Should I take difficult child off our health insurance?

Discussion in 'Substance Abuse' started by Nancy, Feb 21, 2011.

  1. Nancy

    Nancy Well-Known Member Staff Member

    difficult child is living with pothead's family down the street since we kicked her out last Thursday. I heard through the grapevien that she is smoking pot every day and was very sick last night. Pictures she has posted on her facebook of events over the weekend make it obvious she is on something. I suspect she's on a lot more than pot.

    Outside of being sick to my stomach and so angry that these parents allow her to live there and do drugs knowing she has a drug/alcohol problem, I am worried that she will need medical treatment/hospitalization at some point. We are considering taking her off our health insurance plan. We have a very large individual deductible (10,000 per person) and still owe quite a lot from her rehab last year. We can't afford another large bill. Also if we take her off our insurance she may be eligible for services she is not eligible for now.

    It's a big decision because it's accepting that she is gone and won't be back. What are your thoughts?

  2. exhausted

    exhausted Active Member

    Because of my past experiences with huge medical bills for inpatient care for my difficult child, despite double coverage,I would advise against it. She is in no state to go apply for medicaid or medicare at this point.Maybe getting more information on this would set your mind at ease. Will she really be able to get this assistance? I think it is reasonable to take her off once she has been gone for awhile longer. Better to be safe at this point. Some insurances require that kids over 18 have to be in school and/or at home to be on your insurance, so that may be a problem. I would give myself time. I can't imagine how hard it must be to just have her out there doing what she is doing. Hang in there.
  3. toughlovin

    toughlovin Guest

    I think I would not do that yet..... because you have no idea if she could really get other insurance. I believe the new health care bill allows you to keep her on until she is 26 (maybe its 25) and she doesn't have to be in school. I am so sorry she is gone down this path so hard.... hopefully she is going to really hit bottom and hit it hard and soon. I hate to say it but the best thing at this point might be if she gets arrested. Gosh it is all so heartbreaking..... my heart is with you.
  4. susiestar

    susiestar Roll With It

    That is a huge question. Since she is on your insurance she won't be able to get help from many sources, but with-o insurance there are a lot of things that there is no help for. I totally understand your anger at the other family - it must be so hard to not rip their heads off, but you know that won't solve anything but make them feel sorry that she has "awful" parents (which you are NOT).

    I guess my concern would be pregnancy. Do you know if she is using any birth control? I would be terrified she would get pregnant. Would she consider an implant or IUD or even the depo shot? Often you get a big price cut by having insurance. Gcvmom's post about the cost for her son's procedure is a good illustration of how the pricing works. The huge cost was cut almost in half simply because they have insurance. I know one of my docs bills insurance over $250 for an appointment but if you pay cash he cuts it to just $100. He has to bill that much to the insurance or they will not even pay the $100 that cash patients pay. With insurance she can get services cheaper at many places.

    BUT if she is on your insurance you may be liable for the balance that she doesn't pay. I don'tknow if that is something you can afford to be liable for, esp as you still have the big rehab bill.

    If she doesn't have insurance she WILL get free doctor visits for pregnancy if seh will go to medicaid. Sadly there are many women who delay seeing a doctor for pregnancy because most docs drug test pregnant women, at least here. ALL women on medicaid get drug tested while pregnant here - I don'tknow if they tell the moms up front but it is part of the monthly urine testing - and positive results are referred to the police/DHS here.

    I wish I could give you an answer, but it is a complicated issue. There are programs to get medications at lower costs that you don't have to a pay for. They are not free but they knock the cost down a lot. Our electric coop offers one as a free service - cuts my rx's about in half in cost. Our insurance refused to accept the COBRA payment for a week before the payment was due and then said that we didn't pay so we were cancelled (they have played dirty tricks like this for years). It happened right after my doctor asked for approval for about $8000 worth of tests for me and husband had just had a skin cancer cut off of his shoulder. I kind of expected it as I cost them a bundle as a patient, but it has been tough.

    Since she is not still in school she won't be eligible for long, will she?At least here they still have to be full time students after they are out of high school to stay on the parents' insurance. Is she still going to community college?

    I wish I could be more helpful. While you want her to have good health care, how much is it worth if she won't go because she doesn't want to deal with her drug problems, esp when they are wrecking her health?

