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Problems With Insurance Companies for Opiate and Painkiller Addiction

Your child is at a point in their addiction where they can no longer go on living the way they are. They are sick and tired of being sick and tired all because of their opiate addiction. They finally have reached rock bottom and come to you like an open book.  They explain everything they have done and they not only realize they need help, but they are ready for it. You as a parent are excited that they have finally taken the steps to take their life back from their addiction. This brings an overwhelming amount of joy to you, and you can't wait to help them get started on their road to recovery. You call facilities that are in your general area to see if they have any openings. You take your child there while they are going through extreme withdrawal, so you just want them to get help as fast as possible to keep them from relapsing.  A major problem you soon realize is that your insurance company isn't cooperating with the rehabilitation center and refuses to pay.

This is becoming an all too common problem in the world of recovery. Many suburban families are too wealthy to be eligible for state or federal subsidiaries, yet too poor to pay for treatment out of pocket. Many rehabilitation centers cost thousands of dollars per day easily putting a month of treatment in 5 and possibly even 6 figures.  Families sometimes resort to taking out hefty loans to pay for treatment for their children. When you are denied help from your insurance company it makes you wonder why you pay your insurance premiums in the first place.

Many treatment centers speak with patients and their parents "off the record", to tell them the truth about getting admitted to their rehab facility. They explain that they are being denied by the insurance company for their addiction. The rehab facilities explain to them that if the patient admits to wanting to "harm" themselves or a family member, they can then be covered under a term known as “duel diagnosis.” This creates a dilemma for many patients and family members. Many addicts do not want to admit they are suicidal, and they do not want to lie about their issues they are facing. The beginning of recovery is a very important time for addicts to be honest about everything, and this usually confuses and upsets the patient.

It is very discouraging for families to be denied coverage by their insurance companies when their child is ready for help.  You finally get to a place where help looks like it's right around the corner, yet it's denied because of the insurance company.  It makes parents furious and desperate and leads to many doing whatever they can to save their child's life. This includes insurance fraud. Parents persuade their children to lie about how bad their addiction is.  They tell their kids to admit using more drugs than they were using. The more drugs that are documented that the user admits to using, the more likely the insurance companies will cover the expenses. Many parents convince their children to say they “want to hurt themselves,” in order to get the dual diagnosis label in order to get the treatment they desperately need.

This is a problem I hear way too often.  For your child to admit they have a substance abuse problem, and wanting to get help is a very hard step for addicts to make. The only time rehab works is when the addict is ready to make changes in their life and get clean. There is nothing more frustrating and upsetting than to be denied the chance of recovery because of insurance companies declining the claim. Mental health, and drug abuse is a very serious issue, and our society needs the resources necessary in order for addicts to get clean.  Any hurdles in the way, are just more reasons for an addict to continue to use. Hopefully insurance companies will realize that getting help for all of their patients should be their main priority.  The faster an addict can get help, the more successful they will be in their recovery.


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