Have you ever wondered what insurance coverage is available for rehabilitation? We`ve got the answer.
If you or someone you love is struggling with drinking or substance abuse the addiction rehabilitation centers offer you the greatest chance of long-term recovery. The staff at Better Addiction Care advise that Addiction treatment is costly and so is medical treatment. You probably hope your insurance company will cover at some point a significant portion of costs. Although the most straightforward answer to the question “Does insurance cover rehabilitation?” is yes, the real answer is complicated. The Affordable Care Act, also known as Obamacare was enacted in the year 2014. It contained important aspects which affected insurance coverage for drug abuse treatment. Although mental health and coverage for substance use disorders are now essential health benefits but that doesn`t mean your insurance policy will cover the treatments you require. It`s essential to find out what your specific insurance policy will cover prior to you begin rehab to ensure that you do not end up with medical bills you cannot afford.
Factors that could impact your rehab plan
You can get the insurance for substance abuse when you are insured through an ACA marketplace. There are many factors which determine how comprehensive your insurance coverage is as well as the amount you will have to pay for treatment for addiction. The state where you live and the type of health insurance you have will determine the coverage for rehab you get. Different plans differ in a variety of ways, including the following:
Relapses
Prior to 2014, insurers were able to deny paying for treatment for pre-existing medical conditions. This was the case for the treatment of alcohol and drug abuse. Insurance companies often determined that any person who received counseling or treatment for substance abuse in the past and was currently experiencing an relapse, was covered under the existing statute. It`s not the case anymore; even if you are suffering a relapse from the last treatment, you could be covered, provided that you meet other guidelines for treatment coverage.
Treatment for addiction insurance comes with strict guidelines on how many days of treatment are covered as well as the number of visits. If you`ve been in treatment, you may have already met your maximum amount of mental health or addiction treatment visits and exhausted your coverage for the year.
Co-pays and deductibles
The insurance for addiction treatment you have will specify an annual deductible as well as an out-of-pocket amount to be paid before your insurance pays for treatment. If you have a higher deductible, the addiction treatment facility may permit you to set up an installment plan to cover your expenses.
Outpatient vs. Inpatient care
The insurance for addiction treatment usually offers a mix of inpatient and outpatient therapy. Although both forms of therapy work, inpatient rehab provides the opportunity to focus more completely on rehabilitation. Inpatient rehab is substantially more costly, since it is a 24-hour program that requires intensive therapy in a residence. Outpatient care involves individual sessions which means it is more adaptable to your requirements and budget.
Management of care
Based on the coverage of your insurance that you are insured under, you may be required to complete an approval process called Pre-Authorization before you can get authorization to undergo rehabilitation. It could be a lengthy process that the rehab center must be involved with, as the intensive approval process demands answers to questions about the diagnosis and treatment, and could include a peer-to-peer review. The insurance company may require that you seek care from physicians who are part of the network.
Different kinds of treatments
Certain insurance companies have strict guidelines on the types of treatments that they are willing to provide. A majority of insurance companies insist on research-based treatments like treatment for addiction. Insurance companies may not cover the costs if the rehabilitation center you select relies on holistic treatments such as Acupuncture, that haven`t been proven to help with addiction.
Pay-as-you-go options
If your insurance provider will not cover rehab at the addiction facility you pick, don`t worry. There are numerous recognized addiction rehabilitation centers. It shouldn`t be a problem to locate a center that can provide the most effective treatment and is willing to work alongside you to help to pay for the costs your insurance doesn`t cover.