Philadelphia—Imagine a family with a drug-addicted son who has struggled for years. The son finally agrees to treatment, but when the family starts the process, they are faced with a $20,000 bill—with no behavioral health insurance coverage.
When I was directing a psychiatric ER, I always felt so bad when someone came home with a serious need for treatment, but within the last 3 months chose the wrong insurance as certain insurances are more behavioral health friendly with better coverage and less hoops to jump through, like Cigna, Aetna and United Healthcare. This frustrating and dangerous issue is one reason why I started Lighthouse Network to help people understand and navigate this complex and unfair system.
People often don’t realize that insurance companies are in business make promises at the purchase point but deliver the least amount as possible. They prey on consumer ignorance to offer the least amount of treatment but making you think it is the best for you. They want to retain the very healthy and drop the ones who need intensive care and cut into their profits.
Determining how “sick” someone is with a Behavioral Health issue is hard because we have no lab tests to show severity. So a major problem is the insurance company mandating premature discharge from rehab when the addict feels a little better but isn’t properly equipped with skills for sustained abstinence. The insurance company drastically underestimates how a stressful home situation, lack of supervision at home, or exposure to their tempting old lifestyle quickly leads to relapse and worsens the disease and quickens the downward spiral.
Navigating a complicated health care system is difficult enough, without the consideration of mental health and addiction coverage for a loved one. And especially as many Americans may be thinking about enrolling in Obamacare coverage during the current open enrollment period, there is important research necessary when choosing a plan.
Psychiatrist Karl Benzio, M.D., founder and executive director of Lighthouse Network (www.lighthousenetwork.org), an addiction and mental health counseling helpline, says it is heartbreaking when lack of coverage stands in the way of restoring an addicted person to a healthy life.
“Purchasing health insurance can be overwhelming,” Benzio said, “especially when plowing through the options if a family member is struggling with mental health or addiction issues. Considerations for buying health insurance generally include age, health history, family members who need coverage and occupational and cancer risks. But one factor that many overlook is the need for addiction and mental health coverage.”
Roughly a quarter of Americans will struggle with a drug or alcohol abuse issue in their life. Sixty-one million American adults struggle with mental health issues every year.
A recent look at health care coverage by U.S. News & World Report found that various Obamacare loopholes have kept many Americans from seeking behavioral health treatment. For example, some states haven’t expanded Medicaid, leaving about 5 million in a coverage gap—many of whom, experts believe, need mental health care.
Benzio adds that many without health insurance, or those who think the process is too difficult to navigate, end up skipping treatment altogether, which can lead to further problems, like job loss, divorce, legal difficulties or even suicide attempts or overdose deaths. The economic cost of untreated mental illness is more than $100 billion each year in the U.S., according to the National Alliance on Mental Illness.
“People who are not considering mental health and addiction challenges in their health insurance decisions are setting themselves up for catastrophe,” Benzio said. “Think of the tens of thousands in Pennsylvania, New York and New Jersey whose homes were flooded by recent hurricanes, then who realized their coverage did not include flood or water damage. Being without mental health coverage is a definite storm that can wreak havoc on a family’s finances.”
Those with questions about treatment options can call the free, 24-hour Lighthouse Network Christian Addiction and Counseling Helpline at 1-844-LIFE-CHANGE (1-844-543-3242). The most effective help will incorporate God into the healing process to bring lasting healing and transformation. Lighthouse Network also provides online resources for those concerned about a family member, friend or a loved one. Visit www.lighthousenetwork.org/im-family-a-friend.
Benzio shares insights on mental health issues in the one-minute daily radio feature “Life Change with Dr. Karl,” airing on approximately 425 radio stations across the country, including 200 stations in the American Family Radio Network. “Life Change” brings scientific expertise and biblical principles together to examine some common daily struggles and help people successfully navigate life’s obstacles. For more information, visit www.lighthousenetwork.org/life-change-with-dr-karl/.
Lighthouse Network works to guide struggling people through storms to achieve peace and find answers for those who have a hard time defining their problems. Lighthouse Network also offers the free, 24-hour Lighthouse Christian Addiction and Counseling Helpline toll-free at 1-844-LIFE-CHANGE (1-844-543-3242). Several resources are available through www.lighthousenetwork.org as well as through Lighthouse Network’s free daily Stepping Stones devotionals found at www.lighthousenetwork.org/stepping-stones.