Alcoholism and Health Insurance
Member
Thread Starter
Join Date: May 2010
Location: Earth
Posts: 94
Alcoholism and Health Insurance
The recommendation of "go see your doctor" is a common suggestion here. I've always concealed my drinking from my doctor in fear of problems getting health insurance if i ever switch employers. Even when i decided to quit, i asked one of the psychiatrists at work for some klonopin because i was "stressed" about an upcoming inspection with the State. I only asked for 10 pills to get through the next week. I've managed to get liver function tests with other excuses such as "i've been feeling tired and think I need a work up to check things out".
Anyway, does anybody here know the laws in the United States regarding alcoholism and health insurance since Obama passed the Healthcare bill. I hear things are easier over in England and Canada. Right now we are putting out $800 per month for the family and it doesn't even cover MH/D&A treatments.
I haven't drank for over 30 days and haven't had blood work since December. My doctor indicated I had indications of fatty liver but didn't seem alarmed or recommend any follow up. I would like to come clean however since this may change the doc's opinion. Any thoughts?
Anyway, does anybody here know the laws in the United States regarding alcoholism and health insurance since Obama passed the Healthcare bill. I hear things are easier over in England and Canada. Right now we are putting out $800 per month for the family and it doesn't even cover MH/D&A treatments.
I haven't drank for over 30 days and haven't had blood work since December. My doctor indicated I had indications of fatty liver but didn't seem alarmed or recommend any follow up. I would like to come clean however since this may change the doc's opinion. Any thoughts?
Member
Join Date: Jun 2006
Location: LA - Lower Alabama
Posts: 5,068
The Obama healthcare bill hasn't changed anything - the changes that are there don't take place until 2014.
I can't tell you anything about the rest of your concerns because I don't know. I do not advise hiding your drinking from your Dr., and I definitely do not advise klonopin for any reason, that is some wicked stuff, especially when mixed with alcohol.
I can't tell you anything about the rest of your concerns because I don't know. I do not advise hiding your drinking from your Dr., and I definitely do not advise klonopin for any reason, that is some wicked stuff, especially when mixed with alcohol.
Member
Thread Starter
Join Date: May 2010
Location: Earth
Posts: 94
Didn't mix klonopin with alcohol. Used klonopin to detox from alcohol which is exactly what the doctors would order (or a variety of other benzos). i work in D&A and at least know that much - that is why i only asked for 10 pills .5mg. Took 2 x daily for 5 days. made detox very easy. The last thing i need is a benzo addiction. i deal with this stuff everyday. benzos are great drugs though if used responsibly.
Member
Join Date: Apr 2010
Location: Boston, MA (Mattapan) Legit ghetto but I love it
Posts: 174
I have Masshealth. It's public insurance, it'd Medicaid and we had it before the Obama care thing but it's what Obama care is based on...
My healthcare covers mental health care... so I can go to therapy and rehab and they will pay for it (though you DO have a co pay but its not much for me its 10 dollars). As long as you get diagnosed, they can't refuse to treat you. That's what insurance is for... but yeah they said they would cover rehab if I'm diagnosed by a doctor. They whole point of insurance is so you'll go to the doctor not so you'll avoid them so it would be count productive if they refused you treatment...
Also though at least in Mass you have to make below a certain income to qualify for the Gov. health care... if you make above a certain income you have to get private/whatever your company offers. And private insurance is STILL privite insurance...obamacare doesn't effect that it just gives families like mine an option for heath care...and besides its going to take a long time before it really even affects anyone so I would say it's not a huge factor.
My healthcare covers mental health care... so I can go to therapy and rehab and they will pay for it (though you DO have a co pay but its not much for me its 10 dollars). As long as you get diagnosed, they can't refuse to treat you. That's what insurance is for... but yeah they said they would cover rehab if I'm diagnosed by a doctor. They whole point of insurance is so you'll go to the doctor not so you'll avoid them so it would be count productive if they refused you treatment...
Also though at least in Mass you have to make below a certain income to qualify for the Gov. health care... if you make above a certain income you have to get private/whatever your company offers. And private insurance is STILL privite insurance...obamacare doesn't effect that it just gives families like mine an option for heath care...and besides its going to take a long time before it really even affects anyone so I would say it's not a huge factor.
Administrator
Join Date: Apr 2007
Location: Australia
Posts: 211,384
You posted 30 mins ago - you'll get responses 
I'm an Australian.
That and the insurance issues elsewhere don't change the fact I always recommend seeing a doctor and telling them everything.
And I wouldn't recommend self diagnosis and treatment either.
Thats exactly the kind of behaviour that got a lot of us in trouble.
See a Doctor.
What price do you put on your health?
I broke my health drinking.
I wish I had it back.
D
I'm an Australian.
