This information is valuable for staff, students and parents.
Betty Mitchell,
Kingsway Regional School District,
Woolwich Township, NJ
Medication Misuse: What You Need to Know to Help Protect Children, Teens and Young Adults
~ Partnership staff
Special Considerations When Seeking Substance Use Treatment During COVID-19
~ Partnership to End Addiction Staff
In a Time of Disruption, Protecting Your Child from the Risks of Substance Use
~ Partnership for Drug Free Kids
COVID-19: Accessing Critical Medications for Your Loved One
~ Partnership for Drug Free Kids
Alcohol Prevention at a Time of Furlough and Layoffs
~ Jason Kilmer, Jennifer Jacobsen, David Arnol,d Leah Kareti
What is Vivitrol? Answers for Parents
~ Partnership for Drug-Free Kids
What to Know about Drugs Laced with Fentanyl & Other Substances
~ Partnership for Drug Free Kids
Carfentanil: A Dangerous New Factor in the U.S. Opioid Crisis
DEA Drug Information
Addiction and Sleep
How to Know if Your Kid is Vaping Marijuana - and What to Do About It
~ Partnership for Drug-Free Kids
Juul, the vape device teens are getting hooked on, explained
~ Julia Belluz, Vox Media
What Parents Should Know About Kids Using CBD
~ Partnership for Drug-Free Kids
Pediatricians warn against marijuana use: Not your parents' pot
~ By LINDSEY TANNER, AP Medical Writer
The Teen Years: How Parents Can Grant Their Teenager Privacy While Overseeing Their Well-Being at Home
Am I Enabling My Child by Helping Them?
~ Partnership for Drug-Free Kids, Master Addictions Counselor Mary Ann Badenoch, LPC
Not Getting Anywhere Talking to Your Child About Their Drug Use? Try Changing Your Tone of Voice.
~ Partnership for Drug-Free Kids
Your Child's Treatment & Recovery Roadmap: A Guide to Navigating the Addiction Treatment System
~ Partnership for Drug-Free Kids
Covering the Costs of Addiction Treatment, Whether Insured or Not
~ Partnership to End Addiction Staff
No Beds Available: What To Do When You're on a Waitlist for Addiction Treatment
~ Partnership for Drug Free Kids
What is Family Therapy for Addiction and How Can It Help MY Family
~ Partnership for Drug-Free Kids, Molly Bobek, LCSW, and Aaron Hogue, PhD, of the National Center on Addiction and Substance Use
I Was Blindsided By How Insurance Treated My Son's Substance Use Claim
~ Virginia Holleman, Parent & Advocate
Your First Call with Your Insurance Provider: What to Ask about Substance Use Coverage
~ by Lindsey Vuolo, JD, MPH, Associate Director of Health Law and Policy at the National Center on Addiction and Substance Abuse
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  Your First Call with Your Insurance Provider: What to Ask about Substance Use Coverage  
  ~ by Lindsey Vuolo, JD, MPH, Associate Director of Health Law and Policy at the National Center on Addiction and Substance Abuse  

When you are seeking treatment for your son or daughter's substance use disorder (SUD) or mental health (MH) issue, it can seem impossible to navigate the insurance system. Many of the families who have been through it have likened it to a nightmare. insuranceWhat many parents don't know is that, in many cases, your insurance provider is actually obligated to cover your child's substance use disorder. It's the law, plain and simple. (We understand that the language of the insurance landscape is complex. Be sure to visit this glossary of insurance terms if you need help with some of the terminology below.)

To help you navigate this complicated system, we've created a glossary of insurance terms, and outlined some important questions to ask your insurance provider when seeking coverage for addiction treatment, to ensure that you get your child the best help possible, Here are a few examples:

Does my plan cover mental health and/or SUD benefits? And how do I find out for my specific plan?

Many plans do cover MH/SUD and some are required to. If your plan offers these benefits, the Parity Act applies.

questionsRemember: Under the 2008 Mental Health Parity and Addiction Equity Act (Parity Act), private and public insurers are obligated to provide comprehensive and equitable coverage for substance use disorder and mental health benefits. The Parity Act requires a health plan's standards for substance use and mental health benefits to be comparable to — and no more restrictive than — the standards for other medical benefits. Generally, this means that a plan cannot put more restrictive visit limits, impose higher cost sharing or apply more rigorous prior authorization or concurrent review requirements on MH/SUD benefits as compared to similar medical benefits or surgical benefits. For example, if your plan allows for 20 visits for outpatient physical therapy, then it must allow the same amount of visits for mental health counseling.

The Affordable Care Act requires plans sold on the marketplaces (individual and small group plans), as well the Medicaid expansion plans, to cover substance use disorder and mental health benefits as “essential health benefits.”

If you are unsure of your specific benefits, look at your insurance plan's certificate of coverage to determine your coverage. This generally can be found on your insurance carrier's website and if you are still unsure, call your insurance carrier to clarify. You can use the phone number on the back of your insurance card.

What benefits do you cover (including treatment settings and medications)?

Effective care for SUDs is provided in different treatment settings or levels of care. The appropriate level of care should be determined by a medical professional, based on a comprehensive assessment of your child. This assessment creates a foundation for an effective treatment plan that is individualized and tailored to meet your child's needs. The assessment will determine the level of care that is most appropriate.

The plan may say that it offers both inpatient and outpatient treatment. Inpatient treatment may include treatment in a hospital or a residential treatment facility. Outpatient treatment may be provided in a doctor's office or clinic. There are also “intermediate” services, which include intensive outpatient and partial hospitalization. The plan may classify these as inpatient or outpatient services.

phonecallIdeally, the plan should cover all of these levels of care but they may need prior authorization. But if it doesn't, it is important to talk to your child's provider about the level of care that is covered by your plan that is most appropriate for your child. If a patient is placed in a lower level of care than what is needed, his or her needs may not be addressed adequately, but placing a patient in a higher level of care than is needed means the patient may receive unnecessary care at a higher cost.

Depending on the type and severity of your child's addiction and general health status, the use of medications, psychosocial therapies, or both in combination (medication assisted treatment) may be necessary. Medications are an effective and, for some conditions, critical component of addiction treatment.

Ask your insurer what medications it covers and for how long. There are currently three FDA-approved medications to treat opioid addiction: methadone, buprenorphine and naltrexone. Each medication works differently and may be available in different treatment settings. Just like with any other disease, you, your child and your child's physician will decide which medication works best for your child in their treatment.



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