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b ok bad title - insurance and other rant not long

Old 06-18-2012, 09:46 PM
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b ok bad title - insurance and other rant not long

My AS od'ed this weekend. Went back to rehab this morning and that started a long battle with the insurance company. On the way to rehab, he said - I want residential treatment. Ok, 30 years of paying money to this insurance company and we haven't had even a broken bone - and over the past six months when we needed money for treatment, company line was - he needs to fail at lesser treatment levels before we will pay for more care. So, he has 'failed' to the point of near death and now you think you might pay for some care. I don't get it. And every time I call insurance company, I get a 'care advocate' - really, advocate for who?? or is that whom.

WTF
when will addiction leave the shadows and be talked about and acted upon by our community. it is out there.
b.
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Old 06-18-2012, 10:01 PM
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Ask for the appeals process and let them know you will be filing an appeal of their denial of this medically neccesary service and ccing the state insurance commisioner. If he goes in with suicidal ideation, they will have to cover his admission..
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Old 06-19-2012, 03:56 AM
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For some reason they are more willing to treat alcohol inpaitent then if its just drugs. I was told that you wont die from opiate detox you will just feel like your going to but you can die from benzo's and booze. They really said this I had the rehab talk to the insurance co they know what to say.
I realize that treatment is expensive and doesnt always work but these companies make it very hard. If you paid your premiums for 30 years and this is the first time you need service they should have to provide it for you.
My insurance co is very slippery they gave the rehab an ok then refused payment I'm still fighting it more then 3 yrs later
Good luck to you and your son
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Old 06-19-2012, 05:01 AM
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The Salvation Army programs are everywhere and they are free. They have several very good programs, some longer term than others but all quite decent.

The success of any program is usually proportionate to the resident's willingness to work it.

I hope your son finds help soon.

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Old 06-19-2012, 06:12 AM
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We just went through this. Luckily we were able to refinance our house and pay up front, then began the battle with the insurance company for coverage. They denied coverage. We appealed. They denied the appeal. We called the state attorney general's office, who sent us to the federal agency that monitors ERISA compliance. They assigned us to an attorney who contacted the insurance company on our behalf...and low and behold, after one call from a government lawyer, everything was sorted out and we received every penny back.

We had compiled a package of documentation, including a letter from every doctor who'd treated him in the past 5 years as support that in patient was necessary.

Good luck with your battle.
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Old 06-19-2012, 08:47 AM
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Oxford House is another solid alternative. Guests are expected to work and pay their own expenses.
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Old 06-19-2012, 08:51 AM
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Most posters to the SR forums with long term sobriety achieved this state without the benefit of insurance, family financial support or rehab. They each seemed to have reached a state where life was more important than drugs and took full responsibility for their continued sobriety.
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Old 06-19-2012, 07:24 PM
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Good advice here. My heart hurts for you. I know how upsetting it is to see your child almost die and then be told that almost isn't good enough and they need to fail some more before insurance will pay. I hope he can get the support and assistance he needs and you can get some rest and peace.
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