Addiction Services by Insurance
Other Payment Options for Addiction Services
Private programs will always have a cost attached to them, and the cost will be determined by how long the program is or if there are elaborate luxuries provided. State-funded drug treatment centers will also cost something, unless it is 100% funded and free, yet; the cost is low and affordable. State-financed services are one of the most common services you will find within local communities, across the United States. These are the addiction and mental health services, which provide things such as counseling, treatment, detox, and short-term treatment options.
Private drug and alcohol treatment programs within the United States and even state-financed programs can often work with private health insurance. Health insurance plans can help cover some of the costs of treatment, and each plan is different and will be dependent upon the health insurance provider. Through employee health insurance programs, there are services such as employee assistance programs. Employee assistance programs provide short-term help for employees and their dependents. When you have health insurance through your employer, you will have access to these services 24 hours a day, for whatever type of problem you may be struggling with. Along with health insurance, there is also payment assistance, where an outside third party would offer payment assistance for the individual attending the drug treatment facility. This could be through a loan or a grant, and some medical financing.
The Substance Abuse and Mental Health Services Administration do fund a program, which provides access to recovery vouchers. This program allows an addict to apply for a voucher, and to choose the drug and alcohol treatment program they want. There are specific criteria for who can apply, and various drug and alcohol treatment programs throughout the United States, apply for the funding to be part of this program. Sliding fee scales is also common payment options, where the cost of the program would be based on what the client and or the family can pay. Typically, this is for low-income families or anyone who is unable to pay a certain amount. Sliding fee scales and different payment options such as these can be useful resources to utilize. The priority should be finding the right type of treatment and rehabilitation, and when an addict can attend a drug rehab center where they feel comfortable, they will increase their ability to maintain their sobriety.
Ask a Professional
Will my insurance pay for my rehab?
Maybe. Generally, the more severe the person’s addiction is, the more likely an insurance company will pay. The determining factor in getting coverage is if the insurance provider believes you need it. Insurance companies have a team of medical professionals that review all claims submitted. If they disagree that the person needs drug rehab, they don’t pay. All this being said, you must ensure the facility you want to attend accepts your insurance.
How do I know if a drug rehab accepts my insurance?
The easiest way to know if your policy is accepted is to call the treatment facility and give them your insurance information. They will be able to let you know if your insurance is accepted and verify your benefits to provide you with an idea of how much coverage you will get. Another way is to ask your insurance provider for a list of treatment facilities they work with. Doing so can save a lot of wasted phone calls to facilities that don’t accept your policy.
Do all health insurance policies cover drug rehab treatment?
Yes. Between the Mental Health Parity and Addiction Equity Act and the Affordable Care Act of 2010, all insurance providers must offer some form of substance abuse treatment coverage. The level of coverage varies between insurance providers and policies. Generally, more expensive private health insurance policies cover at a higher rate. It’s important to note that treatment facilities may limit the type of policies they accept. Even if your insurance plan has coverage, it may not be taken at the drug rehab you want to attend.
Can I purchase a policy specifically to cover treatment?
Technically, there’s no reason someone can’t purchase a policy specifically to cover their addiction treatment. What makes it challenging is private health insurance companies have developed tactics to prevent people from quickly purchasing a policy to avoid a significant expense like addiction treatment and then dropping the policy afterward. To prevent this financial loss, they only allow people to but policies during a certain period of the year, known as “open enrollment.” Open enrollment can be a window as small as a few weeks out of the year, forcing people to wait until that time to get coverage. Other policies have “blackout periods” where major services like substance abuse treatment aren’t yet covered. Blackout periods usually last for one year, meaning the person must pay to keep the policy active for twelve continuous months before it will pay for any portion of an addiction treatment service.
How are Medicaid and private health insurance different?
Medicaid is free health insurance subsidized by each state and offered to qualified residents. To obtain Medicaid coverage, a person must demonstrate financial hardship that prevents them from getting private health insurance. Private health insurance is not free. It is purchased by individuals from insurance companies or may be provided through employment.
Want to know more?
The questions from Addicted.org’s “Learn from our Experts” are answered by Michael Leach, CCMA. If you need further clarification on any of the questions above or have any other questions you can contact him directly at mike@addicted.org.
