination, transition clinics, providers for interested adults). Medicaid is the main payer of long-term services and supports (LTSS) and offers home and community-based services (HCBS), such as private service nursing, assistant care, assistive technology, non-medical transportation to promote community integration, and case management services. The key questions for the field of transition include how to define “successful health care transition” and whether it improves health-related outcomes in young adults. A research team visited 106 young people with CP annually in their homes four times and monitored the completion of questionnaires and other data on socioeconomic factors, the use of health services, and well-being.