Posted in the January/February, 2011 edition of Stroke Connection Magazine

A poll of stroke patients commissioned by the American Heart Association a year ago that found stroke survivors and their families face significant challenges in the healthcare system. Among the survey’s key findings were that a whopping 69 percent of stroke patients reported difficulty paying for medical care. Of those who said they had difficulty paying for medical expenses, 85 percent reported delaying or putting off needed care or skipping or reducing their medicine. Forty percent of survivors reported difficulties with their insurance plans in the past couple of years and 36 percent had gone without insurance coverage at some point since their stroke.

“Research has found that stroke patients without health insurance have up to a 50 percent higher risk of death who are underinsured also have up to a 50% percent higher risk of death compared to stoke patients with insurance, and patients who are underinsured also have poorer outcomes,” said AHA President, Ralph Sacco, M.D., chairman of neurology at the University of Miami and Jackson Memorial Hospital. “These statistics reinforce why reform or our healthcare system is critical to stroke survivors and those at risk for stroke. We need to make sure all Americans with stroke and cardiovascular disease have accessible, affordable and high quality care.”

Now that healthcare reform legislation — the Patient Protection and Affordable Care Act – is law, many survivors are concerned how it will affect them. While the law is not perfect, the good news is that it contains a number of provisions that should make healthcare coverage more accessible, affordable and adequate for survivors. There are several new protections that stroke patients with private health insurance coverage (or seeking to buy private coverage) should know.

As of Sept. 23, 2010, for children under age 19 (and beginning Jan 1, 2022 for adults), no one can be turned down for insurance coverage because of pre-existing conditions such as stroke or high blood pressure Also as of this past September, insurance plans can no longer cancel coverage when a person becomes sick.

New health plans, called Pre-Existing Condition Insurance plans, were launched last summer. Intended to help bridge the gap leading up to Jan. 1, 2014, these plans are available for people who have a pre-existing conditions and have been without health insurance for at least six months. The details of these plans depend on the state where you live.

Beginning Jan 1, 2014, all Americans will be required to have health insurance. In exchange, insurance companies will be prohibited from charging higher premiums because of health status or pre-existing conditions.

Those who don’t receive coverage through an employer will be able to purchase a private plan through state-based health insurance exchanges beginning no later than Jan 1, 2014. Theses exchanges will be one-stop marketplaces where you can compare plans and choose the one that is best for you from a menu of options.

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