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Does Health Insurance Cover Drug And Alcohol Rehab?

a doctor and patient discuss drug rehab insurance coverage

Don’t let the cost of care stop you from taking control of your life. That’s why we’re here. At Vertava Health, we want to help you begin thinking optimistically about a better future, teach you how it’s possible, and support you while we help you make it happen. Many health insurances offer coverage for addiction treatment, and yours might be one of them. If not, enrolling in a new plan will provide you with low payments toward your lifelong recovery. Drug rehab insurance coverage can be overwhelming, but it doesn’t have to be. When you reach out to Vertava Health Texas at 844.311.8395, we encourage you to ask any questions you have about paying for treatment or the treatment process.

Worrying About Drug Rehab Insurance Coverage Can Be Very Overwhelming

A person struggling with an addiction is already overwhelmed on many levels. Many people caught in the darkness of an addiction might already have a sizable amount of debt or financial turmoil. When a person is addicted to drugs or alcohol, it is common to let critical responsibilities slip away, including paying bills and going to work. If you’ve struggled with this, you might wonder how you could even consider committing to something that costs more money.

It would be best if you considered the cost of drug rehab insurance coverage versus the cost of the addiction were it to continue untreated. Addiction carries a significant financial burden that, if left untreated, will only continue to accrue. Drugs or alcohol being used costs money. The impact of the addiction may result in challenges such as:

  • Decreased productivity or performance at work
  • Criminal or legal fines
  • Late fees due to missed or late payments
  • Medical bills resulting from the health concerns associated with the addiction.

By investing in a treatment program, you are investing in your life. You will be allowing yourself a chance to obtain sobriety and valuable skills that can help you conquer these things and get back on your feet to lead a happier and more stable life. With everything on your plate, considering things like finances may be too much of a task for you to contend with on your own. It can be beneficial for a loved one or friend to step in and help you navigate the information and choices that revolve around this critical decision. Additionally, we’re standing by with an informed and compassionate staff that can help you to figure out how to make treatment happen for you and if and how your insurance can help you get there.

Choosing The Best Facility Could Help You Save Money in the Long Run

Choosing a facility that is not accredited correctly or one that does not have the expertise, insights, offerings, and compassion crucial for success may set you up for failure or relapse down the road. For all of these reasons, choosing a facility such as ours can make a huge difference. To help you make this possible, we accept a variety of major out-of-network, preferred provider organization (PPO) insurance plans.

Things to Consider When You’re Determining If You’ve Got Coverage

Fortunately, in many circumstances, a person seeking rehab will not have to pay for the entirety of the cost. Obtaining assistance through your insurance is one of the ways to do this. Unfortunately, some insurance companies do not offer coverage for drug or alcohol addiction treatments, but on the other hand, most do. Coverage varies from policy to policy.

The first step to receiving this help is asking, Contact an insurance agent or reach out to us, so we can help you figure out if this is an option for you. Determining what your insurance covers might seem like a tricky thing. You may have to spend some time digging into the specifications of your plan, but it will be worth it so that you can fully understand the extent and portion of treatment your provider covers. Insurance coverage for drug and alcohol rehab and detox often has certain stipulations about the form and duration of treatment that they cover. When you’re looking for these parameters within your insurance plan, things to consider are:

  • Will they deny coverage if you’ve been in rehab before?
  • Do they cover detoxification treatment support?
  • How does the coverage change due to the length or type of treatment?
  • Does the coverage change due to the type of addiction?
  • Does your coverage specify that you have to use certain facilities or doctors within their network?
  • Am I responsible for a cost-sharing amount?

Can Drug Rehab Insurance Coverage Be Denied?

If you’ve been to rehab before and either did not find sobriety or relapsed afterward and now need to return, some insurance companies may consider this a preexisting condition. As a result, they may deny you coverage.

It might seem tedious and cumbersome, but taking the time to read the fine print and specific details within your plan can pay off in the long run. Don’t hesitate to ask us or your insurance company questions. The smallest questions and their answers might end up making a big difference. Putting all this time into the process might be frustrating. However, remember, if you put the time in, you’re one step closer to getting results and having a chance to change your life. Addiction is a disease that can also cause mental health problems. With this potential, your insurance may cover some portion of your treatment under the mental health categories.

Again, some coverage might be very specific. For instance, it might cover things related to mental health concerns only, like therapy but not detox. Alternatively, it might only cover outpatient treatment with a limited number of treatment days. Every plan is different, so it is well worth determining what you can get covered as you proceed toward invaluable sobriety.

Does The Affordable Care Act (Obamacare) Cover Rehab?

In 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) went into effect. It requires health insurers and group health plans to provide the same benefits for mental and substance use treatment and services that they do for medical and surgical care. In addition, the Affordable Care Act further expands the MHPAEA’s requirements. It ensures that qualified plans on Health Insurance Marketplace cover many behavioral health treatments and services.

With the advent of the Affordable Care Act (ACA) came more accessible coverage and access for those who suffered from substance use disorders. The only exception is those plans that were grandfathered in, specifically plans that were purchased on or before March 23, 2010. These plans may deny you coverage based on what they consider a preexisting condition.

 For those who have plans purchased later, specifically those plans beginning on or after January 1, 2014, the ACA includes substance use disorders as one of the ten parts of essential health benefits. As such, all health insurance sold on Health Insurance Exchanges or provided by Medicaid to newly eligible adults starting in 2014 must include treatments for substance use disorders. We can help you determine how the coverage you purchased on the Marketplace can finance your treatment and get you to a place of health and recovery sooner.

What Else Should You Consider When Looking for Treatment?

You might also want to consider other financing options as you look into treatment. For instance, many people use personal savings or help from friends and family members to help finance their treatment. Additionally, some facilities offer sliding-scale fees based on income and other considerations. Some employers also offer employee assistance programs (EAPs). These can be a valuable resource, particularly if you need help but are worried about how it will affect your job.

Finally, consider what type of treatment you need. Inpatient treatment, which requires you to stay at the facility for a set period, tends to be more expensive than outpatient treatment. However, it also offers around-the-clock access to care, which can be invaluable during early recovery. You may also require a combination of evidence-based and holistic therapy options. For instance, many people benefit from treatments such as:

  • Cognitive-behavioral therapy (CBT)
  • Dialectical behavioral therapy (DBT)
  • Family therapy
  • Equine-assisted therapy
  • Adventure and nature therapy

If you have questions about what drug rehab health insurance can and cannot cover or about how to finance your treatment, please reach out to Vertava Health Texas. We are here to help you get the treatment you need and deserve.

Get The Facts and Call Vertava Health Texas Today

In any aspect of life, finances and insurance can be intimidating to handle without proper education or the facts. This especially holds true for a person who is struggling with an addiction. That’s why we’re here. Vertava Health Texas can help you begin the necessary financial process to obtain the caliber of treatment we offer. Don’t let the finances deter you any longer. Call us today so that our caring and highly-trained staff can help you take the first step in the right direction.