John Oliver Brings Much Needed Attention to a Very Important Issue

On Sunday night, Last Week Tonight host John Oliver had a segment on the addiction treatment industry. During the segment, Oliver touched on many concerns that those within and outside of the industry have regarding addiction treatment providers.

At Gateway Foundation, we agree that there is not enough transparency or information available to the public about many of the treatment providers. People should be able to have access to the information they need to make a well-informed decision about where they or a loved one will receive treatment.

Oliver also made an assertion that there needs to be more expertise and oversight of the industry. At Gateway, we share his sentiment. There does need to be more oversight of the industry. This is why we are so pleased with all of the great work the National Association of Addiction Treatment Providers, NAATP, has done, including its Treatment Selection Guide and Code of Ethics 2.0. In addition, NAATP has also worked closely with Google and LegitScript to develop the qualification standards a treatment provider has to demonstrate in order to use Google AdWords.

In his segment, Oliver called for more treatment centers to provide evidence-based treatment options. We understand the importance of ensuring each one of our patients receives the treatment they need, which is why we utilize evidence-based practices, including medication-assisted treatment, motivational interviewing, cognitive behavioral therapy, and many more.

Tips for Getting Addiction Treatment Covered by Health Insurance

heatlhcare addiction treatmentGateway Alcohol & Drug Treatment urges Illinois residents—even if denied health benefits for alcohol or drug rehab in the past—to check their current healthcare plan to determine if substance abuse treatment is covered by insurance. Now that federal parity laws, Illinois Parity, and The Patient Protection and Affordable Care Act have all taken effect, many health plans include the same coverage benefits for treatment of mental health/substance use disorders (MH/SUD) as they do for general medical and surgical treatment.

“There are thousands of Illinois residents who need care for addiction issues and now more than ever they have access to treatment through their health insurance. Our goal is to help people understand their treatment options and their insurance benefits” says Michael Darcy, President & CEO, Gateway Alcohol & Drug Treatment.

Here are the top five tips Gateway provides to those seeking coverage for drug or alcohol rehab their health
plans:

1. Know Your Illinois Parity Rights: In the state of Illinois, unless an insurance plan is exempt, large employer plans are required in each calendar year to cover the following for substance use disorders:

2Understand What Insurance Plans Must Follow Federal Parity Laws:

  • Health plans sponsored by private and public sector employers with 51 or more employees including self-insured and fully insured arrangements.
  • All insurance plans sold inside and outside the state exchanges, which are available to individuals and smaller companies with 50 or fewer employees.
  • Some state and local government health plans.

3. Understand What Health Insurance Plans Do Not Have to Follow Federal Parity Laws:

  • Medicare
  • Individual plans not purchased through the health insurance marketplaces
  • Group plans with 50 or fewer employees.
  • Plans who received an exemption based on increase of costs related to parity.

4. Look for a Reputable Treatment Center: Substance Abuse Treatment is a specialty service and it’s important your Financial Counselor is an accomplished expert who can work on your behalf to gain the most from your insurance coverage.

5. Don’t Take No for an Initial Denial: If your health plan meets the criteria of state and federal parity, it’s important to realize an initial denial does not always mean no coverage is available. Knowledgeable Financial counselors may be able to obtain insurance coverage for treatment by exploring different avenues with your insurance company.

“Substance use is a treatable healthcare disorder – and people should know it is covered by insurance, similar to diabetes, hypertension and cancer.” says Michael Darcy.

To learn more about treatment options or insurance coverage for treatment related to alcohol or drug abuse, call Gateway at 877-505-HOPE (4673).

What is Moderate Drinking?

The USDA defines moderate drinking as:

  • Up to two drinks per day for men
  • Up to one drink per day for women.

It’s important to note that alcohol effects each person differently based on factors that can include weight, general health and family health history. Even within the USDA moderate drinking definition, abuse can occur if alcohol is consumed too quickly or if other underlying issues exist. Men and women should know the USDA guidelines and consume moderate amounts of alcohol. A standard drink is roughly 14 grams of pure alcohol, which is found in:standard drink

  • 12 ounces of beer
  • 5 ounces of wine
  • 1.5 ounces of distilled spirits

Quick Facts about Alcohol:

  • One drink can make you fail a breath test. In some states, people under age 21 can lose their driver’s license, be subject to a heavy fine or have their car permanently taken away.
  • Alcohol is a drug. Mixing it with any other drug can be extremely dangerous. Alcohol and acetaminophen—a common ingredient in OTC pain and fever reducers—can damage your liver. Alcohol mixed with other drugs can cause nausea, vomiting, fainting, heart problems and difficulty breathing. Mixing alcohol and drugs also can lead to coma and death.
  • Alcohol is a depressant, or downer, because it reduces brain activity. If you are depressed before you start drinking, alcohol can make you feel worse.
  • Beer and wine are not “safer” than liquor. One 12-ounce bottle of beer or a 5-ounce glass of wine (about a half-cup) has as much alcohol as a 1.5-ounce shot of liquor. Alcohol can make you drunk and cause you problems no matter how you consume it.
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