Mental Health/Substance abuse Insurance coverage?

Discussion in 'Substance Abuse' started by comatheart, Sep 24, 2013.

  1. comatheart

    comatheart Active Member

    I don't know if anyone here knows the answer to this, maybe one of you has been there done that...

    I spoke with one of my son's counselors today at the rehab facility. Turns out, he only has 15 days of this level of care left on our policy. After that's gone, he only has outpatient care available. NO ONE ever said anything to us about a limited number of days on any level of treatment.

    I'm back to freaking out. My son cannot come home yet!! The counselor said they are recommending he get at least 60 days of inpatient treatment, so we are way off here. He suggested I call the business manager tomorrow. I'll also be calling our insurance company!

    Suggestions?? Anyone ever heard of insurance companies paying for more days of treatment if the need is proven?

    Did we get caught in some kind of trap. Get the kid here, "oh sorry you're outta time so now you have to pay big $$ to keep him here" kind of thing?
  2. PatriotsGirl

    PatriotsGirl Well-Known Member

    Insurance is usually awful about such things. Ours covered a while nine days...then even again later they would pay for outpatient but not inpatient and the inpatient was ridiculously expensive. We are lucking out right now because our daughter got involved with the legal system and I jumped on it to get her some court ordered help. Since she just had a baby, she qualifies for welfare and once she qualifies for welfare, she qualifies for free treatment...
  3. comatheart

    comatheart Active Member

    So, after a pretty sleepless night, I called our insurance company this morning ready to go to bat and appeal, appeal, appeal.... Turns out, we have NO maximum day limit for Chemical Dept. OR Mental health on our policy. (I checked both cause I wasn't sure how they bill it since it's a duel program)

    "It must have been a mistake. When your child runs out of approved days, the facility just needs to resubmit for more."

    A phone call to the rehab facility confirmed they'd made an error, no need to worry.

    AGGGHHH!!!!!!!!! I'm so relieved.

    Now I need a nap.
  4. InsaneCdn

    InsaneCdn Well-Known Member

    I'd rather have a "false heart attack" situation than a real one!...
    But the adrenalin effect isn't much different when you're in the trenches.
  5. Nancy

    Nancy Well-Known Member Staff Member

    Thank goodness. Our insurance company only paid for 3 days and we had to pay for the other 57. Under Obamacare substance abuse treatment must be covered. I don't know what that means right now but hopefully after Oct 1st we will have idea.