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An insurance denial led my son to Florida, where he died from an overdose

The Parity Act prohibits discriminatory coverage of mental health and substance use disorder benefits, but insurance companies continue to violate the law.

By Maureen O'Reilly

Within a week, Ed lost his job and broke up with his girlfriend. He was suffering from depression and his drug use escalated. He came home to live with us in New Jersey and we tried to give him support and encouragement, but after a couple of months, we could see he wasn’t getting better.

One night, we confronted him and Ed agreed to treatment. I immediately packed him a bag and brought Ed to a detox facility at 1:00 AM on a Sunday. He was using heroin and cocaine on a daily basis so I was sure that insurance would pay for treatment. But by Tuesday morning, the insurance company contacted the facility saying they wouldn’t cover inpatient detox. We moved him to another inpatient facility but again the insurance company refused to cover his stay.

When Ed was yanked out of treatment after a week, I was in a panic. I went online searching for facilities that might take him and accept his insurance. I found a place in Florida, not knowing about the many scams with patient brokering. I called them and they said they’d work with insurance. We put him on a plane down to Florida the next day. We thought he’d be inpatient for 30 days and then recover. We were so naïve about it.

Ed cycled between treatment programs and sober houses. And the insurance denials continued. I could see the treatment program was having a tremendous struggle with his insurance, which was paying them practically nothing. I think the facility was frustrated with getting nothing from insurance, and in turn became frustrated with Ed. The discharge notes said that “Ed was getting entitled.” He was discharged with no plan. Nothing. Ed died from an overdose in a sober home shortly after.

After Ed’s death, I sued the health plan and was able to get internal records showing that a week after he was removed from the inpatient facility in New Jersey, an internal review found that his stay should have been covered. I was never notified.

“The denial letters stated: ‘you have sober parents; you can go home and live with your parents; you’re motivated to get better.’ He was desperate to get better but he needed help.”

The Problem

The Mental Health Parity and Addiction Equity Act (Parity Act) requires most health plans to cover mental health and substance use disorder treatment the same way they cover treatment for any other disease. Despite strong legal protections, millions of families still struggle to get insurance coverage for addiction treatment and are unaware of their rights to affordable care.

Enforcement of the Parity Act largely relies on consumers to file complaints identifying violations, which can be challenging when insurance denials often occur in the midst of a crisis.

While there have been some recent efforts at the federal level to strengthen enforcement, plans continue to violate parity requirements.

The Solution

Provide often under-resourced federal and state insurance regulators with additional resources and tools to enforce the Parity Act, help consumers navigate denials (e.g., the Department of Labor’s Benefit Advisors help consumers with job-based insurance coverage), and review plans to ensure they do not offer discriminatory coverage before they are sold to consumers.

Take Action


Tell your members of Congress to strengthen Parity Act enforcement tools

It takes just a minute and a few clicks to ask your members of Congress to provide additional resources and tools to enforce the Parity Act.