The Substance Abuse and Mental Health Services Administration says the costs of mental health and substance abuse will rise to more than $280 billion in 2020.
But with so much information to sift through, it can be very difficult to find the best insurance company for your needs.
To help with that, we cover the following main types of rehab insurance so you can learn what to look for in your insurance company.
Drug or Alcohol Addiction
If you’re struggling to overcome drug or alcohol addiction, talk to insurance providers, social workers, staff at rehabilitation centers, and your loved ones to put together a plan to pay for substance abuse rehab with insurance and by other means.
Substance Abuse Treatment
If you meet your state’s guidelines for receiving Medicaid, you can ask an intake worker about covering substance abuse treatment and how much the program can offset your out-of-pocket costs. If you have Medicaid insurance, you can be treated at any provider that accepts payments from the program.
What Will Your Insurance Need To Cover?
Drug rehabilitation costs vary, but each plan is different and may only cover a portion of the amount. This process is detailed below.
Before starting treatment, the patient must detoxify the body from the substance in question.
Wait times can be very dangerous for some drugs, so detoxification is usually done in hospitals.
Treatment is usually done in an outpatient or hospital setting. For outpatient care, I drive to the hospital several times a week and then go home.
Inpatient programs include stays in treatment facilities. Costs can be as low as $1000 or as high as $25,000 depending on where you live and the type of care you receive.
Most insurance companies cover outpatient care but manage inpatients separately.
Some patients may require prescribed medications during treatment. Because these drugs help deal with withdrawal times and drug cravings.
Insurance companies usually refer to these drugs as pharmacotherapy, but some plans do not cover the cost of the drugs.
Which Type Of Insurance Is Best?
Finding the best insurance company for you will ensure you get the best addiction treatment.
Insurance is usually divided into two main types: private and public.
You or your employer have private insurance. Most or all of the costs must be paid.
The government provides public insurance so government funds can cover all or part of your medical bills.
In terms of coverage, most private or public insurance plans provide core mandatory medical benefits as defined in the Affordable Care Act.
These cover mental health, treatment for substance use disorders and prescription drugs.
Below we discuss the pros and cons of both types of health insurance.
Private insurance can be purchased by yourself or through a group plan like your employer.
These are usually more expensive than statutory health insurance, but often offer better quality insurance depending on the price.
Does Obamacare Cover Drug And Alcohol Rehab?
Obamacare isn’t a health insurance option, but it did make it easier to get insurance coverage for drug and alcohol rehab services. Obamacare, or the Affordable Care Act of 2010, is legislation that created new regulations for the health insurance marketplace. One of the areas the act focuses on is mental and behavioral healthcare coverage.
Under the ACA, drug addiction is not considered a pre-existing condition and treatment for it cannot be denied. For people covered under Medicaid and Medicare, the ACA also offers funding and treatment options for drug or alcohol addiction.
Health Insurance Coverage
Now, by partnering with Blue Cross Blue Shield , we are able to help more people than ever before! You now have access to our state-of-the-art recovery and treatment facilities if you have health insurance coverage through Blue Cross Blue Shield. No matter what substance addiction you may be suffering from, don’t go it alone.
Home Paying For Drug Rehab Treatment Cigna Coverage for Drug and Health insurance firms have developed an understanding that addiction is a treatable condition.
What Does It Cover?
The Affordable Care Act says all individual and small group plans must include substantial health benefits.
However, insurance plans created before March 23, 2010, known as Grandfathered Health Plans, do not have to.
My grandparents lack health insurance, but can find it on group insurance plans.
The largest US health insurers are Anthem, Aetna, Humana and Cigna. All of these groups have different types of insurance plans.
Many insurance plans work with specific providers within a network, also known as managed care. There are mainly his three types of managed care plans.
Back to top Private Health Insurance for Rehab Costs Private health insurance covers a long list of health conditions in exchange for a monthly premium, which may be high or low, depending on your location and health habits.
Health maintenance organization (HMO) plans
In addition, HMOs are available to doctors and hospitals from one network whose rates for members are reduced. Care for an HMO plan can only be arranged through an approved medical provider.
Point of Service (POS) plans
A member pays more when utilizing providers from their plans network. Patients also need a referral from a doctor who carries out routine procedures with a specialist on the site.
Exclusive provider organization (EPO) plans
Service is only covered if the provider uses the provider’s network (otherwise during emergency situations). The most efficient kind of plan depends on individual circumstances.
Preferred provider organization (PPO) plans
This allows more freedom in the way of access to other providers. PPO plans can cover the cost if you are not using network services.
Point Of Service
This means you can choose a PPO or an HMO every time you need care. This is the most adaptable example.
Every insurance plan that is sold will encompass basic coverage for each health care category, but each plan will differ as to how much coverage they pay and their particular premium.
Private insurance plans usually come in four kinds, bronze, silver, gold, and platinum.
Bronze plans have the lowest premiums every month, but they only tend to pay for around 60% of the necessary costs.
Silver plans have higher premiums every month, but these pay around 70% off the treatment costs.
Gold plans have greater monthly premiums than silver, but these cover around 80% of the necessary costs.
Platinum plans will have the greatest monthly premiums and can pay for around 90% of the treatment costs.
Medicaid is an insurance funded by government funds.
This will allow low-income households to access health care. The level of income required to access Medicaid coverage depends on how states define poverty.
The coverage usually includes:
- Outpatient and inpatient hospital services
- Mental health facilities, which also cover substance disorder treatment
- Physician assistance
- Home health assistance
- Medical transportation facilities
Medicaid won’t work for most people as the majority of US citizens won’t qualify for receiving Medicaid in the first place.
Another factor is that a lot of quality treatment providers won’t accept Medicaid funding, which would reduce your number of provider options again.
The Bottom Line: Which Insurance Is Best?
The best insurance for you may not be able to help someone else in the same way.
However, people with chronic conditions such as substance abuse may choose a more advanced plan that covers most of the costs.
Insurance companies cannot deny health coverage if you had a pre-existing medical condition before joining the plan.
Before you sign a contract, think about how much you can afford each month, which insurance policy is best for you, and which provider you prefer.