Health care is an ongoing issue in the U.S. and with the drug epidemic plaguing the nation, it’s important now more than ever to have insurance cover rehab for alcohol and drug addiction. So, does health insurance cover rehab? At the end of the day, this will depend upon the type of treatment you are seeking and your insurance plan. Over the years insurance companies have developed a better understanding of addiction as medical disease. They understand that addiction is not a choice, but rather a disease that needs to be treated as such.
When you decide to enter drug rehabilitation, you have options depending on the kind of insurance plan you have and the type of insurance the facility accepts. Among the many factors that will help you make a decision for which rehab center to choose, insurance coverage is an important one. Every facility will work with their selected insurance companies, but all are designed to make treatment as affordable as possible for you.
If you’re wondering if your insurance will cover your rehab, the short answer is yes. It’s the details of your plan and the facility you choose that will make a difference in costs. All insurance plans are required to offer some level of coverage for addiction treatment however your specific policy will determine what types of treatment and facilities are covered. Your plan will also affect how long you can go to treatment and more.
We wouldn’t blame you for finding the entire process a little overwhelming and encourage you to reach out with any questions. Speaking with experts on the matter is the best way to make sure you are aware of all of your options. Similar to filing your taxes, insurance is a tricky topic that you often shouldn’t try to work through alone, it truly is best to consult experienced specialist to get the facts and be informed on your options.
Insurance Basics and Costs
We want to help you get the treatment you need, which is why we offer several drug and alcohol treatment options. We are also here to help you through any questions you may have about coverage and payment. To welcome as many people as we can who seek treatment, we work with most major providers including Aetna, UMR/United Healthcare, and Blue Cross Blue Shield and more. If you do not have this type of coverage, still cause or submit so that we can verify what your plan covers and guide you through available financing and other options to get the help you need.
If you do not currently have insurance, ask about enrollment periods so you can enter at a time where there’s an open window. If employed, check with your human resources department to set you up with these enrollment dates. Additionally, if you are on someone else’s insurance plan, have them fill you in on what coverage entails. Our verification of benefits services are provided at no charge, so call us (link to contact page) and let us know how we can help.
State Specific Costs
Insurance coverage will also depend on what state you live in, as there are different mandates that can help aid you further to get the treatment you need. For example, as of July 2016, a state agency in Massachusetts requires insurers, who are part of the Connector network, to get rid of out-of-pocket costs paid by people who seek addiction treatment for drugs such as suboxone or methadone.
The payment you’re responsible for on your insurance policy may be a set dollar amount or a certain percentage of the total treatment costs. For example, if your costs total $25,000 and your insurance plan covers 70% of the expenses, then you will be responsible for paying the remaining 30% or $7,500 of the cost out-of-pocket.
Percentage costs are also a factor for certain deductibles. While some insurance plans will pay 100% of expenses after you’ve met your deductible, other policies will only pay a percentage of the remaining bills. This amount varies and it’s important to have a clear understanding of what percentage your insurance will cover.
It’s important to remember that if you do not have insurance or your policy does not offer the amount of coverage you would like you can work with an insurance broker to find a plan that is right for you. Our specialist are more than happy to help walk you through this process and connect you with a broker who can help you obtain a more elevated coverage plan that fits your needs.
What Rehab Treatment Includes
With any insurance coverage, there are factors your doctor will consider before suggesting either inpatient or outpatient care. These may include how long you’ve been suffering from addiction, your current mental health, your support system, and how your treatment will be paid for.
Inpatient care typically requires at least 30 consecutive days of treatment where you eat, sleep and live at the facility of choice. Treatment at an outpatient facility may be similar, but will not include overnights where you program but may have a sober living component to offer more extensive support. Your medical care provider or counseling professional will give their recommendation, but also alternatives, especially if cost is an issue.
Treatment coverage for either program of care includes medical monitoring and assistance, group therapy sessions, individual counseling appointments, education about your addiction, and entry into a 12-step program. Each facility will also come with its own amenities or additions. This can range from wellness events, staffed nutritionists, extracurricular activities, and other inclusions that may increase the cost.
Questions to Ask an Insurance Provider
When you talk with your insurance provider about coverage, don’t be afraid to ask questions. It may have been awhile since you enrolled in your plan and like many, you don’t have your full coverage details memorized.
Start by asking if you have a PPO or a HMO? What does it cost if you go out-of-network to a specialist? What are your options within the network? There may be an instance where you will choose to pay more to seek treatment at a facility that you feel you will get the best care.
