As someone who has grown up in the addiction treatment field and became a counselor in the 1970s, I have seen a lot of changes. I’ve seen HMOs come and go, private-pay models come and go, and, recently, our field is at a crossroads in a variety of ways. The Affordable Care Act (ACA) was passed. Half of our country complains about it, and half of our country is grateful for it. Whether you’re a Democrat or a Republican, you probably agree with me that just about every family in America has been touched by the disease of addiction.
As a longstanding executive for one of the well-known addiction treatment providers in the nation, I can tell you that people all over the United States are suffering. Even though they have insurance, oftentimes the wreckage of addiction has ruined them financially. Insurance reimbursements are dwindling. Large for-profit healthcare corporations are taking advantage of consumers and payers. Health insurance companies are denying access to care and breaking parity laws every day.
I am one of many advocates in our country for the addicts that still suffer. People can and do recover, if they are able to get the duration and intensity of care required for the severity of their illness. There are many millions of Americans in long-term recovery. So how does one fight for one's family? Where can someone go to get care, and not get a huge bill if the insurance company chooses to deny the care the person needs to live? How does one choose the best treatment facility? Anybody will says theirs is the best, and there are many of them out there.
A new document that just came out this month from the federal government tells the consumer how to make the most out of mental health and substance use disorder benefits. I find it to be a very powerful resource for individuals seeking help for themselves or a loved one. This guide allows individuals to understand their rights under the ACA and the Mental Health Parity and Addiction Equity Act. It’s called Consumer Guide to Disclosure Rights: Making the Most of your Mental Health and Substance Use Disorder Benefits, released by SAMHSA. It can be found here.
Under these federal acts, every individual is entitled to many different documents related to one’s mental health and substance use disorder and medical/surgical benefits. This guide gives an individual the tools and additional information to ensure that medical plans treat one’s mental health and substance use disorders the same way they treat other health issues. Within the guide, one will be taken through the start of a benefits journey. It begins at step one: Where does one start? The guide offers a scenario in which someone can ask an employer about its medical plan. The scenario will lead the person through benefits and coverage, and guides the person on how to obtain these documents.