Ask an Expert: How Can I Continue Addiction Treatment After My Insurance Runs Out?

By Dr. Richard Juman 07/04/16

Two approaches to ensure continued aftercare in the face of insurance difficulties.

never give up

​Q: I recently completed detox and I'm in an intensive outpatient program. My insurance company has just notified the program that my benefits will run out once I've finished the program, in just another couple of weeks. I'm doing well but I definitely don't feel like I've received all of the services that I need. Is there anything that I can do?

A: First, congratulations on both entering treatment (and it sounds like you're developing a stable early recovery) and on your desire to continue to receive the services that have helped you thus far.

Depending somewhat on which substances you were using prior to treatment, you are decidedly in the early stages of recovery. Your situation highlights one of the problems that is characteristic of our health care system: the tendency to treat chronic conditions like short-term, acute medical problems. Despite the fact that almost everyone involved in addiction treatment, regardless of theoretical orientation, views addiction as a problem that requires long term attention, policy-makers and those who hold the purse strings of treatment dollars often encourage situations in which a longstanding addiction problem is treated in a brief treatment episode. ​

The treatment of addictive disorders is one area in which research points to enormous benefits for both patients and society- since the cost of untreated addiction is gigantic with respect to the close relationship between addiction and poverty, unemployment​, car accidents, crime and a host of related medical problems. Dollars spent on addiction treatment help clients and the rest of society by helping people with addiction issues enter recovery and make positive contributions to the world, with financial benefits that far exceed the cost of treatment. Many changes are underway in the way addiction treatment is construed and paid for (unfortunately some of them have directly resulted from the opioid overdose epidemic); so there is cause for optimism with respect to positive changes down the road.

As for your current situation, I recommend a two-pronged approach. First, advocate aggressively with your provider for ongoing treatment. If you are like most people in early recovery, you are likely impinged upon by a number of symptoms and situations that provide evidence in support of ongoing treatment. Are you experiencing cravings for the substances you were using prior to detox? Are you suffering from anxiety or depression? Have you been started on any psychotropics or addiction-medicine protocols (Suboxone, Naltrexone, etc). Are there risk factors for relapse in your psychosocial environment such as chaotic relationships, unstable home environment, unemployment, etc.? All of these factors are extremely common in early recovery and are part of a persuasive argument that insurance companies find compelling in terms of approving ongoing treatment.

The second approach that I recommend would be to become engaged in an ongoing support system for your recovery. It would be great if your insurance company decides that you will be able to remain in treatment, but it will likely come to an end at some point. Many people find support groups helpful in both early recovery and as part of a long term strategy for maintaining it. In the past, options were limited to 12-step programs such as Alcoholics Anonymous, but now there are many other options available, including Smart Recovery and Moderation Management. I would encourage you to attend a variety of support groups in your area until you find one that has a philosophy and culture that you find appealing.

Good luck in your ongoing recovery!

Richard Juman is the coordinator of Professional Voices, a weekly feature on The Fix designed to provide a forum for addiction professionals to discuss critical issues in addiction theory, treatment, policy and research. He is also a former president of the New York State Psychological Association and a longstanding member of its Addiction Division Executive Committee

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