Wilderness Camps As Intervention For Troubled Teens

[Sandra Pearce]

Our health plan has recently had two cases where adolescents were placed, by their parents, in Wilderness Camp programs as an attempt at intervention related to emotional and/or drug abuse problems. These programs are in some cases licensed by the state but most are not JCAHO accredited. The two cases we had required the parent to pay in full for the “admission” to the camp – usually a stay of from 21-30 days. Both camps stated that they would assist the employee in filing a medical claim for the “admission.” In one case that assistance was a statement on letterhead with the total charge stated to be tuition. Because the facility does not meet the standard required in our Plan we have denied coverage. I’m interested in any information others may have regarding these camps and whether or not the plans you administer provide coverage for this type of “admission.”

[jeanine]

One similar experience although not a wilderness camp. In that case, the plan (self-funded) agreed to pay for therapuetic treatments received while "enrolled". It took some negotiating to get a fee schedule listing out therapies separate from the custodial confinement aspect. Parent then paid the balance. If there is legitimate mental health services rendered by licensed professionals I have no problem paying for that portion of the cost. Is there any state law controlling coverage or are these self-funded plans?

[Sandra Pearce]

Jeanine, thanks for your reply. The first case would not break out the counseling charges which, of course, would have allowed us to pay that portion. We haven't actually received the claim on the second one. We are self funded.