Best Insurance For Rehab

The Substance Abuse and Mental Health Services Administration declared that the costs for mental health and substance abuse rose to over $280 billion in 2020.

Obtaining help for addiction can be expensive, but a good insurance provider can help you cover some of the treatment costs. 

Best Insurance For Rehab

However, as there’s so much information to sift through, finding the best insurance provider for your needs can be a very difficult process. 

To help you along the way, we’ll cover the main types of rehab insurance below so you can learn what you need to look for in an insurance provider. 

What Will Your Insurance Need To Cover? 

Drug rehabilitation involves a variety of costs, but every plan is different, so some may only cover a partial amount. We’ll cover the process in more detail below.

Detoxification

Before the treatment can begin, the patient will need to detox their body from the substance in question.

Some drugs can have very unsafe withdrawal periods, which is why detoxification usually occurs within a hospital.

Treatment

Treatment is usually available as either outpatient or inpatient care. Outpatient care involves traveling to a doctor a few times a week, then returning home.

Inpatient programs involve a stay within a treatment facility. The costs can be as low as $1000 or as high as $25,000 depending on where you stay and the type of care you receive.

The majority of insurance plans cover outpatient treatment but manage inpatient stays separately. 

Medicine

Some patients may need prescribed medication during their treatment, as this can help them cope with the withdrawal period and drug cravings.

Insurance providers tend to refer to these medications as pharmacotherapy, though some plans aren’t guaranteed to cover medication costs. 

Which Type Of Insurance Is Best?

Which Type Of Insurance Is Best?

Obtaining the best insurance provider for you can make sure you obtain the best addiction treatment.

Insurance is usually separated into two main kinds, private and public.

Private insurance is bought by you or your employer. You will need to pay most or all of the costs.

Public insurance is offered by the government, so government funds may fully or partially cover treatment costs.

Coverage-wise, most plans in private or public insurance providers will offer the main essential health benefits defined by the Affordable Care Act.

These cover mental health, substance disorder treatment, and prescription medication. 

We’ll cover the advantages and disadvantages of both types of health insurance below. 

Private Insurance

You can purchase private insurance yourself or with a group plan, like what your employer would pay for.

These are usually more expensive than public health insurance, but they’ll often have higher quality insurance coverage depending on the price.

What Does It Cover?

The Affordable Care Act states that every individual and small group plan needs to include essential health benefits.

Despite this, insurance plans made before March 23, 2010, known as grandfathered health plans, won’t need to do this. 

Grandfathered health plans are in short supply, but you might find them in group insurance plans. 

The largest health insurance companies in the United States are Anthem, Aetna, Humana, and Cigna. All of these groups will have various types of insurance plans. 

A lot of insurance plans work with specific health care providers inside a network, also known as managed care. There are three main kinds of managed care plans:

HMOs 

(Health Maintenance Organizations) tend to specifically cover care from in-network providers, which is why they’re usually more affordable.

PPOs 

(Preferred Provider Organizations) concentrate on in-network providers, though they may need to include some out-of-network provider costs.

If you choose to work with an out-of-network healthcare provider, you might need to pay the costs right there, then ask your insurance company for reimbursement later.

Point Of Service 

This means you can choose a PPO or an HMO every time you need care. This is the most adaptable example. 

Premium Plans 

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. 

Remember that not all insurance providers will have four levels to choose from. The end choice will depend on the insured person’s circumstances. 

Public Insurance

Medicaid is insurance that is paid for by government funds.

This allows lower-income households to access healthcare. The income level that is required to access Medicaid coverage will depend on how your state defines poverty. 

What Does It Cover?

Medicaid needs to cover the same essential health benefits outlined by the Affordable Care Act.

Despite this, Medicaid differs from state to state, so the coverage you receive and its extent might vary. 

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 help another person in the same way.

For example, someone who doesn’t have a lot of medical needs may choose a Bronze plan.

However, someone who lives with a chronic condition, like substance abuse, may decide to go for a higher level plan that covers more of their costs. 

Remember that insurance providers will not be able to deny you health coverage if you have had a pre-existing condition before signing up for the plan. 

Before you sign, think about how much you can afford to pay each month, what coverage would be best for you, and the possible treatment providers you’d prefer to use.

Ryan Ascroft