    Does she have any input on this? Would you be willing to keep her on the policy if she pays the cost to you? The amount extra it costs to keep her on your plan - if she could pay it on time every month, maybe it would be viable to keep her on the plan (if she is eligible). I would find out the exact requirements - in school so many hours, so much $$ by such and such date, etc... and write up a contract. If she doesn't pay on time or stay in school and passing, then it is HER decision to not be insured.

    I don't know if that is doable, but put it in writing and get it notarized with it specifically said that if she is even a day late her insurance is cancelled. Make it a business decision - HER business decision.

    That way it would be her decision either way. As an adult it is HER responsibility to take care of this, whether it has occurred to her or not.
  5. Nancy

    Nancy Well-Known Member Staff Member

    A lot of good points and questions. She is on birth control but it is the nuva ring and she doesn't have one in now and they are here at home. She could never pay the premium to keep her on our insurance, we are having a hard time making the premiums as it is even though we have such a high deductible. My real concern is that she will end up in the hosiptal soon from either an overdose or alcohol poisoning. This idiot family who is allowing her to use in their home won't have to pay, we will. She is not here and engaged in very risky behavior so I'm sure it's only a matter of time before something happens. I hope this pothead family understands what they have on their hands.

    The contract cost vs non contract cost is certainly a concern. I know that the difference is huge.

    I don't know what our financial obligations would be if she went to the hospital and we didn't sign for it. I think they would send the bills in her name and then we could refuse to pay it. I think we should wait a bit longer until she is out of the home for a period of time, but we will have to make a decision at some point.

    I am terrified but I'm trying to put this in one of those compartments that I will try not to open unless necessary.

  6. rlsnights

    rlsnights New Member

    I would take her off if it was me. If she can't be trusted to live in your home why would you provide her medical coverage?

    Maybe it would be helpful for you to think about what it would take for you to be willing to take her back into your home. Then consider whether you think it's likely that will happen in the next year. If not, then what difference (objectively speaking) does it make that you only made her leave last week? been there done that and I know it's still really raw and painful that you had to kick her out. But try to take a minute and set that pain aside to think rationally about this.

    There is coverage for serious illness/accidents if she has no resources through Medicaid. If it's something that's not covered like an abortion then she will have to figure it out.

    We were faced with this decision for difficult child 1 and opted not to do it after talking it over with our attorney. The attorney strongly advised against it mostly because it would create further ties/entanglements with this kid who was completely out of control.
    If the new health care legislation survives reasonably intact, you should be able to add her back on up until 2014 if she gets her act back together. There may be a pre-existing conditions clause, it depends on your State.

    Could your own policy be cancelled or the premium raised or the coverage changed if she continues to incur huge bills? Something to think about.

    You should also check your State's laws regarding medical debt and how long you are legally responsible for providing for your child. Some states require you to provide for your child until age 21. Yikes. If you have an attorney or a legal plan, you might check with them about the legal requirements and responsibilities in your State.

    Normally, if you do not sign anything saying you are responsible for her debt and you are not required to provide for her under State law then you would not be responsible for her medical debts even if she were on your insurance.

    Another option - you could check the EHealthInsurance website for the cost to get her an individual policy to see how it compares to the cost of keeping her on your own. If you really want to provide her with health insurance you could buy her an individual policy so you cannot be construed to be responsible for her bills in any way.

    Good luck.

  7. KTMom91

    KTMom91 Well-Known Member

    I would check with the insurance company and see what their requirements are for children over 18. She isn't a full-time student (correct?) and isn't living with she still considered a dependent for tax purposes, and is that something the insurance company would consider a definer for coverage? When Hubby started working at the utility company several years ago, we knew Miss KT would go off the insurance at 19, full-time student or not. Along with that, the company stated clearly that if we tried to continue her coverage after she was no longer eligible, they would bill us triple the costs that she incurred.

    I would say that you and your hubby need to protect yourselves, and if that means taking your difficult child off your insurance, so be it.
  8. slsh

    slsh member since 1999

    Nancy, we took thank you off when he hit 18 and dropped out of school, because at that time the law said he had to be a full time student. I called this year to see if we could put him back on and our HR dept told us that in order for us to put him back on there, we have to be providing at least 50% of his support and he has to live here 50% of the time (under the new law). So that's a no-go.

