Insurance Denied Continued Mental Health treatment for Teen Despite Suicidal Ideation, Family Says
Michigan - A Michigan family is facing mounting medical debt and emotional distress after their insurance provider, Quantum health, repeatedly denied coverage for their son’s residential mental health treatment, despite documented suicidal ideation and ongoing struggles with addiction. Nick and Misty Benz-Bushling allege their 16-year-old son, Johnathan, was deemed “too unstable to function outside of a hospital setting” by his treatment team, yet Quantum ultimately terminated authorization for his care.
The denials began after Johnathan had shown initial progress in treatment. Quantum outsourced the appeal to AllMed Healthcare Management, which upheld the denial, stating Johnathan was “largely compliant with his treatment plan” and had made progress, no longer exhibiting suicidal thoughts.
Dr. Richard Trestman, a psychiatrist, cautioned that perceived improvement can be misinterpreted by insurers. “When we document in a chart, we’re trying to reflect that the care we’re providing is helping and looking for positive change, but that doesn’t mean that it’s going to stick. That doesn’t mean that it’s going to persist,or that it’s something that should justify reducing the level of care,” he said.
The Benz-Bushlings submitted a 270-page appeal detailing Johnathan’s history of mental health challenges, which began in 2022 with withdrawal from family and constant marijuana use. His addiction escalated as he entered high school, requiring supervision to prevent drug use, even at school.
“It got to the point where he had to be escorted everywhere that he went,” Nick Benz-Bushling said. “He was never supposed to be alone.He was still finding ways to get THC vapes into our house, and he couldn’t get through a school day without getting high.”
Earlier this year,the family relocated from Virginia to Michigan seeking a fresh start and to distance Johnathan from negative influences. He had previously undergone therapy, intensive outpatient treatment, and a prior residential stay in Virginia. the family hoped the move would provide a stable surroundings for continued recovery. The Benz-Bushlings continue to keep all alcohol and medications locked in their bedroom.