What kind of paperwork is required? Ask what kind of information is needed regarding your treatment, medication, and any follow-up care. Our treatment facility corresponds directly with our insurance partners and are happy to help address these questions.
What is my copay? Here you’ll want to understand the copay per day. As an example, when you go to your primary care physician for a regular checkup, you may be responsible for a small copay; a typical amount is $25. For substance abuse treatment, there are copays as well. If you have chosen inpatient care, this will likely be totaled as a copay amount for every day you stay there.
What is not included in your policy? Not all rehab centers are alike and there are parts your insurance may not cover. That is why you don’t have to do the legwork on your own. The facility will tell you what is and is not covered under your insurance plan.
Again, we realize this can be a lot to work through on your own and are more than happy to talk you through everything and help you figure out the best way to approach paying for rehab.Speak with a treatment specialist today to learn more about getting help with your sobriety.
Other Insurance Considerations
There may be varying levels of service for the kind of care you receive. When you are diagnosed with addiction, there are often co-diagnoses that occur. Mental disorders are quite common. These will also fall under most insurance plans, but make sure you understand any difference or specifics of coverage between rehab costs and treatment for your mental disorder.
This is also the case if there are physical ailments discovered during your rehab treatment. If you require additional medical care aside from your addiction, but the condition or diagnosis is a direct result of it, it may or may not be covered under insurance. The best way to have peace of mind is to check.
You don’t want to have any surprises when it comes to cost. It’s better to work with specialist to have the plan laid out for you so you know exactly what to expect. By doing so, you can fully focus on your treatment and not have to worry about insurance paperwork and expenses.
Why Treatment Is Important
You want to find a facility that can take care of your treatment needs. Consider the most important features you want your treatment center to have and start by narrowing down choices by comparing to those who will accept your insurance. We can let you know how much your insurance will cover and any additional expenses you may be responsible for on your own. We want you to get the treatment you deserve for the amount of time that’s necessary. Whatever is best for your physical health and mental wellness is what we want for you.
All stages of rehab have equal importance. None can be avoided in order or rushed through. To have a real shot at long-term sobriety, let us help you figure out the financial path to give you the treatment you need; not just what you think you can afford.
Delaying treatment only puts you at risk for a potential overdose and additional harm to your body. Every day your body has to suffer addiction is another step backward. Treatment provides a positive, new direction for you. It will provide the care, tools, and resources you need to achieve sobriety. It gives you people you can count on to get through each step.
The body’s makeup changes once it’s become dependent on drugs and the side effects of withdrawal or too much to bear alone. It’s highly recommended for you to seek help from a facility who has what you need and can help prevent relapse and guide you toward recovery.
What Can Make Rehab More Costly?
Relapse may require a longer period of time in rehab. When you seek treatment, the goal is sobriety, but you’re also there to learn about your addiction and ways in which to cope with cravings or temptations. This is so the likelihood of you returning to old habits is not as great. At Above it All, we offer a one year guarantee because we truly believe our programs help set you up for long-term success and recovery.
If you’re trying self-treatment, there’s a bigger chance of relapse because you don’t have the medical care or support necessary to pass through the intense stages of recovery. This might mean you are in and out of rehab without staying for the full program. It’s like when you are ill and the doctor prescribes you medicine; you have to take the same doses for the fully prescribed time, even when you begin feeling better.
The length of stay will increase the costs. At the end of the day, recovery timelines look different for everyone. Don Treatment is designed to be intensive, proactive, and to provide what you need to achieve sobriety and transition successfully back to the world sober. At Above it All we place an emphasis on helping you develop the life skills you need to lay the foundation for lasting recovery.
The location of where you decide to receive treatment also matters. While it may seem best to choose a center that is close to where you live sometimes this is not the best option. Luckily, there are centers for substance abuse treatment all over the world. It’s important to focus on finding the best treatment center and environment that will set you up for success.
Where Do I Start?
If you have questions or are feeling uncertain about whether or not your insurance will cover your stay in rehab please do not hesitate to reach out to our team.
Whether you are a loved one seeking information for a friend or family member, knowing the insurance provider can help you get started with general copay and deductible information. The insurance process doesn’t have to be overwhelming when you work with the right people. Know that it’s in place to help you get the care you need. And, we will do everything to maximize your plan so you are paying as little out of pocket as possible.
Whether you are considering treatment for yourself or a program for a loved one you shouldn’t have to go through any part of the treatment process alone, and that includes the financial aspect as well. We are here to support you as best we can and find the right solution for you.Find hope. Find recovery. Begin a commitment to lifelong recovery today – for yourself, your friend, or for your loved one.