Does Insurance Cover Rehab?
Addiction rehab centers offer the best chance for long-term healing for those who are suffering from addiction to alcohol or drugs addiction. The staff at Better Addiction Care advise that Addiction treatment is costly and so is medical treatment. You`re probably hoping that your insurance policy will cover least a part of the cost. Although the obvious answer to the question “Does insurance cover rehab?” is yes, the real answer is complicated. In 2014, major aspects of the Affordable Care Act (commonly known as “Obamacare”) became active that affected insurance coverage for substance abuse treatment. The mental health and substance abuse coverage is now considered essential health benefits. However, this doesn`t mean that your insurance company will pay for treatment that will give you the greatest chance of recovery. Before you go to rehab, it is important to find out the specifics of your insurance plan. This will help ensure that you don`t end up with unaffordable medical expenses.
The factors that can affect the rehab coverage you receive
You can obtain the insurance for substance abuse when you have insurance through an ACA marketplace. There are many variables which determine how comprehensive your coverage is , as well as how much you`ll have to spend on treatment for addiction. The specific coverage you receive for rehab will be determined by the state that you live in and the health plan you choose. The different plans differ in a variety of ways, including the following:
Relapses
In 2014, insurance companies were able to deny paying for treatment for existing conditions. This rule was applied to treatment for drug and alcohol abuse. Many insurance companies determined that anyone who had received therapy or counseling for addiction in their past, who was currently experiencing the effects of a relapse fell within the law that was in place prior to. However, this isn`t the case right now. If you`ve experienced an relapse following treatment, you might be eligible for insurance.
The insurance for addiction treatment has strict guidelines for how many days of treatment are covered and also the number of visits. If you have recently attended rehabilitation, it is possible that you have already met your maximum number of mental health / addiction treatment visits and ended your coverage for this year.
Co-pays and deductibles
The addiction treatment insurance plan has an annual deductible as well as an out-of-pocket amount that must be met prior to the insurance company paying for care. The addiction treatment center might be able to assist you set up a payment plan for those with a high-deductible.
Inpatient Vs. outpatient care
Insurance coverage for addiction treatment generally includes both outpatient and inpatient therapy. Both types of therapy work and inpatient rehab permits you to concentrate on your recovery. Inpatient rehab is more expensive because it requires 24 hour care and intensive therapy in a residential setting. Outpatient treatment is individualized so it can be more adaptable to your particular requirements and budget.
Management of care
It is possible that you will have undergo a pre-authorization procedure based on your insurance coverage before you can be approved for admission to treatment. This can be a lengthy procedure that the facility will have to be involved with, as the lengthy approval process requires answers about the diagnosis and treatment, and could involve a peer-to -peer review. You might be able to only be treated by physicians who are members of the insurance network.
Different types of therapies
Certain insurance plans are strict about the kind of treatment they are willing to pay for. Most insist on evidence-based treatments such as counseling. If the addiction treatment center you select relies on holistic therapies like Acupuncture that does not have a a proven track record for treating addiction, the insurance company will not cover the expense.
Options to pay yourself
Do not fret if your insurance company won`t cover the center you pick. There are numerous accredited addiction rehabilitation centers from to pick. You should be able to locate one that will provide the services that give you the best chance to recovery , and will work with you so you can self-pay for the treatment your insurance does not cover.
