The medical costs for catastrophic injuries can be extremely high—a 2011 estimate from the National Spinal Cord Injury Statistical Center notes that first-year costs of someone who has high tetraplegia, an injury that causes partial or full loss of use in all limbs, is USD $1,044,097, with subsequent years costing $181,328. Many high schools across the United States require students to have an insurance policy, while others offer supplementary insurance to help offset the cost; some schools also request that boosters help families pay for these policies.