That and the insurance issues elsewhere don't change the fact I always recommend seeing a doctor and telling them everything.
And I wouldn't recommend self diagnosis and treatment either.
Thats exactly the kind of behaviour that got a lot of us in trouble.
See a Doctor.
What price do you put on your health?
I broke my health drinking.
I wish I had it back.
D
Member
Join Date: May 2010
Location: chico, ca
Posts: 321
I'm neither from europe nor on medicaid, but I guess it depends on your carrier and the diagnosis. Getting clean with your Md. is up to you, but if you're struggling with staying sober that might be a good idea. If you're an alcoholic like I am, the least of my fears are from the insurance bozos. Medical doctors of the standard form get about 20 hrs in their entire medical school training devoted to alcoholism. The effects, but not the solution. My sponsor gets that in a week. Good luck and God Bless.
Member
Join Date: Jun 2010
Location: California
Posts: 2,693
I have the same thoughts and worries as you Hope4Recovery about telling my primary care doctor. I thought I was clever so a few weeks back I called several public health clinics and asked, "Do you give anonymous physicals and blood work?" The nurses either responded with disgust or laughter. The answer was "no."
I am still in the same boat and have not told my doctor the truth. I have an appointment tomorrow so now is my time. I also do not have health insurance right now.
I think Dee's post above mine says it all: What price do you put on your health?
I am still in the same boat and have not told my doctor the truth. I have an appointment tomorrow so now is my time. I also do not have health insurance right now.
I think Dee's post above mine says it all: What price do you put on your health?
Member
Join Date: Sep 2007
Location: Atlanta
Posts: 31,179
It does depend on your insurance carrier. I didn't have insurance at one point. I went to the "indigent care" hospital, here in Atlanta. Was very upfront with them about my addiction history..it's noted in my records. I got a job at a restaurant that actually had good insurance. They, apparently didn't check into any of my medical history, didn't have the "pre-existing" clause and I had no problem. They didn't, however, cover mental health issues, as I found out when I was robbed at work, developed PTSD and workmen's comp wouldn't cover it and I tried to get counseling (another story).
I'm working at another restaurant, now, though and their insurance is horrible...it doesn't cover ANYTHING that is "pre-existing" unless I had continued my previous health insurance...I didn't, so I'm without insurance.
I can still GET insurance, easily, it just won't cover any of my current health issues for so many months. Generally if you already HAVE insurance, don't have a lapse of more than 3 months, there's no problem in getting insurance with another carrier, or at least that's what I've found recently.
Hugs and prayers!
Amy
I'm working at another restaurant, now, though and their insurance is horrible...it doesn't cover ANYTHING that is "pre-existing" unless I had continued my previous health insurance...I didn't, so I'm without insurance.
I can still GET insurance, easily, it just won't cover any of my current health issues for so many months. Generally if you already HAVE insurance, don't have a lapse of more than 3 months, there's no problem in getting insurance with another carrier, or at least that's what I've found recently.
Hugs and prayers!
Amy
Member
Join Date: Oct 2008
Posts: 6,947
Fatty liver is what it is, it's not always caused be alcohol. If you are worried about the a-word in the chart, perhaps you just don't use it yourself, you can tell the truth ... that you were drinking too much. If, that is what your concern is, fatty liver and alcohol. And that you quit drinking.
You can ask if you can talk "off the record".
Or you can tell your doctor you are alcoholic. Probably you will be surprised by the unconditional support you'll receive... and the benefit of a better, more complete and more accurate diagnosis and treatment.
It is not typical for insurance companies to require a chart review before selling you a policy... they depend on the huge database of claims for medical services... so if a claim is never filed with a diagnosis of alcohol or drug addiction, they'll never know, unless they ask to see your medical records. Be sure to discuss these worries openly with you doctor.
Did the MH/D&A provider submit a claim to your insurance company?
Mark
You can ask if you can talk "off the record".
Or you can tell your doctor you are alcoholic. Probably you will be surprised by the unconditional support you'll receive... and the benefit of a better, more complete and more accurate diagnosis and treatment.
It is not typical for insurance companies to require a chart review before selling you a policy... they depend on the huge database of claims for medical services... so if a claim is never filed with a diagnosis of alcohol or drug addiction, they'll never know, unless they ask to see your medical records. Be sure to discuss these worries openly with you doctor.
Did the MH/D&A provider submit a claim to your insurance company?
Mark
Member
Thread Starter
Join Date: May 2010
Location: Earth
Posts: 94
Originally Posted by dgillz 
What does "MH/D&A provider" mean?
My concern is my health and the damaged caused from alcohol. At this point, i don't need the doctor to stop drinking. I need the doctor to get an assessment of my health status.
