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Inadequate health insurance networks pose multiple problems

Inadequate health insurance networks pose multiple problems

The number of uninsured individuals in the U.S. has declined sharply, but many consumers who have purchased narrow-network health plans feel they are as good as not being insured at all. Americans who bought health plans of Ambetter, a Centene’s subsidiary, are disillusioned after discovering that the coverage is far from what they had expected. Disgruntled consumers allege that the insurer has fraudulently sold limited health care plans, which make even something basic as searching covered doctors and services a daunting task. Ambetter has its presence in nearly 15 U.S. states.

According to a recent legal suit, Centene misrepresented facts about the number of doctors covered under its Ambetter plans to its customers. People have even alleged that Centene resorted to blatant lying about the service provider networks available to insurance policyholders. In fact, the company faces allegations of having listed doctors who categorically asked to be excluded from the network, and medical students who weren’t authorized to practice in the provider network. If that wasn’t enough, in one specific case mentioned in the lawsuit, Centene had assigned an obstetrician-gynecologist to a male customer as his primary care provider.

In recent years, the implementation of the Affordable Care Act (ACA) gave significant visibility to Centene as a national player in the health insurance marketplace. Moreover, through its Ambetter brand, Centene managed to market itself as the preferred insurer of economically weaker Americans. On one hand, the whole concept may seem like a much needed life-saver for the under privileged, but on the other hand, Centene has exploited vulnerable individuals with its inadequate provider network and shabby health plans, which even fail to meet the minimum coverage requirements.

Sadly, narrow-network plans are becoming common nationwide, leaving a large number of policyholders in the lurch without proper coverage. The growing inability to find affordable plans that cover doctors, specialists and other critical services is affecting people who are now feeling frustrated.

Studies show addiction to opioids and other prescription drugs have far-ranging ramifications, including both physical as well as mental health problems. According to the National Survey on Drug Use and Health (NSDUH), in 2016, of 19 million adults with substance use disorder (SUD), 8.2 million had a co-occurring mental illness in the past year. In such a situation, battling dual diagnosis exacerbates the intensity of depressive episodes, mood swings, tendencies to engage in violence and suicide, with each condition escalating the gravity of the other. Therefore, an integrated medical intervention is best suited for dual diagnosis, wherein a person is treated for both mental illness and addiction.

Dual diagnosis is a treatable condition

Dealing with compulsive drug-seeking behaviors has always been a daunting task. Moreover, things get further complicated if patients also suffer from mental problems like anxiety, depression or bipolar disorder. Studies suggest though the two are inter-related, neither is proven to be the direct cause of the other. In most of the cases, self-medication by taking alcohol or drugs to alleviate the existing mental health condition may offer temporary relief, but the consequences in the long run are detrimental and can multiply the underlying risk for further complications. Most victims are pushed to the edge in a desperate effort to seek relief, which could end in fatal overdoses. Such an observably high rate of interdependence calls for a holistic approach to identify, assess, and treat each concurrent problem.

The need of the hour is regular care from trained physicians and personalized dual diagnosis treatment programs to help a comorbid patient break free from the stronghold of mental ailments and addiction to drugs. If you or your loved one is suffering from dual diagnosis, it is imperative to take the necessary medical help before matters go out of control. Sovereign Health is a leading dual diagnosis treatment provider in the U.S. Call our 24/7 helpline or chat online to know about the most effective therapies at our state-of-the-art dual diagnosis treatment centers.

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