Last updated on May 29th, 2019 at 10:08 am
A common worry for substance abusers seeking addiction treatment services for themselves or their loved one is whether or not insurance will cover the costs of their drug or alcohol addiction treatment. Due to the complexities of health insurance, the answer is always a variable, but most health insurance providers have some level of rehab coverage in their plans.
Successful addiction recovery often depends on consistent, specialized, guided rehab treatment, so it’s a very reasonable thing for addiction sufferers to worry about. Unfortunately, it depends entirely on your insurance provider and coverage plan. You may be eligible for partial coverage or full coverage for drug addiction and alcoholism treatment but only for certain types of treatment programs.
We can help you make sense of your insurance plan that way you know what to expect when seeking rehab treatment, plus we can help match you with a rehab center that’s in your insurance network.
Step 1: Review Your Insurance Coverage for Drug and Alcohol Treatment
Contacting your insurance company directly is often a good place to start, that way you can get information directly from the source. Before you call, make sure you have a list of questions prepared so you know what information you need answers to. The nuances of insurance coverage can be confusing and overwhelming, so the list will also help keep you keep your thoughts focused while you take down notes about your policy details.
Here are some sample questions that should give you a starting point for finding out more about your coverage.
- Does my insurance cover every phase of drug or alcohol rehab (detox, inpatient and aftercare)? If not, what phases are covered and for what durations?
- Will my policy cover any of the medications prescribed to me during drug and alcohol rehab?
- Does my policy cover the different types of counseling programs and therapies that are often included in substance abuse rehab treatment programs?
- What will my copay and/or deductible be if I choose to seek treatment for addiction?
- What rehab treatment programs are covered by my current policy?
- Does my policy require me to seek rehab treatment within a provider network? (If so, it may be a good idea to get a list of treatment centers that are commonly covered, if possible.)
What Types Of Drug And Alcohol Treatment Are Covered With Insurance?
While the answer is once again greatly dependent on your insurance policy and health insurance company, most plans cover some of the basic treatment programs. Detoxification is the most likely to be covered by your insurance, in part because detox and withdrawal symptoms can be fatal if the process isn’t monitored closely by trained medical professionals. Inpatient and outpatient treatment coverage is more varied, although the typical durations covered are 30, 60, and 90 days. Sometimes these treatments are only partially covered by insurance, rather than fully covered.
Insurance Policies: HMOs vs PPOs
Do you have an HMO or PPO health insurance policy? Understanding the differences between the two will help give you a better idea of whether an addiction treatment center will accept your insurance.
An HMO gives you access to certain healthcare providers and hospitals within the insurance network. Networks are made up of healthcare providers that have agreed to lower their rates for HMO plan members as part of an agreement with the insurance company. Unlike PPO plans, care under an HMO plan is covered only if you see a provider within that HMO’s network. There are few opportunities to see non-network providers, which can limit treatment options at times. There are also typically more restrictions on policy coverage than other plans, such as allowing only a certain number of visits to facilities, limiting tests, or recurring treatments.
A PPO plan provide more flexibility when decided where to receive healthcare services, compared to an HMO. These programs also feature a network of providers, but there are fewer restrictions in regards to seeking treatment outside of your network. In addition, your PPO insurance will still covery a non-network provider, although it may be at a lower rate than if you received treatment in network.
Work with an Insurance Coverage Professional
Navigating complex insurance policies on your own can be really difficult. You may find that speaking to your insurer directly leaves you with more questions than answers, even if you try to prepare as much as you can. In these situations, you and your family may be better off reaching out for extra support rather than making a decision with limited, possibly conflicting information.
Our team of addiction professionals offer over a decade of experience with addiction treatment and finding rehab options, such as inpatient or outpatient treatment programs, for substance abusers all over the country. We’re happy to help people find the treatment they need to regain control over their lives and we’ve worked with a variety of providers, including:
Our service specialists are well versed in helping families find the best treatment options for their loved ones and guiding individuals seeking addiction recovery into effective rehab programs without breaking the bank.
Consider Drug and Alcohol Addiction Treatment Without Insurance
If your insurance plan doesn’t cover rehab treatment, don’t give up hope. There are still options available that can help you cover the cost of treatment even if your provider won’t cover the plan you need. Many treatment centers offer affordable payment plans for patients who need help but lack insurance coverage for drug and alcohol recovery treatment. Some centers even offer financial assistance in extreme situations where patients need immediate help and care.
You may have to do some searching in order to find a solution that helps you cover rehab expenses, but opportunities for getting help covering rehab treatment are certainly available. Consider working with an industry expert to help you find new ways to save money on the addiction recovery treatment you or your loved one needs. Just because your insurance provider can’t help you doesn’t mean you’re stuck paying out of pocket expenses all on your own.
Let Us Help You Find a Rehab Center Today
Don’t let confusing insurance policies stop you from asking your provider for clear answers about your coverage details. While this is easier said than done, knowing what to ask and how to ask the big questions is much easier when you have an industry expert guiding you through the process.
We’re dedicated to helping people just like you make informed decisions about alcohol or drug rehabilitation and treatment options. Out services specialists are available 24/7, so give us a call if you’re ready to learn more about your insurance policy and find a rehab center.