Will My Insurance Cover Addiction Treatment?
Do you happen to be suffering from an addiction? You might be worrying that it’s the end of the line. That you can’t get your old life back anymore. But you should not worry because there is hope for you yet.
You may think of addiction as a crime that will land you a lifetime in prison. But in most cases, it isn’t supposed to be treated as a crime. Rather, addiction is a disease. So, just like any other disease, you need to get treated for it.
Treatment for addiction is widely available today, and you have many choices. These treatments are also comprehensive, meaning they address your entire self. Not just the biological aspects, but the psychological, social, and emotional ones as well.
But as with any treatment for a disease, this would cost money. And you might be concerned that you don’t have enough funds for rehab.
Thankfully, you happen to have health insurance. Then again, you may still be worried that your insurance doesn’t cover this kind of treatment. Addiction is not exactly like many physical diseases, so your fear has some basis.
Plus, addiction rehab is a complex treatment. It has many components, including behavioral therapies, relationship management, housing, medications, skills training, and aftercare treatment. Moreover, rehab can last for months on end. Thus, it may cost a fortune.
So, the question remains: Does my insurance cover this kind of treatment?
You’ll be glad to know that most health insurance policies actually include addiction rehab. Read on to find out more.
Government health insurance usually covers addiction treatment
The Affordable Care Act (ACA) helps people with addictions finance their recovery programs. And because ACA makes health insurance more affordable for many, it has increased access to mental health services like rehab.
The ACA states that drug addiction is not a pre-existing condition. Thus, no one can deny you treatment for it. So, if you’re covered by the ACA, rehab is within your reach. Also, if you’re under Medicaid or Medicare, you are also covered for addiction treatment.
ACA coverage of addiction treatment is comprehensive. It includes things like:
- Evaluation of your specific case
- Medications to curb drug cravings
- Medically-assisted detox
- Visits to the clinic
- Drug tests
- Family counseling
- Home health visits
Some states also have their own health insurance programs. They are different per state, so you should check your state’s specific insurance program to know more. Usually, state insurance plans depend on income, family size, and age.
How about other insurers?
If you have company health insurance or private insurance, addiction treatment is often covered as well. But each policy would differ, so it’s best to check yours first to make sure that you’re adequately covered.
As different insurers have different policies, there is not a simple yes or no answer here. For example, you may be covered for rehab, but there may be exceptions.
For one, medically-assisted detox may not be included. Also, certain types of addiction may not be covered. It could also depend on how long the rehab program lasts. You could even be limited to the insurer’s preferred doctors or rehab centers. In other cases, you may need a referral from your primary care doctor before your insurer pays for your rehab.
What if I already have a particular rehab center in mind?
If you have decided on a rehab center, first make sure that your insurer covers it. Most centers employ people whose job is to find out what your insurer does and does not cover. Talk to them first before enrolling in a program.
It could be that your insurer is partnered with your preferred rehab center, but the policy does not cover certain types of treatment. Again, there is no one-size-fits-all for private insurance, so you really need to do your homework first.
What if I don’t have health insurance yet?
Understandably, private insurance is expensive and not everyone can afford it. Also, some people are not fortunate enough to have employer-subsidized insurance.
If you’re one of those without insurance yet, you can buy an ACA plan. It’s affordable and has extensive coverage, so you don’t have to worry much about getting addiction treatment.
Do you need some extra financial help? If you’re in a low-income category, you can actually get subsidies to lower your premiums.
What if I really cannot get insurance?
Despite the ACA helping millions of US citizens get affordable health insurance, there are still those who just cannot get it. If you’re one of them, don’t despair. You can still find help to turn your life around.
Some nonprofits, charities, and religious organizations offer no-fee rehab programs. If you can’t get insurance and have very little money, these free rehabs are your best bet.
A huge challenge, though, is the limited capacity of these no-fee facilities. Because their budgets are generally smaller and they have fewer staff, many free rehabs admit patients through a long waiting list. If many people had enrolled before you, you could face weeks to months of waiting for treatment.
You might also be concerned if you would get the same quality of care as paid rehab centers. Yes, you would. Free rehabs are also run by professionals in the field of addiction recovery. You’ll receive similar treatments.
More so, you could be pleasantly surprised at how genuinely they care about you – not just your recovery, but you as a person. If you feel truly connected to the professionals helping you, your recovery would be faster and more successful.
After all, human connection is a big factor that ensures recovery. Addiction is a disease of isolation, so the more you form good relationships with others, the less your desire to take drugs.
Suffering from addiction? Get help as soon as you can.
Don’t wait. Get help right away. The earlier you have professional help, the sooner you can get your life together again.