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GARY HIGGINS/The Patriot Ledger
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| Earl Dandy, program director at Project Rebound, says full capacity at the treatment center would be another 50 teenagers a year. But the state has drastically cut spending on substance abuse treatment and this Quincy center now has just 10 beds. |
Financial burden often hits parents
Parents struggling to get help for addicted teenagers often must pay thousands of dollars for treatment because private insurance policies do not cover long-term care, addiction specialists say.
State public health officials say the lack of coverage places a greater burden on state resources that always fall short of meeting the demand, forcing more people to battle their addictions alone.
Local treatment officials say they routinely turn people away because they are short of state funds and families cannot pay for a bed, which costs at least $9,000 for a recommended three-month stay.
Most private policies include language saying inpatient addiction treatment must be deemed “medically necessary,” a subjective threshold that is often difficult for addicted clients to meet.
“I work, I pay taxes and I have insurance, and yet I cannot get the help I need,” said Robyn, a Weymouth single mother who struggled for months to get help for a 17-year-old daughter with a heroin addiction.
In the end, she ended up paying more than $2,000 for outpatient counseling and three weeklong hospital stays. She said she battled with her insurance company, Tufts Health Plan, to get her daughter into a two-week inpatient program in Attleboro.
But after that, she said, the money dried up, even though her daughter’s addiction remained.
A spokeswoman for Tufts said the company covers acute inpatient care and outpatient services, but that clients must show that long-term residential care is a “medical necessity.”
“In reality, we have an excellent mental health program and we will work with families in crisis to match the benefit with the services they need,” said the spokeswoman, Catherine Grant.
Officials of Harvard Pilgrim Health Care and Blue Cross Blue Shield described similar policies, saying they will pay for care if medical criteria are met.
Casey Ross may be reached by clicking here.
