If you`ve ever wondered: does insurance cover rehabilitation? We`ve got you covered.
If you or someone you love has been struggling with alcohol or drug addiction treatment centers for addiction offer you the best chance for long-term recovery. The staff at Better Addiction Care advise that Like any other medical treatment addiction rehabilitations can be costly, so you`re probably hoping your insurance company will take care of at least a little of the cost. The easy answer to the question, “Does insurance cover rehab,” is yes, it does, but the practical answer is a little more complex. The Affordable Care Act, also called Obamacare was enacted in 2014. It contained key clauses that changed insurance coverage for substance treatment for abuse. Substance abuse and mental health coverage are now considered important health benefits, but there is no guarantee that your insurance will pay for treatment that gives you the most chance of recovery. It`s essential to determine the specifics of your insurance policy covers before you start rehab, so that you do not end up with medical bills that you can`t afford.
Things that could affect your rehab insurance
You can purchase coverage for substance abuse if you are insured through an ACA marketplace. There are numerous factors that affect how comprehensive your coverage is and how much you have to pay for treatment for addiction. The location you live in and the type of health insurance you have will affect your rehab coverage. Different plans will vary on a number of levels, including the following:
Relapses
Insurance companies could deny payment for treatment for preexisting conditions prior to 2014. This rule was applied to treatment for alcohol and drug abuse. Many insurance companies determined that any person who received therapy or counseling for substance abuse in the past, and who is currently experiencing the effects of a relapse fell within the existing statute. That doesn`t apply now however, even if you`re suffering a relapse from treatments in the past, your treatment may be covered, provided that you meet certain guidelines for treatment coverage.
The insurance for addiction treatment has strict guidelines for how many days of treatment are covered, and also the number of visits. If you`ve recently been to rehab, you may already have completed your maximum number of mental health / substance abuse visits and ended your coverage for this year.
Co-pays and deductibles
The addiction treatment insurance plan has the yearly deductible as well as the out-of-pocket amount that must be met before the insurance will pay for the treatment. If you are a victim of a high deductible, the addiction treatment center might allow you to set up the payment plan you need to pay your costs.
Outpatient vs. Inpatient care
The insurance for addiction treatment usually provides for a combination of outpatient and inpatient therapy. Although both forms of therapy can be effective, inpatient rehab provides an opportunity to focus more on rehabilitation. Inpatient rehab is significantly more expensivebecause it is a 24-hour program that requires intensive therapy in a residential setting. Because the outpatient experience is personal and customized to meet your needs and budget.
Management of care
Based on the coverage of your insurance you are covered by, you could be required to complete an authorization process prior to receiving permission to begin rehabilitation. It is a lengthy process that the treatment center will be required to participate in since the rigorous approval process requires answers about the treatment and diagnosis, and may be accompanied by a peer-to peer review. Insurance companies may also require that you receive treatment from doctors that are in the network.
Therapies that are available
Insurance plans could have specific guidelines for the treatments they will pay for. They generally prefer evidence-based therapies like counseling. The insurance company might not cover the costs if the rehabilitation center you select relies on holistic treatments such as Acupuncture, which has not been proven effective in treating addiction.
Self-pay options
If your insurance company will not cover rehabilitation at the center for addiction you pick, don`t worry. There are many accredited addiction rehab centers from which to choose. It should not be a challenge to locate a facility that can provide the most effective treatment and will aid you in helping to pay for the costs your insurance doesn`t cover.