Before you go through the admissions process at an addiction treatment facility, it’s best to determine if you can use your health insurance for drug rehab costs.
Many insurance companies didn’t cover substance abuse treatment in the past. Most denied addiction treatment coverage based on whether substance use disorders or other co-occurring mental health conditions were pre-existing. However, the Affordable Care Act – also known as Obamacare – passed in 2010, and it requires that all health plans provide coverage for mental and behavioral health services, including substance abuse treatment.
Even with ACA, though, how much an insurance company covers a client’s drug rehab still depends on their individual plan and their addiction treatment program composition. Sometimes, a client will need to acquire a referral from their primary care physician before their insurance provider pays for any treatment.
Need help in understanding how health insurance for drug rehab works? Reach out to Oceanfront Recovery and ask about our programs and services. Contact us online or call 877.296.7477.
Does Health Insurance Cover Drug Rehab?
The ACA regards substance abuse treatment as an essential health care benefit for all US citizens. Thus, private insurance companies are now required by the ACA to provide some form of substance abuse treatment coverage in their health plans.
Most insurers can’t completely deny substance use disorder coverage. However, client coverage specifics will depend on the details of their particular health care plan – whether or not it’s a preferred provider organization (PPO) or a health maintenance organization (HMO) plan, for example.
Note that health insurance companies can ask their members to choose from a small set of approved providers. This is typically done to ensure that treatment comes at a lower cost. Insurance companies may also ask members to pick up some costs required for care in the form of co-payments, deductibles, and premiums.
5 Questions To Ask About Health Insurance for Drug Rehab
Is It Worth Paying for Drug Rehab?
Drug rehab can be far from affordable for some clients. However, it’s helpful to think of the cost as an investment in their future. Any cost wouldn’t compare to the improvement that recovery makes in a client’s life. Fortunately, good health insurance can go a long way in covering drug rehab costs.
What Rehab Costs Will You Need Insurance to Cover?
Every addiction treatment plan is different, and a client’s insurance company may cover some or every part of it:
- Detox: For many clients, this process can be extremely uncomfortable. This is often done in a health care center with 24-hour medical supervision and support in overcoming withdrawal symptoms.
- Addiction treatment: A comprehensive assessment at an addiction treatment facility will help determine if a client needs outclient care or the structure of an inclient program. The latter is less affordable. While most health plans cover outclient treatment, some may handle inclient care separately.
- Prescription medication: Some clients will need one or several drugs to help deal with cravings and other withdrawal symptoms. Not all health plans will cover medications like this.
Can You Afford Private Health Insurance?
There’s private insurance and public insurance. Private insurance is insurance that you purchase by yourself or through your workplace, and you’re responsible for all or some of the cost. It’s generally more expensive than public health care. However, it often has better rehab insurance coverage.
Many private insurance companies coordinate with certain health care providers within a managed care network. There are three main types of managed care plans:
- HMO: This affordable option generally only covers care from in-network providers.
- PPO: This plan focuses on in-network providers but may still cover some costs from out-of-network ones. If a client goes with an out-of-network health care provider, they may need to pay upfront and seek reimbursement from their insurance company afterward.
- Point of service: This plan allows clients to go with an HMO or PPO every time they need care.
Should You Rely on Public Health Insurance?
The government provides public insurance. It may be partially or completely covered by government funds.
Medicare is government-funded insurance for those aged 65 or older, alongside some younger people with disabilities. Coverage is divided into parts, so a client may choose not to cover all types of care.
Medicaid is government-funded insurance for low-income households. It must cover the same essential health benefits required by the ACA. However, Medicaid varies by state – so the coverage may vary based on a client’s location.
Does the Rehab Center You’ll Be Working With Accept Your Health Insurance?
This may be the most important factor when a client is choosing a rehab center. Do they accept their health insurance? Only insurance-covered rehab facilities should be considered.
Learn More About Oceanfront Recovery’s Programs and Services
Does your insurance cover drug rehab? Need help in understanding how health insurance for drug rehab works? Reach out to Oceanfront Recovery and ask about our programs and services. Contact us online or call 877.296.7477.
