Will my insurance cover my scoliosis treatment?
It depends on what kind of insurance you have. Some insurance companies will cover all treatment that is prescribed by a doctor. Some insurance companies will pay the majority of treatment costs but will require you to pay some portion of it in the form of a co-payment or a deductible. Deductibles are a set amount of money you must pay for health care before the insurance starts to pay for it. For instance, if you have an annual deductible of $100 and your health care costs for the year are $300, then insurance would pay for $200. A co-payment is a set amount of money which you must pay for a particular health care cost. For instance, if treatment X cost $100, you might have a co-payment of $10, and every time you had that treatment you would pay the same $10. Even if you have good insurance coverage you still may incur additional costs if you choose to try supplemental treatments. Supplemental treatments are not generally covered by insurance except for chiropractic treatment which is sometimes covered. You should call your insurance company if you have questions about what is covered.

What about Medicare?
Medicare is a government program which was started in 1965 to help older people obtain and pay for Medicare care. Generally, you are eligible for Medicare if you or your spouse meet the following conditions: you have worked for at least 10 years in Medicare-covered employment, you are 65 years old (or older) and you are a citizen or permanent resident of the United States. Medicare also covers disabled individuals and their spouses. In general, Medicare is an "individual" insurance. However, sometimes spouses and children can become eligible for Medicare based on the work record of the family’s wage earner.

Medicare does cost some money. People often pay part of their health care costs through deductibles and co-payments. (For definitions of these terms see the section under insurance.) Also Medicare has limits on its coverage. Limits mean that certain types of medical car will be covered for only a certain number of days. Once the limit has been filled, the patient either pays a greater amount or the full amount of the cost.

Medicare is divided into two parts: Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B). Part A coverage is the basic coverage and is usually free. Part B is a kind of supplementary (or additional) insurance coverage. It is voluntary and costs a monthly premium ($43.80 in 1997). Almost everyone who is 65 is eligible for Medicare Part B. Most of the Medicare population has some sort of supplemental (private or public) coverage. Coverage under Medicare is somewhat complicated.. Included below is coverage which might be relevant for scoliosis treatment. It is not a complete list of Medicare coverage. Part A covers inpatient hospital care for the first 60 days with a deductible. (This deductible was $716 in 1995.) It also covers skilled nursing care or rehabilitation associated with recuperation is covered for up to 100 days following a hospitalization. It is completely covered for the first 20 days and after that a co-payment is required. (This co-payment was $89.50 in 1995). Part A also covers home health care which includes skilled nursing or rehabilitation benefits provided in the home and prescribed by a physician. There are no payments required or limits on the number of covered days. Medicare will only pay for chiropractic if the spinal abnormality is demonstrated by X-ray.

As stated above, Part B costs around $50 a month. It covers 80 percent of physician and outpatient services after an annual $100 deductible. Coverage includes physician services, laboratory and other diagnostic tests (including x-rays), physical therapy, and outpatient services at a hospital, rehabilitation facility, or rural health clinic. Medicare does not pay for most outpatient prescription drugs.

If you are entitled to Medicare Part A you may be eligible for one of the low-income medical assistance programs. To be eligible, your financial resources such as bank accounts, stocks and bonds may not be more than $4,000 for one person or $6,000 for a couple. (These figures may not be up to date.) In addition, your income must be at or below the national poverty level.

There are frequent changes in Medicare involving costs and coverage. You should always call for confirmation or if you have any questions If you have questions about eligibility or if you want to apply for Medicare, call the Social Security Administration at 1-800-325-0778. If you are hearing or speech impaired you may call: 1-800-325-0778.

What about Medicaid?
Medicaid is an assistance program which serves low-income people of every age. In most cases it is completely free. Sometimes a small co-payment is required. (A co-payment is a set amount of money which you must pay for a particular health care cost. For instance, if treatment X cost $100, you might have a co-payment of $10, and every time you had that treatment you would pay the same $10.) Medicare is run by state and local governments within guidelines set by the federal government. As a result, Medicaid varies from state to state. To find out if you are eligible or to apply for Medicare can contact local state welfare offices, state public health departments, and state social service agencies.

What if I don’t have insurance?
If you are a child under 18 you might be able to receive treatment from Shriners Hospitals. Shriners Hospitals for Children is a network of pediatric specialty hospitals, founded by the Shrine, where children under the age of 18 receive excellent medical care absolutely free of charge. Shriners Hospitals accept and treat children without regard to race, religion or relationship to a Shriner (a member of a fraternal society). Any child may be eligible for treatment at one of the orthopedic Shriners Hospital if the child is under 18; if, in the opinion of the hospital’s chief of staff, the child has an orthopedic condition that Shriners Hospitals can help; and if receiving treatment at another facility would place a financial burden on the family. There are 16 orthopedic hospitals and 1 combination orthopedic and burn hospital located in the United States. You can obtain an application for admission any of the following 3 ways:

1. Stopping by any Shrine Temple or Shrine Club
2. Writing to:
   Shriners Hospitals
   PO Box 31356
   Tampa, FL 33631
   
3. Calling the Shriners Hospitals for Children toll-free referral line at 1-800-361-7256 between 8am and 5pm Eastern Standard Time

A list of these Shriners hospitals can be found in the Appendix. The hospitals are alphabetized by state.