    Even if she's on your insurance, that does not make you responsible for her medical bills. She's an adult - it's her problem. She would probably qualify for Medicaid, but you probably are having as much luck as we are getting her to sign up for it. thank you's uninsured right now - when I think about it, it terrifies me. He's been in 3 major car accidents as a passenger in the last 6 months. At least one of those times he should have been checked out at the ER given the nasty seat belt bruises that were still there 3 weeks later - he refused medical tx.

    I have no control. I have no say. He will either get his act together or not. I would have gladly put him on our insurance if we could have, just for my own peace of mind. But... he seems completely unconcerned about it, despite my prodding every time he calls with a symptom (knee pain, back pain, etc). I have to let it go.

    Personally? I'd keep her on as long as you legally can.
  9. Suz

    Suz (the future) MRS. GERE

    I can certainly understand both sides of this issue but truth be told, I would keep her on, too. It has been heartbreaking to watch the financial repercussions for Rob after his motorcycle accident and his poor aftercare because he was uninsured. She is making stupid-stupid-stupid decisions right now that you have absolutely no control over. But if having her insured will help her get better care should she need it, it would be worth it to me to pay the premiums.

  10. katya02

    katya02 Solace

    If your deductible is that large and you can't manage another big bill, I would consider taking her off. She may be ineligible anyway, due to not being a student and not living at home, but you'd have to check with your company on that. In our county it's more common for people to be uninsured than otherwise; but the county hospital sees everyone and writes off massive amounts of bad debt. If something major happened she would get care, if not the Cadillac version, still the essential care she would need. The difference is that you wouldn't be faced with a bill of $10,000.00. If it's your insurance I would think that deductible would be billed to you. It sounds as if your difficult child would qualify for MA if she were to apply; if she refuses, there isn't much you can do. I sympathize with your situation and think it's probably time to consider your own financial health. Oh, and if your difficult child has a health crisis due to using while in pothead's parents' home, you could make sure they are charged with everything possible. Maybe that can be arranged before a crisis happens ... they are providing/abetting illegal substances/use in their home to underage young people. That's a crime.
  11. susiestar

    susiestar Roll With It

    In OH they are legal adults for all except alcohol at 18. We lived in Cincy for quite a while and a friend of mine ran across this with her 18yo. Parents can CHOOSE to shoulder the bills but the debt is teh 18yo's problem in most situations if the parent will not cover it. Double check this, of course, because it was 9 or 10 yrs ago.

    If she overdoses at their home or in their vehicle it is their insurance that will cover it. Their homeowner's insurance would cover the cost of her hospital bills if she is hurt on their property. It is one reason I will allow NO ONE to use an illegal substance on any property I own or am responsible for. Same thing applies for their cars. If they don't have insurance it is still their problem.

    Heck, OH has such bizarre alcohol laws that if she is drunk and goes into a restaurant and has even a free glass of water and then is in an accidetn because she is drunk or high - the restaurant and manager and server can be held responsible for her accident and all damages!!! No, this is NOT a joke or old wives tale. When I managed a restaurant in OH we had to go through a lengthy alcohol training program even though we didn't serve alcohol of any kind for just this reason. We had to be able to tell if someone was drunk and call the police. Even a free glass of water meant that we had the responsibility under the law to stop them from driving or getting hurt. A couple of years later I worked at a liquor store and had to do some training from the state liquor board and again this was part of it.

    If she is in a major accident or OD's or something a hospital social worker will help her apply for medicare/medicaid and it will be approved to cover her expenses. She won't get the best of care, but she will get care. If she needs major surgery or something it will happen that way too. The hospital will help her because they know it is the only way they will get paid. ER bills will follow her for a while but they will be written off. She won't get a choice of hospitals if she wants to go to a private one, but that is less and less of an issue with the current economic problems.

    If she is on your insurance you can possibly be held responsible for her medical bills even though if she didn't have insurance they wouldn't come after you at all.

    If you are having financial problems it is likely to be a better choice to cut her and help her later with what you can help her with rather than to spend all your resources keeping her insured when the deductible is that high. You still have a huge rehab bill to pay and she is choosing to not work her program. It might be a wiser financial choice to get her a policy of her own, pay it for a few months and let her pay after that if she wants it. A policy that just covers major medical won't be as expensive as a plan that covers everything.

