Insurance Coverage

Health insurance can help with covering costs of addiction treatment or rehab.

The cost of addiction treatment is a stumbling block for many seeking help for themselves or loved ones, yet money and concerns about treatment expenses are often just one more excuse for continuing an addiction. Effective addiction treatment is easier to find and more affordable than ever thanks to health care changes and access to information about insurance and recovery.

Choosing Your Addiction Recovery Services

Treatment costs and insurance coverage vary based on your treatment needs and recovery preferences. Outpatient services are typically more affordable than inpatient care, but your insurance may cover one and not the other. Choosing a more intensive recovery program also ensures better treatment outcomes, meaning you will only have to pay for treatment once. Dual Diagnosis treatment, treatment that addresses co-occurring addiction and mental health issues, may seem more expensive on the surface, yet it provides better treatment outcomes and means you only need one form of treatment rather than separate addiction recovery and mental health care services.

Treatment location and provider may make a difference in terms of cost and coverage. Some insurance companies will only cover in-state options, while others offer broader coverage. In-network providers, those your insurance company works with directly, will be covered to a greater degree and involve reduced out-of-pocket costs. While you may be tempted to simply choose the in-network option that comes at the least cost, finding the right recovery program is more important. Treatment needs to be personalized, and the program you choose should be staffed by professionals who have experience treating individuals with similar addiction and mental health issues. Your addiction recovery program should be tailored to your needs and personality, and it should be flexible, as your recovery progresses.

While finding a treatment program that meets your basic recovery needs is essential for long-term recovery, you may also be interested in recovery programs that offer additional services. Luxury addiction treatment provides top-notch care in comfortable settings. Staff-to-patient ratios are typically lower at these facilities, and they may offer alternative therapy options such as equine therapy, art therapy and yoga classes. These services come at additional costs that may not be covered by your insurance plan, but they may be worth paying for if they will benefit your long-term recovery or encourage you to participate in and complete a treatment program.

The Affordable Care Act and Insurance Coverage for Addiction Treatment

Addiction treatment may be more widely covered under the Affordable Care Act (ACA). This act requires equal coverage of mental and physical health care and makes insurance available to more individuals than ever before. According to whitehouse.gov, “The ACA includes substance use disorders as one of the ten elements of essential health benefits.” Health insurance companies will be required to cover services related to addiction and recovery. The details of this coverage will still vary based on plans and individual circumstances, but it is a start to seeing addiction recognized as a medical condition and making treatment more readily available.

Parity Law and Insurance Coverage for Addiction Treatment

The Mental Health Parity and Addiction Equity Act (MHPAEA) is another government mandate that benefits individuals struggling with addiction. If an insurance company offers mental health coverage, it must do so at the same level and with the same benefits as its physical health care. This means that copays, out-of-pocket costs and treatment limits cannot vary between mental health and physical health treatment. This act does not require insurance companies to cover mental health or substance use disorders and does not apply to all insurance coverage offerings, but it may apply, if you have an employer-funded plan, Medicaid or certain individual plans.

Know Your Insurance Coverage

Both the ACA and MHPAEA can reduce costs associated with treatment and increase access to effective recovery resources, but you must know your current insurance plan to determine how these laws will affect you. Our admissions coordinators understand health care coverage and the laws that apply to your unique situation. They can contact your insurance company on your behalf and determine what programs and services will be covered. Dealing with insurance companies yourself can be frustrating and overwhelming, but we can make sure you are getting the most from your health care plan.

Find the Right Addiction Resources for You

We can help you find the effective addiction treatment you need, no matter your budget or personal situation. All calls are free and confidential, so there is no reason to put off learning about the resources available to you. We will talk with you to learn about your unique recovery needs and will explore your insurance coverage. We are here for you 24 hours a day, whether you are interested in family mediation or intervention or are ready to choose a recovery program and get started on your path to recovery. Please do not wait to get the help you need and can afford. Call today.