The Heroin Addiction Crisis & Not Enough Solution for the Problem
The heroin addiction crisis in America is at an all-time high, no pun intended. The truth is it’s not a laughing matter. We face several issues, but this article will address three. Heroin addiction & overdoses seem to be a common occurrence. It seems that every day there is another R.I.P. status on Facebook. What is the solution for addiction treatment? What are we doing to find the solution?
An article published on DrugFree.org by the Join Together Staff in 2014 Heroin Addicts Seeking Treatment Face Insurance Roadblocks. The article talks about insurance companies needing proof that the client went to outpatient addiction treatment before they receive approval to go to inpatient or residential addiction treatment programs. Some insurance companies also demand proof that the individual has little or no outside support network, has already failed at a less expensive treatment facility or has a health condition that makes treatment a medical necessity, the Courier Post Reports.
Where the problem is in 2016
At Bright Futures Treatment Center we receive a lot of phone calls from people looking for help. Many don’t have insurance or they have Medicare or Medicaid policies which typically won’t cover them for treatment. Most States we receive these calls from have programs that will accept Medicare and/or Medicaid, but they have waiting lists dated 3-4 months out.
If you’re lucky and you know someone you might have the ability to get some strings pulled and get them into a program. What good does this do for countless others? Absolutely none!
What is the solution to the addiction issue?
On March 23, 2010 The Patient Protection and Affordable Care Act was written into law, otherwise known as Obamacare. This made some headway for people seeking addiction treatment because it took away the ability for healthcare providers to limit coverage based on pre-existing conditions.
The enacted laws also opened up affordable exchanges for people to receive coverage based on sliding scales. Meaning, depending on how much you make you may be eligible for tax credits that will allow you to receive reduced rates on premiums for insurance. The law also made Americans responsible for obtaining insurance so that every American is covered or a certain fine was given towards tax season. There are also qualifying life events that allow you to obtain coverage outside of the open enrollment period.
What are the qualifying life event criteria?
- Involuntary loss of other coverage
- Individual plan renewing outside of the regular open enrollment
- Becoming a dependent or gaining a dependent
- Becoming a United States citizen
- A permanent move
- An error or problem with enrollment
- Employer-sponsored coverage reducing benefits such that it no longer provides minimum value, or becomes unaffordable
- If your income changes and makes you newly eligible (or ineligible) for certain tax credits to receiving affordable healthcare
Much of this information can be found HERE
How does this apply to addiction and what is my solution for this problem?
I can cite a few examples from my personal experience of how the information above can help you or your loved one get help for Heroin Addiction or Alcoholism. In many cases parents or family members try the tough love approach with a family member suffering from drug addiction or alcoholism by putting them out on the street and shunning them. Which means you’ve officially changed their address for good, right?
This would be classified as #7 (A permanent move). This would make your loved one eligible for receiving healthcare coverage outside of open enrollment. I would suggest that instead of letting them die in the gutter, buying them a policy would be a better route.
If your Son, Daughter or family member recently turned 25 and they are struggling with addiction, they may have been kicked off of your policy which would be qualifying life event #1. This would allow you to go onto the exchange and apply for benefits for your son or daughter and give them access to healthcare coverage.
I am sure there are many other angles that this would work for you to provide you with what you’ll need for coverage to obtain valid addiction treatment for drugs and alcoholism.
What is the real issue with Medicare or Medicaid addiction treatment coverage?
The majority of the phone calls we receive to Bright Futures Men’s Rehab Program are from people seeking drug & alcohol treatment with Medicare or Medicaid coverage. I am sure they do their best to provide valid treatment options. However, not enough places accept Medicare or Medicaid for addiction coverage and if they do, most don’t have beds available or you must be between 18-20 or 65 and older for coverage at their rehab program.
This leaves us in a pickle because we don’t have the ability to help the people. If we receive a phone call from someone looking for help, we want to help them. Many just refer out to the Samhsa hotline and even then they aren’t able to provide much of a solution.
How can we solve the problem for people seeking addiction treatment
The addiction treatment community needs to come together with the insurance companies of the world and find a solution. They need to find solutions that will take care of heroin addicts seeking treatment. They need to make healthcare more affordable and even easier to access.
In my own personal network of friends on Facebook I see an R.I.P status 1-3 times a week from heroin overdose. Families are left weeping because they (A) were not educated on affordable healthcare or (B) did not have the resources for a solution. Many wind up looking over a pine box which is quite morbid to mention, but it’s the truth.
If you or your loved one is struggling with addiction please don’t hesitate to call us. We want to help you no matter what. We will find you a solution no matter how long it takes us. This has become part of Bright Futures mission and our goal is to educate and inspire change.