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Insurance Coverage for Rehab

Insurance can cover the cost associated with inpatient and outpatient addiction treatment.

One of the main concerns many people face after the decision to go into rehab is how the cost for the treatment will be covered. Paying or rehab might be a distressing thought, especially if your financial situation is not the best one. Many people are unsure about insurance coverage for rehab and feel worried that this could be an obstacle in the recovery process.

First of all, we need to recognize that addictions are expensive, and in the long run the money spent in sustaining dependence—especially substance dependence—is of a much greater quantity than the money that might be spent by paying for rehab. Ultimately, finding a way to cover the expenses of addiction treatment benefits both the health and the finances of the addict.

Insurance Coverage and Related Concerns

Modern insurance firms have come to realize that coverage for both inpatient and outpatient rehab treatment for addiction is a necessity, recognizing that it is a medical problem that needs prompt attention. The fact that the ongoing adverse effects of an untreated addiction could mean higher expenses for the insurance company has begun to change the way rehab is covered. On the other hand, addiction is sometimes considered as an incurable disease with relapses being a high possibility, which makes insurance policies on this matter more complex.

Another factor to consider is the type of rehabilitation program needed. Detoxification is necessary when an addict becomes physically dependent and the body needs constant doses to function normally; medical supervision is recommended in this part of the process. The coverage may also vary depending if the treatment is of an inpatient or outpatient nature. Co-payment is sometimes a requisite in outpatient treatment coverage with every visit to the treatment center.

You can always call your insurance provider and inquire about insurance coverage for rehab. However, these calls can often be confusing and emotionally draining. Because rehab programs are often covered under different insurance plans and policies, the rehab you choose may or may not be covered under your plan. Fortunately, our helpline works with a wide network of rehab companies to help callers find a rehab program that fits both their needs and their insurance coverage.

Healthcare and the Parity Law for Rehab

In 2008, a federal law regarding healthcare was passed under the name of Mental Health Parity and Addiction Equity Act. This law gives Americans the opportunity to benefit from substance abuse treatment with a better insurance coverage for rehab. Basically, the parity law for rehab involves these three concepts:

  • Benefits must be equal – This means that mental health coverage (including substance abuse) must be equal or superior to physical health coverage, recognizing drug addiction as a medical condition.
  • Limitations must be equal – Limitations and restrictions must not be stricter for substance abuse and mental health than those for physical health.
  • Cost-sharing must be equal – Deductibles and other out-of-pocket costs should not be higher or any different in the case of substance abuse and mental health disorders.

We need to mention, however, that the parity law has some limitations and does not apply to every single health insurance plan. For example, the act only applies to health plans with more than 50 employees and does not cover the individual insurance market.

Regarding the diagnoses included in the act, it includes any kind of mental disorder diagnosis including substance addiction at parity (same coverage) with physical health issues. Still, coverage and benefits remain under the terms established for the insurance plan and in harmony with pertinent federal and state laws.

In-Network and Out-of-Network

In-network coverage for rehab refers to a prearranged list of providers of treatment selected by the insurance company. The insurance plan usually offers discounts and more benefits to the client if he chooses an in-network provider. The contract between an insurer and the provider gives profit to all parties—the insurance company, the treatment center and the client.

Out-of-network coverage for rehab refers to a treatment or rehab provider who doesn’t have a contract with the insurance company and thus meaning lower coverage rates without any special benefits. If a health plan offers some benefits for out-of-network providers regarding physical problems, the parity law might apply in the sense that the program needs to add the same benefits for substance abuse and mental health disorders.

An Affordable Recovery Process

A rehab program can fluctuate from being a very affordable option to an expensive process. But as we stated earlier, leaving addiction untreated is ultimately a bigger economical loss and a life-threatening problem. Cost may depend on length, type and services offered by the program. It is always useful to ask your insurer about payment plans and if you or your loved one qualifies for a reduced rate.

Another option to consider is public insurance. This kind of insurance can make some forms of treatment more affordable because some rehab centers are subsidized by the state or federal government, accepting insurance plans to cover the expenses. Again, research needs to be done to know if a particular public insurance plan covers your specific treatment needs. You might also want to be informed about group insurance and how a package of this nature can help you to make the recovery process a more affordable one.

You shouldn’t give up if none of these options are available to you. There are charitable programs and faith-based organizations that offer very affordable alternatives or even free treatment. Remember that recovering from addiction should not be forsaken because of finding some obstacles. Using every resource available is of major importance.

Free Assistance and Advice on Paying for Rehab

Call our toll-free helpline today to obtain free help and information regarding your insurance coverage and the benefits you are eligible for. The lines are open 24 hours a day to assist you on checking if your insurance covers the rehabilitation program that you need and on how to obtain the best values for your treatment. Also, we can inform you without a cost about detox programs, intervention services, rehab facilities, family counsel, transport to and from rehab and more. Don’t suffer any longer because of addiction and call now.