It is highly advisable that you should seek inpatient rehabilitation if you get a PA or NJ DUI-DWI-DAI or you have a drug and/or alcohol addiction. Not only will it help your personal problem and possibly save your life, but it will also help your case. The sentencing judge will appreciate that you took affirmative action on your own to get treatment. Also, inpatient rehab in both PA and NJ can be considered as “time-severed” for the purpose of jail sentences.
Beginning in 1989, Pennsylvania law required that all health insurance companies had to include drug and alcohol dependency treatment in their health insurance policies issued in Pennsylvania.
The treatment must include detoxification services in a licensed hospital or facility. If recommended by a physician or a psychologist, the covered treatment also must include residential care of up to 30 days in a calendar year and may be subject to a lifetime limit of 90 days of total residential care. Coverage is also required for a minimum of 30 full-session outpatient visits or equivalent partial visits per year and may be subject to a lifetime limit of 120 full-session outpatient visits or equivalent partial visits.
After the change in the law, the Pennsylvania Insurance Commission issued regulations forbidding insurance companies from imposing “managed care” or other limitations on drug and alcohol dependency treatment recommended by an insured’s physician or psychologist. In response, a group of insurance companies sued the Pennsylvania Insurance Commission, claiming that the new drug and alcohol treatment laws did not limit the provisions in health insurance policies that require “pre-certification,” “gatekeepers,” or “utilization review” and other procedures that are often found in managed care policies.
Recently, the Pennsylvania Commonwealth Court dismissed the lawsuit, agreeing with the Insurance Commission that insurance companies cannot impose any additional limits on patients whose physicians or psychologists have recommended drug or alcohol treatment. Noting that the 30-day annual limit and the 90-day lifetime limit included in the statute adequately protect the interests of the health insurers, the court found that the legislature wisely limited the available care and equally wisely addressed the social importance of drug and alcohol treatment by requiring its inclusion in Pennsylvania health insurance policies.
