Plan members on long-term disability may now qualify for addiction treatment funding: Path to Health

November 25, 2020

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3sHealth’s disability claims management redesign project is now in its second year, and the project team continues to work on improvements for plan members.

One of the big changes we made in year one was expanding access to treatment funding for plan members on an approved disability claim. “Providing plan members with support and investing in their recovery is an important part of their path to health experience” says Alana Shearer-Kleefeld, Director of Employee Benefits.

Throughout a long-term disability claim, a plan member and their adjudicator communicate regularly. These touchpoints help the adjudicator understand the plan member’s progress and, in consultation with their physician, where additional treatment might be beneficial.

In the second year of Path to Health, treatment funding was expanded to include addiction treatment. Based on specific criteria, plan members on an approved long-term disability claim may qualify for treatment funding to attend a 45- to 90-day inpatient addiction treatment and aftercare program. Upon successful completion of the program, eligible plan members may be reimbursed up to 50 per cent of the cost of their treatment to a maximum of $10,000 once in a lifetime. Successful outcomes are more likely when the plan member can choose an addiction treatment facility in a place they feel comfortable, and one that aligns to their personal beliefs and values and that treats the type of addiction they have.

“As work on this strategic priority continues, we will keep exploring new treatment funding alternatives to assist plan members on their path to health,” adds Shearer-Kleefeld.


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