Farfalla

Greetings all.
Does anyone have any experience with the medical insurances, specifically Blue Cross Blue Shield or Aetna and drug detox/rehab? I am very anxious. My AH was denied by BC/BS for inpatient detox. Aetna approved inpatient detox. Now it is my understanding he will be assigned a primary therapist tomorrow who will be in contact with the utilization review department at the rehab who speaks to the insurance. Is it usual for them to only get approval for a few days coverage as they move along through treatment? I am so nervous they will call and say he was denied and to come pick him up. Is treatment usually denied if you are an inpatient rehab repeater? I was also asked to participate in the family weekend. Of course this is another $200 to shell out! I feel here I am dishing out more money due to his addiction. Any experience with the family weekend programs out there?

YearForMe

He's not living with you anymore.....right?

Why would it be your responsibility to run down there and fetch him?

My opinion......

You are slowly getting sucked back in.......

Farfalla

anvilhead,
Yes I have been through enough already. His drugs were worse than I could of ever imagined. You all were so dead on...always worse than we know.

YearForMe,
He is not living with me anymore. He has his own apartment. I feel a responsibility because I am legally still married and he is the "father" of my children. I don't know what the future holds for us but I know what it holds for me...a life with drugs not being in the equation.

Now...
He gave me several blank signed checks to access his money in his personal account. He hasn't paid HIS mortgage on OUR home. I am only on the deed not the mortgage note. I was going to send a check to the mortgage company but of course many people with anger and hostility toward him are weighing in. I feel the mature thing to do would be to pay the mortgage. My sister feels I should not pay the mortgage with the money and use it for me and the kids instead. She is not optimistic when he gets out that he won't go back to the same bullsh&t and what did I do but pay his mortgage so his credit is protected. Meanwhile...bring it on I know...I put $600 on my credit card to get him into detox. I know I know. She feels I should use the money and pay my credit card for the charge I incurred. Advice? Suggestions? I think I know the answer for ME but like to hear some objective opinions out there.

Farfalla

I will pay my credit card bill the $600 charge. I truthfully did not think as we waited for the insurace pre auth at the rehab either one of us thought he would be denied inpatient by the primary insurance. The secondary approved it and there was a deductible to be paid. He left all valuables back at my house and all we had on us truthfully was my purse. I know it sounds like an excuse but we didn't expect out of pocket expenses at all.

Seren

Hi family!

My experience is that for anything that a health insurance company deems to be a "mental health issue", there will be several approval processes for a few days at a time. First 3 days, then maybe 15, etc. Frustrating, I know!

Hugs, HG

hopeful0323

My AXBF's insurance company (BCBS) only approved 15 days in detox, if he wanted to continue a 30 -90 day inpatient rehab, he would have had to pay out of pocket. Which NO ONE was willing to do for him. I don't even know if he would have gone anyways to tell you the truth. Also three months later AXBF recieved $3500 bill from detox center. However, as far as paying for rehab or even picking my AXBF up from rehab....not my problem. He made the decision to pick up drugs, it's his responsibility to find a way out. He asked me a few times to come and pick him up from rehab even though the rehab would give him a train pass. I told him to take the train pass because there was no way in hell, i was taking time off work and missing on a day's pay to pick him up from rehab. His problems, he needs to own them. He is the father of my children, but he is an adult and not my responsibility.

useyourwords

Insurances vary, and often times programs have to re-justify through the program a continuation of coverage. This is why you will find some programs have a staff person who is dedicated to being the go-between for the program and the insurance company. This person often specializes in providing the best possible documentation to make sure treatment continues to be covered. That being said, insurance companies have their own policies and even the best program might not be able to get as many extensions to coverage as the person may need. My sister was able to get a 10 day detox and 28 day rehab program covered, but did pay a $600 deductable. They started by approving 7 days in detox, extending it to 10. Detox recommended rehab, so they approved 28 days. She went to a halfway house (she pays for) and rehab recommended IOP, which then was another approval. It is a PROCESS. My uncle's sister got a 44 day detox (intensive, off 100mg of methadone +cocaine after 15(or 18?)) covered and they were fighting hard for longer because of the severity of her needs, but it was denied. This being said, my sister had friends in her program who had to leave after only 7 or 10 days because of insurance denying extensions.