    You also may be ina better position if she ends up needing to take medications regularly if she is uninsured. There are programs that will help her with free medications if she has no insurance, but if she is insured she isn't eligible. We got into a position where we struggled to pay the insurance each month even with the COBRA subsidy but after we paid that we couldn't afford the copays to see docs or get medications. Since we had insurance we couldn't get any help from the manufacturers. Now I can go to the free clinic in our town, staffed with docs who have private practices and are good docs, and tehy even cover the lab tests I couldn't afford (and got dropped from the insurance right after they approved a huge bundle of tests that I need - they didn't outright drop us but they refused to accept our payment in any form and we have learned from many others that this company is doing this right, left and center to others in our situation os that they don't have to cover those with health problems). It will take a few weeks to get all the tests scheduled and done, but it is possible.

    She can get birth control free from the county health dept, planned parenthood, or likely from the Dept of Human Services. Same for preg related services though probably not abortion services. At least around here they are not free from most sources - but birth control sure is. Heck, even STD testing can be had for free from the health dept.

    She is determined to live life on her own with-o responsibility to the family. maybe she needs to truly experience this so that she can fully experience what she is asking for. It might even help her to truly hit bottom and become determined to overcome her addictions if she knows she doesn't have that safety net of health insurance provided by you to catch her when the health consequences of her actions catches up to her.

    it is a TOUGH decision, and these are just things that occur to me. You and your husband have to make this decision and whatever you choose you have to live with. We can make suggestions but we will support you regardless of the decision you make.

    Katya has a good idea about holding the neighbors liable for aiding and abetting the drug and alcohol use they are permitting on their property (and supporting most likely). You would have to have some proof, but it cannot be that tough to get. Esp if you drop in to give her something and see/smell drugs or see your daughter inebriated. I don't know if you want to go that route.
  12. KFld

    KFld New Member

    This is a tough one. My son is going to be 24 and is allowed to be on my insurance until he's 26. I have an HSA account with a high deductible and he used up the entire thing in the last 6 months. The only good thing is now everything is covered 100%, but that money would have also remained in my HSA account if it hadn't have been used by him. I don't think I would take my son off mine because I would be so afraid he would get sick and wouldn't be able to get medical attention, but then again, he might be able to get on state insurance.

    I guess in this case I would say follow your gut instincts. I always ask myself when I'm trying to make a decision like that is am I really going to be o.k. with it in the end and if the answer is yes, then I do it.
  13. DDD

    DDD Well-Known Member

    Health insurance is the only contribution GFGmom has made for the boys. She works for the State and has decent coverage. The new law extended coverage to the age of 24 (I think) and it has been of great value. The uncovered expenses are the responsibility of the boys. Obviously they are not paid and go on their credit report BUT there is great peace of mind knowing that they will not be turned down when they show up at the ER. I vote to keep her on until things settle. DDD
  14. busywend

    busywend Well-Known Member Staff Member

    I absolutely would NOT take away health insurance. Keep her on as long as you can.

    Also, it is different state by state - in NY she does not even have to live with me. The main stipulation is that she can not get it from her employer on her own.

    Don't even let this one enter your brain again. Not worth even thinking about.
  15. Nomad

    Nomad Guest

    There is some new kind of law that requires group policies to keep disabled children on the policies longer than typical. Usually, this type of thing is tied into school and/or family support. However, we were able to keep our difficult child on our policy due to this new law. Your deductible is so high, I'm not sure it makes a big difference, especially when it comes to things like see the doctor for birth control, etc. But if she ever needed surgery, I'm sure this would make a difference. I think I would hesitate to take her off the policy (for now).
    However, I would find out what your legal responsibilities are in terms of medical debt. Our difficult child has primary and secondary health insurance. We have a form that we created with this information on it. If the bill is $10 or less, we usually pay it. If it is more...we send them the form which reiterates that difficult child is over 21 and responsible for her own debt and that they should double check that her insurance was filed properly with the two policies and include the proper information. I send this stuff out fairly regularly. difficult child goes to ER fairly often. Sigh.
  16. Nancy

    Nancy Well-Known Member Staff Member

    Busywend, this is our dilemma, we have $10,000 deductible so we would be responsible for the first $10,000 of all medical bills. Unless she was in an accident or needed an operation that deductible will not be spent. We can't afford to pay her medical bills, especially with her risky life style. She is no longer living here so how long do we cover her? At some point we have to take her off. This is not how we wanted it to be but how long can we bankrupt ourselves?