If you`ve been asking yourself whether insurance covers rehabilitation? We`ve got your answers.
If you or someone close to you is suffering from drug or alcohol addiction treatment centers for addiction offer you the best chance at long-term recovery. The staff at Better Addiction Care advise that Like any other medical treatment addiction rehabilitations can be costly, so you`re probably hoping that your insurance policy will cover at least a portion of the costs. The easy answer to the question, “Does insurance cover rehab,” is yes, it will, but the actual answer is a bit more complicated. In 2014, important aspects of the Affordable Care Act (commonly known as “Obamacare”) came into force which affected insurance coverage for substance abuse treatment. Although mental health and coverage for substance abuse are now essential health benefits however, that doesn`t mean your insurance will cover treatments you require. It`s essential to know the specifics of your insurance policy will cover prior to you go into rehab so you don`t end up with medical bills that you can`t afford.
Certain factors can impact your rehab plan
If you`ve purchased your insurance via one of the ACA marketplaces and you are a member of the ACA marketplace, then you have insurance for health that covers the use of drugs. There are numerous factors that influence how complete your coverage is and how much you have to cover treatment for substance dependence. The location you live in and the kind of health insurance that you have will determine the amount of rehab coverage you will receive. Different plans can differ in many ways, such as the following:
Relapses
In 2014, insurance companies were able to not pay for treatment for existing conditions. A number of insurance companies applied this policy to alcohol and drugs treatment by determining that people who had had therapy or counseling for substance abuse previously and was having a relapse fell under the existing statute. It`s not the case anymore; even if you are having a relapse following recent treatment, your treatment can be covered, provided that you are within other guidelines regarding treatment protection.
The guidelines for addiction treatment insurance coverage contain strict guidelines on the days and visits covered. If you have recently attended rehab, you may already have reached the maximum amount of mental health or treatment for substance abuse and have ended your coverage for this year.
Co-pays and deductibles
The insurance policy for addiction treatment that you are covered by will have an annual deductible and an out-of pocket amount to be paid prior to the insurance company paying for treatment. If you have a high deductible, the addiction treatment center may allow you to set up a payment plan that will cover the cost.
Outpatient Vs. Inpatient care
Addiction treatment insurance typically allows for a combination of outpatient and inpatient therapy. Both types of therapy work with inpatient rehabilitation, however it allows the patient to concentrate on your recovery. Inpatient rehabilitation can be more expensive due to the need for 24/7 assistance and intensive therapy within a residential setting. Because the outpatient experience is personal and customizable to meet your needs and budget.
Management of care
There is a possibility that you`ll have to go through a Pre-Authorization procedure based on your insurance coverage before you can be approved for rehab. The lengthy approval process could require answers about diagnosis and treatment. It may also include peer-to–peer reviews. Insurance companies may also make it clear that you are only able to get treatment from doctors who are part of the network.
Types of therapies
Insurance plans can have specific rules regarding the types of treatments they pay for. Most insurance companies insist on the use of evidence-based therapies like the behavioral therapy. If the addiction treatment center you select relies on holistic therapies like Acupuncture and does not have an established track record of helping to overcome addiction, your insurance provider might not be able to cover the costs.
Options to pay yourself
Do not fret if your insurance company doesn`t cover the rehab you choose. There are numerous recognized addiction rehabilitation centers. You should be able find one that provides the kind of treatment that gives you the greatest chance of recovery . They will also help you to ensure that you can self-pay for any amount of treatment the insurance doesn`t cover.