As for the money, pay the credit card bill. There is just no question in my mind. HIS treatment HIS responsibility to pay for it!!!

IMHO, I would not take on the responsibility of handling his finances in the future -- this is just another way for him to suck you in to his chaos and make you feel responsible for his responsibilities. He should be able to mail out bills from a detox or rehab, or work out a way with his counselor to ensure they are paid. I can promise you that he would not be the first person who has been in their program who has had bills to pay and no family willing to assist! If he wants to find a solution within his program for bills he can, and it should not have to depend on you.

Farfalla

anvilhead,
I verified funds and plan on withdrawing everything in HIS account. I also have his unemployment being direct deposit into our joint checking account which I can transfer electronically into MY personal checking account. He left his financial paperwork at my house which included the signed checks. He did this on Saturday afternoon when he came and saw his children before going to rehab. He still has HIS apartment. HIS treatment, HIS responsibility. I have no intention on paying the apartment rent. I have no intention on paying his cable or electric. I have the house and the expenses there which I have taken on since he left. I also have the expense of college tuition. My responsibility is to my children and myself. I knew the answer to pay the credit card bill but just needed to hear it from someone else. Yes, I paid the deductible when we were there. Yes, I drove him to the rehab. He wanted to go. I took him. While we were there which I never thought would ever happen he was unexpectedly hit with the deductible expense. I had it with me. I knew I would be able to get it back. I don't see the harm in doing what I did. I understand his problem his responsibility.

laurie6781

Well ....................................... I sometimes wonder how much 'rehab facilities' are abused by the A's.

If and that is a big IF he really really WANTS recovery he can go to Salvation Army.

Sheesh.

Please for your own serenity and sanity, STAY OUT OF IT. Take care of you and the kids.

If I were in your place, I would be looking for a house for you and the children, knowing full well he is behind in the mortgage, and the mortgage is in his name. Of course, I would check with an attorney first to see if I was going to be held liable in any way and if his being 'foreclosed' on would affect my credit in any way.

J M H O

Love and hugs,

Farfalla

I did check. The default on the mortgage will not affect my credit. I have another home I can go to. My parents live in the same school district and have three empty bedrooms ready for us. I have my own income and career. I have been with the same company for 17years. I have my own checking and savings account. My credit cards are my credit cards. I do not have any credit cards with him. The utilities in my home are in both our names. His utilities and rent at his apartment are just that his expenses. My car is in my name. My daughters car is in my name.

hopeful0323

This statement totally hits home!! I believe my AXBF used rehab quite a few times just because he had no where else to go, not because he honestly wanted recovery. Rehab aka homeless shelter??

outtolunch

Insurance operates at the state level. So the protocol and outcome in one state is not necessarily going to be the smae in another state. I suspect most insurers would be bankrupt if they gave everyone unlimited and extended treatment in a rehab facility. And even then, a substantial percentage of patients will relapse within days-months of release.

My sense of most with serious recovery time under their belts who frequent the SR forums, did nt spend any time in a rehab facility.

Put your and your kids first. If he really serious about recovery, the Salvation Army offers a top notch program for those who are really motivated.

dollydo

"I know it sounds like an excuse but we didn't expect out of pocket expenses at all."
********************************************
What is all the "We" about? Why can't you allow him to become an adult and handle "His" issues on "His" own?

I must admit once again...I cannot follow your thinking, any little ray of hope and you jump in feet first. Someone else could have driven him to rehab/detox, he could have paid the $600 himself and there is no reason to pick him up after this "new" stab at recovery, he can take the bus.

Your sister seems to have some common sense, might be time to give her "sense" some consideration.

I hope this all works out as you have it planned.

laurie6781

You know OTL now that you mention it, it goes far beyond SR. I know many folks, sober and clean for many years, not a one of them went to rehab.

They 'worked' their butts off in a 'program', be it AA, NA, SMART, CBT, AVRT, Life Ring, etc and they worked HARD for a long time, but live sober and clean lives today.

J M H O

(((((Familydestroyed))))). Why are you still involved in his supposed recovery?

Take the $600 he owes you. Take only 1/2 of what the children's food costs and what their share of the utilities are. That is CYA. Your attorney will be able to present to the court, if and when you go for divorce, that you have only been taking 'his share' of the children's part of of the utilities and food.

