A check of $33,000 sent to a man with addiction by his insurer. The final payment – his life

A check of $33,000 sent to a man with addiction by his insurer.  The final payment - his life

April 25, 2019

A check of $33,000 sent to a man with addiction by his insurer. The final payment – his life

Addiction Substance Abuse

What can be the most heart wrenching thing for a parent? To learn about their child’s death. That is what Jennifer Alba had to go through on the unfortunate day of Sept 2, 2017. Her beautiful blue-eyed first born, Joseph Hockett II was found dead at midmorning in a motel room. The cause: cocaine and heroin toxicity leading to an overdose. Joseph Hockett’s lifelong struggle with drug abuse started at the age of 13 when he was caught with marijuana at school. Over the next 16 years, he had been in and out of at least 20 drug rehab programs, spent several nights in jails, and even served two prison terms.

What was perplexing to Alba was a deposit of $33,000 made by her son in August 2017. Hockett or Joe, as he was fondly called by his mother, worked as a DJ whose income never exceeded $100 a night, and that too on a good night. In addition to the deposit, Alba also found three cash withdrawal receipts totaling up to $13,000 in his belongings.

The deposit came from a check for $33,399.76 sent to him by Blue Cross and Blue Shield of North Carolina in January 2017 as reimbursement for an emergency care procedure. He had gotten into a bar fight at Wilmington during which he had broken his jaw and it had to be wired together. His friend had taken him to a hospital nearby which was not in his insurance network.

Only after the police gave back Joe’s belongings, did Alba come to know about the checks and figured out what must have happened. After coming across a similar story about how Anthem and its Blue Cross entities were sending checks directly to patients for out-of-network care, Jennifer reached out to CNN. Along with the receipts for the $33,000 deposit, she found two more checks from Blue Cross for $ 6,096.14 in April 2017 and $ 14,104 in June 2017. She also found a spreadsheet in Hockett’s laptop showing that Blue Cross owed him a further $73,400 for medical services in 2017.

Jennifer had signed up her son for insurance to avoid the tax penalty authorized by Affordable Care Act (ACA). Little did she know that the very same insurance, meant to protect her son, would claim his life. What angers her the most is that Blue Cross knew about her son’s addiction problem. She showed an Explanation of Benefits form which showed that Blue Cross had covered at least one of Joe’s visits to the rehab during his last months. Criticizing Blue Cross, she said that sending checks to her son instead of the hospital directly was not only ridiculous and absurd, but also careless.

The “real” problem

According to Cody Hand, senior vice president with the North Carolina Healthcare Association (NCHA), sending checks directly to patients is a pressure tactic employed by insurers to make providers join their networks and accept lower payments. However, in this struggle, the patient is used as a “bargaining chip” and made the scapegoat. He goes on to say that while several other insurers pay the out-of-network providers directly, Blue Cross “blatantly” sends money directly to the patients.

The insurance industry argues that this policy was intended to protect patients from surprise bills, overpriced charges, and inflated invoices by out-of-network hospitals and doctors.

Mike Causey, North Carolina’s insurance commissioner, agreed with Hand. Speaking to CNN, Causey said that the real problem was lump sum payments and insurance benefits with few restrictions on out-of-network providers. This needed to be addressed as soon as possible. He also said that the goal was to ensure that guidelines were established so that the consumer was protected while the insurers had the ability to control health care costs.

A thoughtless act

Alba is angry at Blue Cross because of the checks directly endorsed to her son. She said that her son was the last person who should have received such large amounts of money. She asked why a person suffering from addiction and mental health problems was given such large sums of money, despite knowing thier condition. The money prompted Hockett to go on the largest binge of his life, which proved to be fatal. She said that the Blue Cross policy was amorally wrong and a thoughtless act.

Blue Cross and Blue Shield of North Carolina refused to answer any questions about Hockett’s case. Citing privacy laws, Austin Vevurka, Blue Cross spokesperson, said that they cannot divulge the details of the case. However, he said that though the company initially tried to negotiate with the out-of-network hospitals for payments exceeding $25,000, they were obligated to pay the patient directly if the negotiations did not come through. Blue Cross declined to comment when asked why it sent checks of such large amounts to people struggling with addiction and mental health problems directly and also if they had sent checks to other people with similar problems.

Gone but not forgotten

To see her son’s name on the tombstone feels like a “punch to the heart” for Alba. She had fulfilled her son’s last request to be buried near his beloved grandmother, who was like a second mother to Hockett and had helped raise him. Holding back her tears, Alba says that her son should not have died the way he did.

She goes on to add that she would continue to speak up and make sure no one else goes through the same pain she had to at the hands of an insurance company which continues to send checks of large amounts to patients rather than paying the drug treatment center directly.

Addiction is a menace

Hockett and Alba’s story is not an isolated one. There are several people out there who are at the mercy of their addiction. In spite of wanting to seek treatment for their condition, their access to mental health and drug rehab centers is limited as their insurance providers do not cover treatment sought at some of the best accredited mental health and addiction treatment centers. Unfortunately, some insurance providers prefer providing these patients with checks amounting to large sums which tempt them to relapse and indulge in binge behavior leading to their deaths rather than directly paying the treatment provider.

If you or a loved one are also battling an addiction and is looking for a licensed drug treatment center, then get in touch with the Invictus Health Group. Call our 24/7 drug addiction treatment helpline 866-548-0190 and speak to a member of our team. We accept most insurance plans and are committed to providing the best practices in mental health and addiction treatment. You can also chat online with a representative to get your free insurance verification done today.

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