update on son: found hospital/RTC but there's a hitch...

[DDD]

Guess I should forewarn you about the next insurance trick. After your GFG is approved for coverage and starts the program the insurance company stays in contact with the facility and randomly can deem that your child no longer needs residential services because "he is no longer actively using substances".

Yep! It happens. That's a catche 22 that caught me off guard.

Fingers crossed you don't get that roadblock. I'm rootin' for you. DDD

[Ephchap]

RD,

I'm not sure of the ins and outs with the juvenille system involved, because in my son's case, he was considered an adult by the courts (just turned 17), but a juvenille by our health insurance provider - so we were also in limbo.

My son wasn't court ordered, but was arrested while we were waiting for a bed to open up at the RTC.

My insurance company would not pay for anything that had the word "residential" in it. I still to this day do not understand why, but they wouldn't. They also wouldn't pay for anything out of state.

We were able to go through an agency of our county's MHMR agency, and they helped us file for medicaid for him - since it was based on his income (zilch). Although they did have us fill out financial papers and we were required to pay a monthly fee, it was minimal compared to the total cost. Just a thought - you might try contacting one of the agencies that deal with mental health in your area. Maybe they can help figure out financing.

Hugs to you. I know that feeling when you're so close to thinking something might help, and then a hiccup in the system happens and you worry who will help.

Keep us posted, and I hope it all works out !

Hugs,
Deb

[recovering doormat]

Merry Christmas and belated Happy Hanukah to all:

Yep, I'm prepared for any and all insurance "tricks," from not getting a precert to the arbitrary decision that treatmetn is no longer "medically necessary." Our carrier has no limit on days in residential but it is governed by medical necessity, which means the staff at the facility will be calling the carrier about every three days to beg another three days. I expect more stress, but at least we are making a dent in our son's rock-hard cabesa, that we will not tolerate his activities.

One of his "friends" just got placed in juvenile detention for four months for beating and punching another boy so badly that bones were broken -- not a shoving match, a real beating. This boy, the perpetrator, is a year younger than my son and had spent several weeks in a wilderness program over the summer. Apparently it didn't do enough. My son spent a lotof time this past summer with this young man, staying at his dad's house wehre there was little or no supervision.

My son cannot come home immediately after this 45-60 day diagnostic program. He needs a real RTC experience away from home to break from kids who drag each other down.

Just gotta stay strong until he goes, whether it's Tuesday or Friday.

I am counting my blessings today, that although my family is messed up, I know where everyone is, and they are safe. I"m praying for those out there who are not so fortunate.

[standswithcourage]

I have to count my blessings too. I do know where everyone is also. If you have the chance read the book The Christmas Sweater by Glenn Beck. It is awesome.

[bonx4chaps]

Just FYI..this is totally irrelevant to your initial thread but I didnt know this beforehand so I wanted to fore-warn you ...My insurance completely covered my son's RTF treatment but Children and Youth took me and my husband (we still even live together) for two separate hearing/cases for child support. After further review with every agency possible (I even wrote to OBAMA!) I found this is policy anytime the child is placed in RTF the parent relinquishes custody. Between the two of us we pay $800.00 a month plus the arrears- not a penny goes towards my son or the program- it is put into the state welfare system. And this is the amount taken into consideration that we have four OTHER children to take care of at home. So, be prepared because that was a really bad hit for us- (nothing like salt in the wound).

[recovering doormat]

Bonx4chaps:

My son has been in the RTF for one full week, and the insurance company only gives certification for three consecutive days at a time. Today he is covered (ins. pays 70%, we are liable for 30%, education expenses are borne by our home district), by MOnday they will have to call again to beg for some more days. At some point the insurance company will just flat-out refuse, and that could be any minute now.

The insurance coordinator at the facility called my ex and I today and suggested two things: they have an application for a "charity" something or other where they would work out an extended payment plan, and shave down some costs (other facilities have done one better and charged us the rate they received from the insurance carrier, perhaps 35% less); and they suggested we contact our state DCF and see if they can help us out financially. Probably not, since we went out of state from CT to PA, and most states are cracking down on sending dollars out of the state. But it can't hurt to ask. Otherwise, it comes down to ex dh doing the right thing and raiding his IRA, and I have no control over that.

[tracyf551]

My son also went to RTC 2 times during his teen years. I personally called Children services b/c I was out of ideas, doctors, therapists, etc. Tried them all. I also had to give up parental rights, but I still had a say in his care. I live in PA and I believe even though we give up rights we still have a say in things. He was court ordered to go to RTC. We had to pay support also while he was there and were in the rears before we knew it. I finally got everything paid off about 5 months after he was home. Just in time for him to quit school and go back to the way he was.
I hope your situation works out much better than mine.