Addiction and Insurance | Video

Retha Colclasure | 2/25/2013

If you have a heart attack and go to the emergency room you likely won`t have much trouble getting your insurance provider to cover the necessary treatment. The same goes for diabetes or cancer. But more Americans suffer from addiction than are affected by those three diseases combined. However, some are finding that the insurance coverage for addiction isn`t always as easy to access.

Kristin Sande is one of the 40 million Americans who suffer from the disease of addiction. "When I was drinking, I was drinking. I didn`t go golfing and drink. I didn`t do things and drink. I drank."

She drank at home, alone, hiding it from almost everyone and thinking she had it under control. But after her mother died, her drinking spun out of control.

"I wasn`t suicidal but I remember thinking often it would be so much easier if I didn`t wake up in the morning because I don`t know how to fix this. I can`t stop."

She had tried to stop, more than two dozen times. She`d quit for a few days, then start drinking again. She visited her doctor. Went to the emergency room. And finally made a call to the Heartview Foundation, a call she says may have saved her life.

"The more you try to quit and you can`t, the more worthless you feel and the harder it is."

That`s a situation that addicts face every day. And many of them turn to addiction treatment centers like Heartview for help.

"If people are served at the appropriate level of care they have a better chance of a successful outcome," said Heartview Executive Director Kurt Snyder.

But just what is an appropriate level of care? That question used to be one that treatment centers and insurance providers fell into an easy agreement on. But since January 2011, things have changed.

"Health care reform is trying to cover many different people so insurance companies have made a lot of adjustments with the requirements of health care reform and what it`s going to look like. So the changes ultimately came to where they became more rigid upon what they were approving as for level of care and length of time at that level," Snyder said.

"They" is Blue Cross Blue Shield of North Dakota.

Heartview has worked with Blue Cross for years, and Snyder stresses that they continue to have a close working relationship. But Snyder says things have changed in the past two years and now Heartview has a more difficult time getting the insurance provider to agree to providing certain levels of care for a certain length of time for patients.

Today marks Sande`s one year sobriety anniversary.

Tomorrow night we`ll examine where the differences are in what providers want covered. What guidelines Blue Cross Blue Shield of North Dakota says they`re following and what all of that means for patients seeking treatment.

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