Member
Join Date: Aug 2008
Location: SE and then South some more
Posts: 2,648
If you are covered under insurance through your company, all insurances are required to provide full coverage for mental health and substance abuse in accordance to this, The Parity Act....................
https://www.cms.gov/HealthInsReformf...hParityAct.asp
I work in a treatment center where we get addicts all day. Addictions for eating disorders, gambling, alcohol and drugs. It depends on what kind of insurance coverage you have as to what your out of pocket and deductible is. That you have to pay. After that your insurance company can tell you what they cover. Some will cover 100%, others 80, 70, 60 and so on.
Under the parity act, your insurance is required to cover detox, partial hospitalization, inpatient and outpatient. Some provide unlimited lifetime with a million dollars or more in benefits to cover your treatment, and again, they will vary.
It's basically the same as if you had to have major surgery, had cancer treatments, required what some people would consider "normal" health care. EVEN THEN you would be required to pay the deductible and out of pocket (if none has been met, or the rest of what you have to pay) to get treatment.
I just noticed that you're really looking for blood work, why not call and see who's in your network and get an appt. and go? I don't know if you have anyone in your office that calls the insurance companies, but if so, maybe as them as well. If it were me, I'd call my insurance company and ask them.
Good luck!!
https://www.cms.gov/HealthInsReformf...hParityAct.asp
I work in a treatment center where we get addicts all day. Addictions for eating disorders, gambling, alcohol and drugs. It depends on what kind of insurance coverage you have as to what your out of pocket and deductible is. That you have to pay. After that your insurance company can tell you what they cover. Some will cover 100%, others 80, 70, 60 and so on.
Under the parity act, your insurance is required to cover detox, partial hospitalization, inpatient and outpatient. Some provide unlimited lifetime with a million dollars or more in benefits to cover your treatment, and again, they will vary.
It's basically the same as if you had to have major surgery, had cancer treatments, required what some people would consider "normal" health care. EVEN THEN you would be required to pay the deductible and out of pocket (if none has been met, or the rest of what you have to pay) to get treatment.
I just noticed that you're really looking for blood work, why not call and see who's in your network and get an appt. and go? I don't know if you have anyone in your office that calls the insurance companies, but if so, maybe as them as well. If it were me, I'd call my insurance company and ask them.
Good luck!!
Member
Thread Starter
Join Date: May 2010
Location: Earth
Posts: 94
As far as costs go, it does matter to me. i already made the step to stop drinking. if I do have liver damage, the main prescription is "stop drinking". That's the good thing about AA - no insurance claims filed. Personally, working in the field, I don't have a huge amount of faith in professional treatment services anyway. Most of these folks either don't what they are doing or don't care. it is a job just like any other job - some are good, some aren't. Getting professional treatment is not an option to me. My insurance doesn't cover it and the costs would be astronomical. I have savings and do not qualify for any public funding in the State i live in.
I will see my doctor agin and figure out a way to get more blood work. I did have a thorough work up on my heart back in December and everything came out OK. This in when I was told about the fatty liver. the doctor told me to lose 10 - 15 pounds. This was in the emergency room and i did tell the doctor about my drinking patterns. He did not seem concerned about the liver even when i brought it up. (I had some pain right above the liver - for some reason they focused on the heart).
I feel pretty good both mentally and physically since stopping drinking - just not as good as i did ten years ago. I also smoke cigarettes and could lose 10 pounds or so. I already lost 10 pounds since giving up the beer (currently 180 pounds). I should be around 170 - 175 when lifting weights and working out, or 160 - 165 without weight lifting.
The people we treat where i work are at the end of the line. Been through several rehab programs and receive public assistance. Government medicaid programs are much more generous than the one I pay $800 per month for. My trip the ER back in December cost me $1000 out of pocket on top of the current premiums. This is why costs do matter to me.
Anyway, financial stability brings me peace of mind. Financial instability causes me stress and worry. Reducing stress is also good for the liver. People with Hep C often exacerbate the virus simply with stress. I'm trying to manage my health on both ends (physical and mental). I don't want any prescription medications - just baseline data on my blood counts so i can see if things improve in 3 - 6 months.
While fatty liver is not cirrhosis, it is the first step towards a bad liver.
I will see my doctor agin and figure out a way to get more blood work. I did have a thorough work up on my heart back in December and everything came out OK. This in when I was told about the fatty liver. the doctor told me to lose 10 - 15 pounds. This was in the emergency room and i did tell the doctor about my drinking patterns. He did not seem concerned about the liver even when i brought it up. (I had some pain right above the liver - for some reason they focused on the heart).
I feel pretty good both mentally and physically since stopping drinking - just not as good as i did ten years ago. I also smoke cigarettes and could lose 10 pounds or so. I already lost 10 pounds since giving up the beer (currently 180 pounds). I should be around 170 - 175 when lifting weights and working out, or 160 - 165 without weight lifting.
