The average amount individuals pay out-of-pocket for catheters and catheter supplies varies widely by health plan type and commercial plan brand.
Among surveyed catheter users with commercial coverage, those with United Healthcare reported having the lowest coverage, with 42% surveyed saying United Healthcare did not cover any catheter costs.
The average annual outlays for catheters and catheter supplies for surveyed users who were insured by United Healthcare were $2,188BlueCross BlueShield tracking ($1,670) and Etna ($1,385).
Cigna had the highest catheter coverage of the commercial health plans included in the report. Of the catheter users surveyed, 79% said the insurer covered “some or all” of their catheter costs.
More than one in ten (12%) users surveyed say they reuse catheters, with the majority citing cost issues and lack of health plan coverage as a factor.
“Life can be difficult enough for people with disabilities and their families, and it’s unfair that insurance companies only add to that burden by refusing to cover essential medical supplies every day,” said Jenna Daviswhose 2-year-old daughter, Merritt, depends on catheters because she lives with spina bifida.
“When our insurance company refused to cover Merritt’s catheters, we were stunned. They had lumped the catheters into the same supply category as bandages and gauze. Merritt uses over a thousand catheters per year, so to pay them out of pocket, we’re talking about thousands and thousands of dollars in excess medical bills,” Davis added.
People with a public or government health plan reported having better coverage for catheters than those with a commercial or private plan, paying the least out-of-pocket (on average $531/year).
The study, which surveyed 2,510 people with disabilities, was conducted to determine the extent to which catheters are covered by insurers and health plans. The report was co-sponsored by United Spinal Association, Christopher & Dana Reeve Foundationand Paralyzed Veterans of America.
The Spina Bifida Association along with all partner organizations and allied stakeholders will work with representatives of Congress and federal agencies to ensure that all people with disabilities who use catheters have the access and coverage they need. for prescribed medical supplies to maintain their own health and avoid costly expenses. and preventable hospital readmissions, infections and even deaths.
To access a PDF of the full report, visit https://www.spinabifidaassociation.org/wp-content/uploads/Catheter-Survey-Key-Findings.pdf.
About the Spina Bifida Association
the Spina Bifida Association (SBA), founded in 1973, is the only voluntary national health agency dedicated to Spina Bifida. The mission is to build a better and brighter future for everyone affected by Spina Bifida. Fueled by dedicated healthcare providers, parents, adults, caregivers and others, we are committed to helping people live longer, healthier lives through research, education and research. support, clinical care, networking and advocacy.
About Duke Health
Duke Health is committed to conducting innovative basic and clinical research, rapidly translating breakthrough discoveries into patient care and population health, providing a unique educational experience for future clinical and scientific leaders, improving the health of populations and to actively seek policy- and intervention-based solutions to complex problems. global health challenges. Underlying these ambitions is a belief that Duke Health is a destination for exceptional people and a commitment to continually explore new ways to help our employees grow, collaborate and succeed.
About the Reeve Foundation
the Christopher & Dana Reeve Foundation is dedicated to healing spinal cord injuries by funding innovative research and improving the quality of life for individuals and families affected by paralysis. By bringing together the brightest minds in the field, we work tirelessly to accelerate scientific discovery in spinal cord research by investing in laboratories around the world. Additionally, through a cooperative agreement with the Administration for Community Living, the National Reeve Foundation Paralysis Resource Center (NPRC) promotes the health, well-being and independence of people living with paralysis, providing comprehensive information, resources and referral services helping more than 100,000 individuals and families since its launch in 2002. The Reeve Foundation is committed to raising the voices of our community and must achieve greater representativeness and independence. We meet the Better Business Bureau’s 20 standards for charitable accountability and hold the BBB charity seal. For more information, please visit our website at www.ChristopherReeve.org or call 800-225-0292.
About America’s Paralyzed Veterans
Paralyzed Veterans of America is a 501(c)(3) nonprofit organization and the only congressionally chartered veterans services organization dedicated solely to the benefit and representation of veterans with spinal cord injuries or diseases like MS and ALS. For 75 years, the organization has ensured that veterans receive the benefits earned through service to our nation; monitored their care in VA spinal cord injury units; and funded research and education in the search for a cure and improved care for people with paralysis.
As a longtime partner and advocate for veterans and all persons with disabilities, Paralyzed Veterans of America also develops training and career services, works to ensure accessibility in buildings and public spaces, and provides health and rehabilitation opportunities through sports and recreation. With more than 70 offices and 33 chapters, Paralyzed Veterans of America serves veterans, their families and caregivers in all 50 states, the District of Colombiaand Porto Rico. Learn more about PVA.org.
About United Spinal Association
Founded in 1946 by paralyzed veterans, United Spinal is a national 501(c)(3) nonprofit organization dedicated to empowering people with spinal cord injuries and disorders (SCI/D), including veterans, to lead successful and fulfilling lives. Membership is free and open to anyone with SCI/D, with over 53,000 members in 49 chapters nationwide. Known for its groundbreaking advocacy efforts, United Spinal played a significant role in drafting the Americans with Disabilities Act, made significant contributions to the Fair Housing Amendments Act and the Air Carrier Access Act, and played a instrumental in achieving accessible sidewalk ramps and public transportation in New York City, which created the standard accessibility model used in many cities across the United States.
SOURCE Christopher & Dana Reeve Foundation