Seeking healthcare is expensive. The cost of professional alcohol and substance misuse rehabilitation is a deterrent for those who may desperately need help. An insurance cover offers much-needed relief for alleviating the cost of care. Therefore, if you or your loved one are struggling with addiction, it would be best if you are informed about the insurance plans that cover alcohol and substance misuse rehabilitation.
The costs of rehab can be prohibitive. Fortunately, numerous marketplace insurance plans cover alcohol and drug addiction to increase treatment access and help recovery. The coverage is sometimes referred to as alcohol and drug rehab insurance, and many treatment centers accept insurance coverage to assist in addiction recovery.
The Affordable Care Act
The affordable care act mandates private insurance companies to provide a plan that covers substance misuse and abuse treatment to American citizens. Treatment for alcohol and substance abuse is regarded by the affordable care act (ACA) as essential healthcare service for American citizens.
The ACA implies that your insurer cannot wholly deny you coverage. However, your specific insurance coverage may depend on the state you bought your coverage in and your chosen health care plan. Your insurance plan may also require selecting from an approved list of “in-network” service providers. Insurance companies do the former to lower their overhead costs. You may also be expected to pick up some costs related to the rehabilitation presented as copayments, premiums, and deductibles.
Whereas the affordable care act is progressive, some insurance covers may require a referral from a primary care physician before paying for the treatment. Alcohol and drug abuse often occur with underlying mental illnesses such as depression or anxiety. Therefore, your insurance coverage may also cater to therapy costs, time spent in a residential rehab center, and treatment medicines in an inpatient facility.
The Role of Medicare and Medicaid in Addiction Treatment
Medicaid is the federal insurance coverage for people with low income. Medicare is also a federal insurance cover for Americans sixty-five years or older and those under sixty-five with a medical disability.
Medicare only covers alcohol use disorder and drug abuse rehabilitation if:
- You seek the services from a Medicare-approved facility
- Your provider is the one who sets up your treatment plan
- Your provider can ascertain that the services being requested are of medical importance
You should also ensure that your treatment center of choice accepts Medicare and Medicaid because not all rehab centers will accept Medicare and Medicaid coverage.
What Percentage is Covered by an Insurance Plan?
Not all insurer covers are equal. You are therefore advised always to read and understand all the details of your cover before paying for it. Some insurers will cover all detox and rehab costs once you have met the deductibles.
Other insurers may require that you make copayments for all the facility charges of the rehab (the insurance only covers a certain percentage of each cost). An out-of-network facility (a facility not approved by your insurance provider) may cost you even more.
The detox process usually depends on the drug of addiction. As a rule of thumb, addiction to Schedule I drugs calls for a more vigorous rehabilitation process. This will heavily translate to the cost of rehab.
Additionally, the costs covered under your specific insurance plan may vary according to the treatment plan selected by the professional service provider. This implies that an in-hospital detox plan may be more costly than a non-medical detox.
What is the length of Rehab that Insurers Cover?
Your insurance may use different criteria to determine the appropriate length of treatment to be covered. The insurance provider often works in consultation with your doctor to establish an appropriate time.
Addiction treatment has numerous treatment stages. Your insurance may only cover some or all these crucial steps. As you go through the stages, you will be assessed for signs of improvement by your clinical team. Your insurance provider may use this data to establish whether to extend the duration of your treatment coverage.
In summary, it is crucial that you interrogate your insurance coverage to understand the benefits your specific coverage offers. Reach out to us today at 833.970.2054 to start your journey toward addiction recovery.