Options available for son battling opioid addiction; Covering; The Bases

My 34-year-old son was both a high school honor roll student and a star athlete and, as such, he was awarded a generous college scholarship. During his collegiate athletic career, sports injuries were liberally treated with prescription narcotics such as oxycodone. Prescription pain killers on his college campus were rampant; he could obtain these medicines even after physicians stopped prescribing. My son became addicted to opioids and transitioned to heroin by age 25.

He suffered a traumatic head injury as a result of a prison assault and now has seizures. I have spent my retirement savings for multiple rehabs. He has been on methadone treatment since 2012, and this has saved his life. He is able to work a part-time job, but due to his seizures and criminal records, he cannot earn enough money to get off of Social Security Disability Insurance.

Currently, he has Medicaid under the Affordable Care Act. He has just learned that since he has been on SSDI for almost two years, his Medicaid will end and he will be transitioned into Medicare, which will not cover his methadone. Without methadone, I am certain he will relapse into heroin use.

The opioid epidemic in the U.S. has harmed so many of our young, promising youths. As a nation, we are wresting with how to treat the more than 2 million people either addicted or abusing opioids.

As a mother, you are wrestling on how to best help your son on his day-by-day recovery from the horrors of his addiction. You are correct; Medicare does not cover methadone for opioid addiction treatment. In preparation for his transition into Medicare, your son needs to discuss treatment plans with his addiction counselor and his physicians. Perhaps the treatment facility has access to "under-insured" funds to allow your son to continue his treatment.

Another option is to transition from methadone to other therapies. There are other medications, such as buprenorphine, that may be prescribed for opioid addiction. Medicare Part D covers buprenorphine products. Have your son discuss this option with his addiction counselor and his physician.

Not every recovering addict is a candidate for buprenorphine therapy. If you son is, he will need a physician approved to prescribe buprenorphine for opioid addiction. Your son's addiction counselor, or physician, may be able to make an appropriate referral. You son may find a provider by visiting www.samhsa.gov.

Since your son is on Social Security Disability Insurance and is working, he might have another option. While Medicare does not cover methadone, Medicaid does. If he can continue Medicaid, he would retain coverage for methadone. Many times the income from SSDI and work places a person above the threshold for Medicaid. However, there is a program called Employed Individuals with Disabilities that he would want to investigate.

The EID program is designed for people ages 18-64 who are both disabled and working. This program allows a person to purchase Medicaid for a small monthly premium. More information on this program is available at mmcp.dhmh.maryland.gov/eid/Pages/Home.aspx.

I hope that the above suggestions help you and your son in his recovery. For readers and their families struggling with addiction, the Anne Arundel County Department of Health offers valuable resources through their website at www.aacounty.org/departments/county-executive/county-initiatives/heroin.

Amy Rubino is the director of the Senior Health Insurance Assistance Program and the Senior Medicare Patrol for the Anne Arundel County Department of Aging and Disabilities. You may contact either program at 410-222-4257 or ship_program@aacounty.org.

Credit: Amy Rubino - Amy Rubino is the director of the Senior Health Insurance Assistance Program and the Senior Medicare Patrol for the Anne Arundel County Department of Aging and Disabilities. You may contact either program at 410-222-4257 or ship_program@aacounty.org.