That way he will have money should he choose to pay the mortgage payment and in the long run your conscience won't end up nagging at you.

Please step back. Start focusing on only yourself and your children. He is an adult, please allow him to 'sink or swim' on his own.

J M H O

Love and hugs,

Farfalla

Thank you all for the advice. I doing my best while trying to raise my children, take care of myself and continue to give my all at work. I feel overwhelmed and obligated to support him if he wishes to work recovery.

useyourwords

"You know OTL now that you mention it, it goes far beyond SR. I know many folks, sober and clean for many years, not a one of them went to rehab.

They 'worked' their butts off in a 'program', be it AA, NA, SMART, CBT, AVRT, Life Ring, etc and they worked HARD for a long time, but live sober and clean lives today."

As I think I have posted here in the past, I am a social worker and had to do a lot of course work in substance abuse (after my sister had been an A for several years -- ended up being a huge help for me). Statistically there is no difference in the outcomes for inpatient vs outpatient programs, which is why any good substance abuse counselor will assess each A on an individual basis to determine what is most likely to be the best fit. There are a lot of different factors that go into it, but I think the key is that it is never "went to rehab OR 'worked' their butts off in a 'program'". It is rehab as the start to working their butts off in a program. Some people can do the latter without the former, and some people can't. One article on this below, though it is a really basic one and only talks about alcohol. I have a number of more thorough ones on this topic, but they are scanned and I am not sure if there is anyway on this site to attach them as pdfs.

http://pubs.niaaa.nih.gov/publicatio...22-1/44-46.pdf

Just wanted to add, since rehab can certain be a successful START to recovery. I have 4 dear friends who all have 10+ years clean and will all swear without inpatient rehab they would never have found their path, but know others who have been successful without rehab. As the above article says, I believe outcomes have more to do with the A than the setting.

laurie6781

One of the 'tenets' of AA and NA:

"We become 'self supporting' through our OWN contributions."

And that does not mean just monetary.

If and that's a BIG IF he should go for recovery, he HAS TO DO IT ALL on HIS OWN. Your support could actually be a DETRIMENT to his recovery.

This is HIS PROBLEM and it is UP TO HIM TO FIX IT.

Please for your own sanity, serenity, and peace of mind stop. You will know when and if he finds recovery by HIS ACTIONS and that is months and months if not years down the road.

Love and hugs,

addictionwife

I am not sure about the insurance so I can't comment on that one, we had to pay out of pocket. And for me I do say "we" because it's money that should be going to support our family, our home, our kids. I know for me and the situation I am in, which is very similar to yours, the questions about finances are really tough ones. For me, I'm a stay at home Mom. Although I'm looking for a job, until I find one I am completely dependent on his income to feed my kids. You said the house going back or being paid late won't affect your credit, but how will it effect your assets should matters come to a divorce? I know that might sound very materialistic or something but it's something to think about. The house may not be in your name however it's still legally half yours should you divorce. That's a lot of money to walk away from basically to prove a point, you know? At least that's my take on it. There is also the question as to what kind of toll it will take on you and the kids staying with relatives on top of dealing with everything else that you currently are. I guess what I'm saying is that just because your name isn't on the mortgage, doesn't make this your home and equally yours to protect.

Windblown

Sometimes...like today...i get so focussed in on the details of someone elses recovery when they should be doing the footwork. I feel frantic...needing answers...trying to Mr. Toad's Wild Ride. The big picture gets lost...the one where the addict is responsible for his own recovery.

My insurance pays for detox only and outpatient. Some of the rehab directors have said they might be able to get some more inpatient time but it depends on the history and past failed attempts of the addict and the aggreement between the particular rehab and insurance. It is awful.

After my bout with this sort of insanity today...I am letting go...just too tired to make it all better for addict. I have also heard many get detoxed, do outpatient or meetings and never need rehab. Rehab to me would be good for my son so he learns and educates himself on the disease but it sounds like your guy already has been around the block a few times. He knows what to do.

Sending you a peaceful pink cloud to envelope and smooth away anxieties...we can only do so much...or we can do too much...and get discombobulated and delusional.

Farfalla

The house will affect my assets but I come from a family who is financial supportive and the money I would get from the house is not significant enough in the big picture. I do believe it is a WE because there is 20 years of being a WE.