Monday, January 30, 2012
Rehab & insurance stupidity...
I am in awe of the stupidity of some rehab centers and insurance companies. Well, to be fair, it could be that I’m the stupid one because I just don’t understand.
A family member’s husband is an end-stage alcoholic and he was transported to the medical center via ambulance. While racing down the highway, he flat lined three times. This man is at the end of his end-stage journey. Fortunately, he was saved and, miraculously, lived through detoxification. Over the past couple of years, he has been through detox about 4 times. Each time he immediately returned to drinking.
Imagine this wife and children’s surprise when he announced he wasn’t coming home right away, but rather going to rehab. Well, OK, so it’s not is first time there either. In spite of that, everyone rallied around and offered up support for his decision.
The wife was asked if she would like to participate in the family program. She has been reading my blog and understands the importance of educating herself and her family in everything about alcoholism. She had never attended a family program before and she enthusiastically agreed. She asked if her husband’s sister could attend with her. The center responded that any family member may attend.
The ladies were excited for the opportunity and began to prepare for the 300 mile trip to the center. They didn’t have a lot of money, so they decided they would bring an ice chest so they could get food from a store and use the motel microwave to heat it up. They used their coupons to shop, cashed in aluminum cans and used every resource they had to scrape up some money.
Then they received the phone call telling them that the center needed payment for the program before they could reserve them a place. The cost is more than $200. Huh??? They were under the impression that they were being invited by the center as part of the husband’s rehab program. They thought the cost of the family program was included in the cost of alcoholic’s program. They were wrong. It not only was NOT covered in the alcoholic’s program, it was also NOT covered under the wife’s health insurance plan.
When I say NONE of the expenses were covered, I mean NONE. The wife not only has to pay the program fee, she also has to pay for her gas, lodging and food. She will not be allowed to use the cafeteria facilities at the center – which she was hoping she could do in order to have one solid meal a day. The program is 5 days long and that’s a long time to subsist on Hot Pockets, sandwiches, tv dinners, oatmeal and the $1 value menu of fast food restaurants.
A hasty recalculation was made and they determined they could not afford for the sister to attend the program. The wife asked for some money from her husband’s parents and she was able to pay the fee. She left on Sunday night and will return on the following Saturday after her husband’s release.
My irritation lies in the fact that the rehab center is so self-serving that they did not include the family in the alcoholic program’s cost. What is up with that?? Doesn’t everyone in the substance abuse industry understand that to return an alcoholic to an uneducated family environment is like throwing a fish back into a polluted pond?? Isn’t that common knowledge?
I find it counter-productive to supply an alcoholic with all the keys to achieving and maintaining sobriety and also expect the alcoholic in turn to educate the family. The alcoholic has all he/she can handle just staying inside the sobriety life preserver. The family inadvertently sabotages the alcoholic’s effort, not because they WANT to, but rather because they don’t know any better.
Fortunately, for this alcoholic, the wife has been reading my blog and has my workbook (The Workbook for Caretakers of End-Stage Alcoholics). She was fairly well-educated before she got to the center. But still, she says the program was good for her because it was more of a classroom environment. She didn’t want to demean what she had learned from me, but to hear the same things in a classroom environment made the whole thing more “real.” As a couple they received some one-on-couple counseling and that was extremely helpful.
The couple was very grateful they could gather the funds for the program and have the wife attend. It was money well spent. The only regret was that the sister (who is extremely close to the alcoholic) wasn’t able to reap the benefits. The sister will gain knowledge from reading the blog and helping to update the wife’s workbook.
No one knows for sure how long the alcoholic will stay on the road to recovery. We all pray he will maintain his sobriety. He’s a really great guy, wonderfully devoted father and an award-winning grandfather – that is when he is sober.
If you are a director of a rehab center – do you include at least ONE family member in a family program covered in the fee of the alcoholic’s program? If not – why not?? I truly hate to say this and I hate even imagining that it may be true – but is your center looking forward to the alcoholic’s relapse so they can be re-admitted to your center?? That would let the center reap the financial reward from the insurance company — yet again. Is it a one-for-two kinda thing? One person – two fees?
Just the suggestion of such a thing is so distasteful to me that I hope I get lots of angry comments, not just from my readers, but also from rehab centers around the world. Defend yourself – PLEASE – tell me why it makes sense to NOT include the family program in the cost of the alcoholic’s program.
I know for a fact that there are rehab centers that include a family program. If they can do it, I see no reason why they can’t ALL do it.
And to all the health insurance companies – do you not understand that getting the family member into a program might just prevent health issues later on?? Stress causes illnesses. Alcoholism or any substance abuse causes stress for the families. This is not a new, enlightened statement. So why are the insurance companies so far behind the times? The fact that they do NOT cover family programs as an individual benefit only costs the other policy holders more money. Who do you think pays the price when insurance companies have to pay out for heart attacks, strokes and a variety of other illnesses? The premiums go up and everyone with a policy pays. Well… maybe that’s what they want… for us to pay higher and higher premiums. I guess there may be big money in that.
I’m just a simple girl. You can add to that – loud-mouthed and opinionated. I’m not a medical professional or an insurance expert. However, I am not stupid or ignorant. I strive to be informed. Maybe I have unrealistic expectations as I have a tendency to do that, but I expect anyone dealing with alcoholic/addiction rehabilitation to have a realistic, informed and intelligent program leading to sobriety. I expect our insurance carriers to do the math and stop sticking their heads in the sand as to the far reaching consequences of addition.
Does anyone else see the absurdity or am I the one who is off the rocker?
at 8:35 AM