In the nick of time

Consumer Reports News: September 24, 2010 05:01 PM

I knew something was seriously wrong the moment the 22-year old walked into my office. The area around his left eye was unusually prominent, and his complaints of headache and left-sided forehead numbness for the past two weeks troubled me. It was August 2nd; my patient had just gotten health insurance benefits on July 1st. I sent him for an emergency MRI, and unfortunately, my fears were confirmed. He had a brain tumor.

One of the first changes the new health reform law has made—effective yesterday—is to allow young adults to stay on their parents' insurance plans until age 26 instead of being taken off when they graduate from high school or college. My patient was fortunate; his mother's employer's insurance consortium had unanimously voted to enact this change six months sooner that the law mandated.

Other new protections for consumers include the Patient's Bill of Rights prohibiting insurers from canceling coverage if you get sick, setting lifetime limits on coverage, and denying coverage to children under the age of 19 who have pre-existing conditions.

The new law also enabled my patient to get the best of care. If he had not been covered, it's likely that he would not have gone to the doctor so quickly, and would have tried to "wait it out", risking neurologic damage. He would have had to pay $1,000 or more for the MRI scan out of his own pocket. Moreover, he would have not had coverage for the top-notch neurosurgeon who specialized in the operation he needed, and the hospital costs would have been over $100,000.

Earlier this month, he had the entire tumor successfully removed. Luck was shining on him again. It was benign, and he is now recuperating nicely. If you have a story to share related to your care because of health reform changes (or lack of care in the past), let us know, or enroll in our Facebook video contest.

—Orly Avitzur, M.D., Consumer Reports medical adviser

For more information on the new benefits of health care reform see our extensive coverage.

Photo: brain_blogger