The people we treat where i work are at the end of the line. Been through several rehab programs and receive public assistance. Government medicaid programs are much more generous than the one I pay $800 per month for. My trip the ER back in December cost me $1000 out of pocket on top of the current premiums. This is why costs do matter to me.
Anyway, financial stability brings me peace of mind. Financial instability causes me stress and worry. Reducing stress is also good for the liver. People with Hep C often exacerbate the virus simply with stress. I'm trying to manage my health on both ends (physical and mental). I don't want any prescription medications - just baseline data on my blood counts so i can see if things improve in 3 - 6 months.
While fatty liver is not cirrhosis, it is the first step towards a bad liver.
I got nothin'
Join Date: Jun 2008
Location: My house.
Posts: 4,890
Please be honese, HR.
I don't have insurance but I'm sure 'alcoholism' is on my med. records. No matter what I'll find a way to get the care I need.
Impurrfect and Mark75 bounced around some good ideas and whatnot.
Take care of yourself.
I don't have insurance but I'm sure 'alcoholism' is on my med. records. No matter what I'll find a way to get the care I need.
Impurrfect and Mark75 bounced around some good ideas and whatnot.
Take care of yourself.
Member
Thread Starter
Join Date: May 2010
Location: Earth
Posts: 94
Originally Posted by vegibean
If you are covered under insurance through your company, all insurances are required to provide full coverage for mental health and substance abuse in accordance to this, The Parity Act....................
https://www.cms.gov/HealthInsReformf...hParityAct.asp
I work in a treatment center where we get addicts all day. Addictions for eating disorders, gambling, alcohol and drugs. It depends on what kind of insurance coverage you have as to what your out of pocket and deductible is. That you have to pay. After that your insurance company can tell you what they cover. Some will cover 100%, others 80, 70, 60 and so on.
Under the parity act, your insurance is required to cover detox, partial hospitalization, inpatient and outpatient. Some provide unlimited lifetime with a million dollars or more in benefits to cover your treatment, and again, they will vary.
It's basically the same as if you had to have major surgery, had cancer treatments, required what some people would consider "normal" health care. EVEN THEN you would be required to pay the deductible and out of pocket (if none has been met, or the rest of what you have to pay) to get treatment.
I just noticed that you're really looking for blood work, why not call and see who's in your network and get an appt. and go? I don't know if you have anyone in your office that calls the insurance companies, but if so, maybe as them as well. If it were me, I'd call my insurance company and ask them.
Good luck!!
https://www.cms.gov/HealthInsReformf...hParityAct.asp
I work in a treatment center where we get addicts all day. Addictions for eating disorders, gambling, alcohol and drugs. It depends on what kind of insurance coverage you have as to what your out of pocket and deductible is. That you have to pay. After that your insurance company can tell you what they cover. Some will cover 100%, others 80, 70, 60 and so on.
Under the parity act, your insurance is required to cover detox, partial hospitalization, inpatient and outpatient. Some provide unlimited lifetime with a million dollars or more in benefits to cover your treatment, and again, they will vary.
It's basically the same as if you had to have major surgery, had cancer treatments, required what some people would consider "normal" health care. EVEN THEN you would be required to pay the deductible and out of pocket (if none has been met, or the rest of what you have to pay) to get treatment.
I just noticed that you're really looking for blood work, why not call and see who's in your network and get an appt. and go? I don't know if you have anyone in your office that calls the insurance companies, but if so, maybe as them as well. If it were me, I'd call my insurance company and ask them.
Good luck!!
Member
Thread Starter
Join Date: May 2010
Location: Earth
Posts: 94
Here is what I read:
MHPAEA preserves the MHPA protections, and adds significant new protections. Although the law requires "parity", or equivalence, with regard to annual and lifetime dollar limits, financial requirements and treatment limitations, MHPAEA does NOT require large group health plans and their health insurance issuers to include MH/SUD benefits in their benefits package. The law's requirements apply only to large group health plans and their health insurance issuers that already include MH/SUD benefits in their benefit packages.
MHPAEA preserves the MHPA protections, and adds significant new protections. Although the law requires "parity", or equivalence, with regard to annual and lifetime dollar limits, financial requirements and treatment limitations, MHPAEA does NOT require large group health plans and their health insurance issuers to include MH/SUD benefits in their benefits package. The law's requirements apply only to large group health plans and their health insurance issuers that already include MH/SUD benefits in their benefit packages.
Member
Join Date: Aug 2008
Location: SE and then South some more
Posts: 2,648
My trip the ER back in December cost me $1000 out of pocket on top of the current premiums. This is why costs do matter to me.
If you haven't "bled" your benefits, you should still be covered so I would not base what you would be covered for based on the clients you see in your office that are
at the end of the line.
Currently Active Users Viewing this Thread: 1 (0 members and 1 guests)
