4 Steps to Discovering How Much Your Insurance covers

One of the biggest problems facing individuals who’ve developed an addiction is the expense associated with treatment. Like other medical services, detox and rehabilitation can cost thousands of dollars. Most health insurance provides addiction coverage, but you’ll likely have to pay a portion of the bill out-of-pocket. That’s why it pays to know how much coverage you can expect.

If you’ve developed an addiction, professional substance abuse treatment is the best way to recover and avoid a relapse. According to the National Institute of Drug Abuse, successful treatment options include medication, behavioral counseling, and applications to aid in the withdrawal process. These all require the assistance of a medical professional in a rehab facility.

Entering a treatment center isn’t an easy thing to do. If you’re in this position, you’re probably under a lot of stress and worried about the potential bills you’ll have to pay. However, if you have insurance, some of your treatment should be covered. You just need to figure out how much. Keep reading to learn some crucial steps in determining your addiction coverage.

Understand How Addiction Coverage Works

It helps to understand how alcohol or drug addiction works within the insurance industry. This will help give you an idea of what to expect once you enter a facility and receive treatment. For the most part, addiction coverage is very similar to coverage for other health issues. However, there are some minor differences and things you should know.

All insurance plans within the Health Insurance Marketplace must cover substance abuse services according to HealthCare.gov. If private insurance plans want to be sold in the marketplace, they must cover addiction treatment as well. However, they don’t have to if they aren’t included in the marketplace.

Furthermore, insurance policies that provide addiction coverage do so without applying conditions. For example, they provide coverage for addiction treatment regardless of what drug you’re addicted to and how you became addicted. This means that your provider won’t look at the details of your addiction to determine the amount of coverage you receive. This is determined by your plan.

It’s also important to understand that the majority of states require group health insurers to provide addiction coverage just like they would other illnesses.

Determine What Level of Treatment You Need

The type of addiction coverage you receive from your insurance provider has everything to do with your plan and the type of treatment you require. It’s important you participate in a treatment plan that’s best for your level of addiction.

You also need to consider that your insurance policy may not cover every type of medication needed during your recovery. These medications are typically given to clients who need help detoxing and dealing with severe withdrawal symptoms.

Before you enter a treatment facility, you need to have a meeting with a substance abuse specialist to determine which recovery approach is right for you. Possible treatment plans could include:

  • Inpatient treatment programs
  • Outpatient treatment programs
  • Inpatient detox
  • Substance abuse counseling

If you’re suffering from addiction to opioids or heroin, you may need to take part in a maintenance program. These help individuals who need additional assistance to function without the drug. They typically utilize prescription medications such as Suboxone to help patients overcome their dependence.

Consider your options carefully and come up with a treatment plan.

Consult With Your Insurance Provider

Once you’ve determined what type of rehabilitation you require, you can speak with your insurance provider to determine your level of coverage. You could also check the details of your policy yourself, however, this can be confusing. For a more concrete idea of your addiction coverage, it’s better to call your provider directly.

Remember, your particular plan determines the level of coverage you have. Your provider can tell you how they’ll cover different types of treatment. They can also help you determine what medications they’ll cover if you need prescription assistance during the detox stage of your recovery. Make sure you write all this information down to reference in the future.

You also need to ask about inpatient coverage and ongoing treatment. An inpatient program can last anywhere from 30, 60 to 90 days. You need to know how much of this will be covered. If you’ve opted for outpatient treatment, ask your provider how they handle this. You’ll also need to inquire about ongoing treatment coverage for after you’ve finished your program.

Covering all your bases is important during this step. Make sure you understand your deductible along with all policy conditions so you don’t end up with unexpected bills after your treatment has ended.

Seek Assistance From a Treatment Center

You may get all the answers you need regarding addiction coverage from your insurance provider. If you don’t, most rehab facilities have staff on hand who specialize in these matters. They can sit down with you before your treatment begins and go over your policy and what you can expect.

Even if you understand your policy coverage, it’s a good idea to consult with the treatment center anyway. They deal with these types of issues on a regular basis and may be able to provide additional insight into your coverage. You may also get some information on how you can save money on your bill.

If your insurance only covers a small portion of your care, a representative of the treatment center can go over payment options so you know what to expect. Keep in mind that your recovery is the most important thing right now. Worrying about financial issues will only make the process more difficult.

Start Your Road to Recovery Today

Deciding to seek substance abuse treatment is a huge step. Although it may be daunting to think about medical bills at this crucial time, it’s important you understand what kind of help you can expect from your insurance provider. Use the steps discussed above to help you determine your addiction coverage.

We can connect you to a wide range of substance abuse treatment services. Let us help you take the first step toward recovery.

Resources:

https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/