Does Insurance Cover Addiction Rehab?

In the United States, there are over 15,000 specialized centers for addiction treatment. However, some people are still struggling with substance abuse because of the cost of professional treatment. Let’s look at some statistics:

According to the American Addiction Center, about 22.5 million people in the US required treatment in 2014. Only 11.6% got help from a professional. In the UN’s world drug report of 2019 it was discovered that 1 in 7 people get treatment because most people

• Can’t afford the cost
• Do not have insurance
• Can’t find the specific help required

Because of the complexity of substance abuse, addiction treatment encompasses several components such as the level of drug use, therapy, aftercare treatment, and housing. Most people may not afford comprehensive treatment out of pocket. Thankfully, various insurance programs and faith-based organizations now cover addiction treatment.

This article explains the types of insurance that cover drug and alcohol addiction treatment. You will also find out what to do if you don’t have insurance.

Insurance Programs for Addiction Treatment

Substance abuse can result in a mental or physical health condition. This will not only affect the life of the patient but also their relationships with friends and family members. When left untreated, a person who is suffering from addiction can cause harm to their community.

Due to the opioid epidemic, the life expectancy of many Americans has declined. As a result, addiction disorder has become a public health concern. The Federal, state, and local governments have also come up with programs that cover addiction treatment. These programs include the following:

Private and Employer-Sponsored Coverage

Private companies provide coverage for both addiction treatment and other medical conditions that may arise due to the disorder. Although there is no guarantee of full coverage, you should find out from your employer before relying on this package.

The major challenge with employer-sponsored coverage is that coverage may change due to the length of treatment. As a result, patients spend less time in rehab and may not fully recover. Also, the plan may not cover specialized treatment.

The Affordable Care Act (ACA)

The Affordable Care Act, also known as Obamacare, was signed by President Obama in 2010. It ensures that all insurance plans under the scheme provide coverage for both mental health conditions and substance abuse disorders. Insurance companies that do not comply will face the consequences of their actions.

When substance abuse is left untreated, it results in mental health problems, which the same insurance companies must cater to. Due to this, most plans now include addiction treatment. However, insurance companies need to improve access to treatment such that patients can access the resources required to recover properly.

Medicaid and Medicare

Medicaid is federal insurance coverage for low-income earners. It also covers treatment for substance abuse through the Affordable Care Act.

Medicare is also provided by the Federal government. However, it is for disabled people who are below 65 years or people who are 65 years and older. It covers alcohol and drug abuse disorders under the following conditions:

• The services should be proven beyond reasonable doubts to be medically necessary
• The patient must receive care in a facility that Medicare approves of
• The patient’s insurance provider must establish the care plan

Some rehabilitation centers do not accept Medicare and Medicaid. Therefore, you should find out from your provider if there’s a list of facilities they cover. You can also check out Ambetter Insurance drug rehab to find a list of plans that can cover the cost of rehab services.

Does Insurance Cover Detox?

Some providers will pay for detox in full provided your contributions are up to date. Others will require you to pay a fraction of the fees for each service you receive at the rehab. Also, if the facility is not in your provider’s network, you will pay more.

Because the level of substance use differs from one patient to another, the type of detox required will differ. This also applies to the cost of the detox procedure. For instance, medical detox will cost more than a non-medical procedure.

How Long Does Insurance Cover Rehab?

Different factors are considered before an insurance company decides what should and shouldn’t be covered. Your provider will meet with your physician to ascertain the treatments that are necessary before deciding how long they can cover the necessities.

Addiction treatment requires different types of care and your provider may be able to cover just a few. Some will cover detox while others cover inpatient to outpatient care. A physician will assess the patient to find out whether they are improving or struggling. The result of this assessment coupled with the insurance company’s policy will determine whether a treatment will be extended or not.

What Can You Do if You Don’t Have Insurance Coverage for Addiction Rehab?

If you do not have insurance for addiction rehab, here’s what you can do:

Discuss with Your Employer

Even if your employer is not obligated by law to offer insurance, they may offer it anyway. Reach out to your superiors; they may be happy to help, especially if you’ve been an excellent employee. Some employers will grant you a leave of absence so your job stays secure until you return from rehab.

Contact the Rehab Center

The cost of rehab may sound outrageous but don’t let it deter you. Most rehab centers have flexible payment plans such that you can pay in installments. This way, you can commence treatment without paying in full.

As soon as you recover, you can get back to work and then pay your debt. You can visit https://www.careercast.com/ to find out how to get a job after rehab.

You can try other options such as:

• Secure a loan
• Find an organization that helps people who need rehab
• Find out whether there are free or cheaper rehab services in your locality
• Join a support group
• Download a mobile app for therapy

Conclusion

Alcohol and drug addiction can result in more serious health conditions if you do not seek help on time. Contact your insurance provider to know what your plan covers. You should also utilize local resources available in your state such as support groups.

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