Does Insurance Pay for Rehab?
For so many people who suffer from a substance use disorder or alcohol addiction, the cost of treatment and financial burdens are the single biggest barrier to entering treatment. The stress of how to pay for treatment becomes an added challenge on top of living with a substance addiction. One way to combat this issue is to find financial options through medical health insurance. Does insurance pay for drug and alcohol rehab? Many of the major insurance providers such as Blue Cross Blue Shield, Cigna and United Healthcare all offer healthcare plans that will help pay for all or most of your substance use disorder treatment.
With the enactment of the Affordable Care Act, many policies have now been implemented to provide more accessibility to substance use disorder and alcohol use disorder treatment for millions of Americans. Under the ACA, addiction is no longer considered a pre-existing condition. The ACA also expanded the funding and treatment options available for people who are covered under government insurance programs such as Medicare and Medicaid.
The Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) helped to widen access to substance abuse-related treatments for Americans. It ensured that health insurance providers and group health care plans that offer mental health and substance use disorder treatment do not impose greater limitations on these benefits than they would for other medical and surgical health benefits. Parity protections for mental health and substance use disorder remove the limits that apply to these types of services.
Despite this policy, it turns out many Americans are unaware of the healthcare options available to them when it comes to behavioral health treatments. In a 2015-2018 study from the National Survey on Drug Use and Health, about 37% of the participants were unaware that drug and alcohol addiction treatment was covered and included in their health insurance policies.
Benefits of ACA Insurance plans
- Under ACA, addiction and behavioral health treatment are given the same weight as other physical ailments and conditions
- ACA has broadened access to substance abuse treatment for over 32 million Americans
- ACA insurance plans help assist with inpatient services such as medical detox and residential treatment
- Treatment options such as the following are available: addiction evaluation, intervention, addiction treatment medication, clinic visits, drug and alcohol testing, home health visits, group, family and individual counseling
- ACA insurance plans help reduce the costs of addiction treatment
- ACA insurance plans help increase treatment options and can extend many benefits of employer-provided insurance plans and individual medical insurance plans
Insurance benefits for Substance Use Disorder Treatments
- Addiction treatments are often covered by many insurance plans and include inpatient rehab, medical detox, MAT, co-occurring mental health disorder treatment, outpatient treatment and individual counseling.
- All marketplace insurance plans must cover behavioral health treatments including psychotherapy and counseling, mental and behavioral health inpatient services and substance use disorder treatments.
- All marketplace insurance plans cannot deny a person coverage or charge more because of any pre-existing conditions including mental health and substance use disorders.
- All marketplace insurance plans cannot put yearly or lifetime financial limits on coverage to any type of essential health benefit including services for mental health and substance use disorder.
How to find out if your Insurance pays for Drug and Alcohol Rehab
Most private insurance plans will cover at least a portion of the costs for substance abuse treatment. The U.S. has four major insurance providers that cover treatment care, United Healthcare, Cigna, Blue Cross and Blue Shield and Aetna. There are in-network and out-of-network behavioral health providers to consider when looking for treatment. In-network providers will usually cost less and are more likely to be covered by insurance.
Then, you must be up to date on all your insurance premiums. Premium is the amount the patient will pay either monthly or biannually in order to keep the insurance plan. In some cases, you will also need to reach your annual deductible. The annual deductible is based on your specific insurance plan. Usually, the higher the premium, the lower the annual deductible. To find out the full extent of your insurance benefits and coverage policy for substance addiction, you can always call your insurance provider. Information such as the amount of copay maximum that needs to be reached or how much you have left on your annual deductible can be helpful in figuring out how much your insurance can financially assist with your addiction treatment.
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Other avenues to pay for Rehab
- SAMHSA Grants. The Substance Abuse and Mental Health Services Administration offers block grant programs that directly provide money to rehab centers to help cover the cost of treatment for those who cannot afford it.
- Scholarships. Some treatment centers offer scholarships or provide financing options that allow you to make payments after discharge from the program.
- Financial support from family and friends.
- Private loans and payment plans.
- Federally funded and state-run substance addiction rehabs can also provide assistance for treatment. They can offer both inpatient and outpatient treatment services as well as other supportive addiction services. The programs often have specific requirements to qualify for assistance including proof of residency, documentation of your addiction and you must demonstrate the inability to afford other treatment options.
- Nonprofit treatment centers. There are also many faith based or faith focused treatment programs that incorporate religious elements to help clients overcome their addiction. These programs typically last between 6-12 months. An example of this is the Salvation Army. They have a substance addiction treatment program that requires no payment, but in return, clients are expected to work 40 hours per week at one of the company’s facilities to pay for their housing.
How much does Rehab typically cost?
The cost of rehab for substance abuse and alcohol addiction will depend on many different factors. The level of care needed can dictate the price of treatment. Inpatient treatment programs, which include detox, and residential programs provide 24-hour care and therefore tend to cost more. Outpatient treatments like PHP and IOP are lower levels of care and typically cost less than traditional residential programs.
The type of treatment facility that you choose can also dictate the cost of treatment. Private facilities are more likely to cost more than government-run or non-profit-run treatment programs. The length of time in which you need treatment will also impact the cost. The longer someone stays in treatment, the more money it may cost. Medication-assisted treatments. For some clients, substance use treatment medication is needed to help with the detoxing process or with the overall health of the client during their rehab stay.
Reach out to Hotel California by the Sea
We specialize in treating addiction and other co-occurring disorders, such as PTSD. Our Admissions specialists are available to walk you through the best options for treating your addiction.
Do you need Substance Use Disorder Treatment?
If you have medical health insurance, there is a high chance that you are also covered for substance addiction treatment. The cost of rehab will vary depending on the type of care you need and the level of care you need to help you overcome your addiction. Substance use disorders and alcohol addictions are best treated through a behavioral health treatment program such as Hotel California by the Sea.
We accept most major insurances and provide all levels of care including detox, residential, PHP and IOP. We use effective evidence-proven methods that include CBT, DBT and EMDR therapy. Hotel California by the Sea is dedicated to providing individualized care for all of our clients. We work with clients and their insurance to establish the best course of action as well as the necessary treatments to help our clients in recovery.
References:
https://zinniahealth.com/substance-use/alcohol/inpatient-rehab-insurance
https://www.alcoholrehabguide.org/treatment/insurance-alcohol-addiction
https://www.addictioncenter.com/rehab-questions/affordable-care-act-obamacare
https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage
https://www.addictioncenter.com/rehab-questions/paying-for-treatment