ABOUT THE EPISODE:
When Virginia Holleman's son finally entered in-patient treatment for his substance use, she thought things would get easier, especially since her company-sponsored insurance covered his treatment. Or so she thought.
The nightmare Virginia went through with her insurance company and their denial of her son's treatment isn't unique, but what is unique is the fact that this momma is an insurance coverage lawyer and now an advocate for parity - meaning substance use and mental health treatment has to be covered in the same way as any other illness.
This episode will be extremely helpful if you're a parent considering treatment for your son or daughter, or if they're currently in a program. You'll learn about the Federal Parity Act, what it means, how it's relevant to your situation, and what you can do to have the best chance at getting your child's treatment covered.
EPISODE RESOURCES:
Virginia's top 5 tips for handling an adverse decision by a health insurance company:
1. Don't accept a denial/adverse decision.
2. Educate yourself on your plan benefits and the federal parity law, as well as your own state's parity law.
3. Communicate with the health care provider and insurance company.
4. Appeal, appeal, appeal!
5. Submit complaint(s) to the appropriate government regulatory authorities (state insurance department, attorney general's office, etc.)
General information on the federal parity law:
- https://drugfree.org/article/what-is-the-mental-health-parity-and-addiction-equity-act/
- https://www.parityregistry.org/
- https://www.lac.org/resource/health-insurance-for-addiction-mental-health-care-a-guide-to-the-federal-parity-law
Understanding your rights/things to do before and during treatment/signs your insurance company is violating the parity law:
- http://parityat10.org/wp-content/uploads/2019/03/1.-Parity-at-10-BASIC-v3.1.pdf
- http://parityat10.org/wp-content/uploads/2019/03/2.-Parity-at-10-WARNING-v3.1.pdf
- https://www.lac.org/assets/files/Red-Flags-Tool_poster.pdf
- https://drugfree.org/article/how-to-properly-document-your-contact-with-your-insurance-company/
Help with appealing adverse decisions:
- Https://drugfree.org/article/i-just-got-denied-coverage-now-what-how-to-file-an-insurance-appeal-
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