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Getting treatment for substance use disorder is notoriously difficult. When your loved one is in the grips of this disease, the willingness to undergo treatment often comes in a fleeting moment of opportunity.
Recovery begins when willingness meets opportunity in the individual's life. Sadly these “moments of clarity” often meet closed doors when treatment facilities lack space to accommodate your loved one. If you’re considering treatment for yourself or a loved one, use the NYS OASAS Bed Availability Dashboard to find the closest
available treatment facility on Long Island.
RIGHT TO COVERAGE FOR SUBSTANCE USE DISORDER TREATMENT SERVICES
Under New York and Federal law, if you have insurance you have the right to receive the following substance use disorder treatment services when medically necessary:
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Unlimited detoxification services in a hospital;
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Unlimited inpatient care in a hospital, inpatient rehabilitation or residential treatment facility;
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Unlimited outpatient care in both outpatient facilities or in your provider’s office;
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Outpatient methadone treatment; and
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Suboxone and Subutex, if your health insurance coverage includes a prescription drug benefit.
Knowing the details of your health insurance plan, the law and your rights can be critical when you seeking treatment for yourself or a loved one. For more information visit the New York State Department of Financial Services website
KNOW YOUR RIGHTS WITH INSURANCE PROVIDERS
Health insurance (or lack thereof) can often be a barrier to getting into treatment, or getting the right amount of it. This has cost the lives of Thomas and many others who could have made it if they stayed in treatment long enough! If your insurance wants you out of rehab early, you have a right to an appeal. During this time, the insurance company is REQUIRED to continue paying for your treatment. Those extra days could have sent Thomas straight from rehab into aftercare, without the gap in treatment that ultimately led to his relapse and death.
**NYS law requires that treatment programs funded by OASAS provide treatment services for people who cannot pay for the services.**
DENIAL OF COVERAGE
Suppose your health insurer denies coverage for any substance use disorder treatment services for the reason that it is not medically necessary. In that case, you have a right to appeal the decision with your health insurer. If your health insurer upholds the denial you have the right to an external appeal with an independent reviewer.
For more information on your rights to appeal the denial of insurance coverage visit the New York State Department of Financial Services website