Kids and Health Care: Recovery Programs

Standard indemnity health insurance and even managed care plans will cover recovery programs for insured people -- including kids -- who are abusing alcohol or drugs.

In most cases, the plans will limit any individual's in-patient use of a recovery facility to one 30-day stay per year. A few, stingier programs limit this benefit to once every three or five years; a few limit it to once, period.

But inpatient recovery isn't always what a child needs. In most cases, a young person who's using alcohol or drugs can get effective help from meeting with a counselor on an outpatient basis.

Most health care plans treat outpatient drug or alcohol counseling like they do psychotherapy: They will limit the number of visits available -- to something like a total of 25 visits. And some plans will require a new referral from the primary doctor after every four or five visits. Usually, you'll have to pay a deductible or copay for each session. Assuming that your child meets with a counselor once a week, these benefits cover about six months of treatment.

After these limits are exhausted, you would have to pay out of pocket for continued treatment.

One thing that this system clearly encourages: Only kids who really have a problem with alcohol or drug use are likely to benefit from counseling. If your kid has been caught once experimenting with drugs or drinking, neither you nor he or she will find the bureaucratic aspects of getting counseling worth the benefits.

A silver lining to these cost controls: Most alcohol and drug counselors are well aware of the bureaucracy -- and are experienced in dealing with it. They will usually coordinate with your doctor and even the claims office of the insurer or health plan.

Of course, there are low-cost or no-cost alternatives to private counseling. Many non-profit organizations -- from the Salvation Army to Boy's Clubs/Girl's Clubs or your local city- or county-run recreation center -- offer counseling in small groups for kids who've used alcohol or drugs at a young age. One big advantage of these programs is that they tend to take a more constructive approach -- encouraging and offering alternative activities, rather than just dwelling on a kid's personal problems.

In many cases, a better outlet for activity is all a kid needs.

Managed care plans acknowledge that some people need personal counseling to deal with a variety of issues, including alcohol and drug use. But they don't pay for a person to use counseling or psychotherapy as an ongoing "lifestyle" choice.

This may seem harsh at first glance -- but, on reflection, it's not such a bad strategy for dealing with a kid with personal problems. Six months of private counseling and then a move to some more outward-directed activity is a good mix in most cases.