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Colorado family fights insurance company to get mental health treatment for their son

Posted at 8:00 PM, Jul 20, 2018
and last updated 2018-07-21 01:23:49-04

GREENWOOD VILLAGE, Colo. -- A Greenwood Village couple says they fought their insurance company to get mental health treatment for their teenage son, and it was finally approved -- a month after he died. Two years later, they are fighting with mental health advocates to change public policy in what they call "a matter of life and death."

Karen and Jeffrey Galinkin remember their son Zac as a highly intelligent, musical child, who also struggled with mental health issues such as depressive psychosis for years.

"Here you go, this was his 7th grade school year photo," said Karen Galinkin, who said that was the year, at only 12-years-old, when their son first tried to take his own life. "We found a suicide note and we got him to Children's Hospital immediately."

They said their insurance covered everything at first, but when the moved Zac to a step-down treatment program in Utah, coverage was denied.

"They said, 'You can't prove medical necessity. And I would have a psychiatrist, one, two three, all saying it was medically necessary," she said.

While they appealed, they spend thousands of dollars out-of-pocket a month for months, a year.

"We had to start selling things. We sold things. We borrowed," said Jeffrey Galinkin, who said they also struggled with their son being so far away, at the closest facility they could find to provide the needed treatment.

"So it was a definite financial and emotional reason for him to come home," said Karen, who said they believed he was well enough to come home. But a few months later, at just 14-years-old, Zac tried once again to end his life.

"And Zac walked out at lunch and laid down on the train tracks and that was it," said Karen. "He died in 9th grade."

These parents are a doctor and a lawyer, and they said if they can't nagivate the system, it's hard to believe anyone could.

Andrew Romanoff, the President and CEO of Mental Health Colorado, said these types of stories are far too common, even though by law, insurance companies must provide equal coverage for mental health and physical care.

"But those laws are almost entirely useless unless we actually enforce them, and we're not," said Romanoff. "The system is broken and fixing it is a matter of life and death."

Mental Health advocates are working on an action plan for the next governor and legislature to strengthen enforcement of existing laws by the state Division of Insurance, Department of Health Care Policy and Financing and U.S. Labor Department and help families hold insurance companies accountable.

"If you’re fighting for a mental illness or caring for someone who is, you probably don’t have the time or money to fight the insurance company, too," Romanoff said. "And you shouldn't have to." 

Romanoff said people who have been denied mental health care by their insurance company must come forward to tell their stories, though, because the Division of Insurance has said it can't investigate rumors and anecdotes. They are asking Coloradans to respond to this survey about their experiences.

For the Galinki family, the news that their appeal was successful came too late.

"I got an email from the lawyer who said his claim had been accepted. They accept that it was medically necessary," said Karen, who is calling for a public outrage. "I think it's so sad we're waiting for all the kids to die and then going, 'Oh, look at those numbers, we should do something.'"

Some change is already on the way. A state mental health ombudsman's office was signed into law this year, and the office opens in November.

If you or someone you know needs help, call the suicide crisis hotline at 1-844-493-TALK (8255) or text TALK to 38255.