When you realize the need to seek treatment for drug or alcohol addiction, there are many issues to consider. Inpatient programs often provide the best long-term results, but they also involve stepping away from work and family obligations. At the same time, putting off drug or alcoholism rehab may result in lost jobs and broken relationships.
Health Insurance and Rehab Services
The cost of rehab is another important factor. Addiction treatment facilities like Virtue Recovery Center specialize in helping people get free from drug and alcohol addiction. They work with highly-trained medical professionals using evidence-based therapies while providing comfortable rooms and nutritious food for the residents.
The costs for an inpatient rehab program will add up quickly. Fortunately, in many cases, health insurance plans can help people handle the expense.
The Move to a Medical Understanding of Addiction
Some medical professionals used to consider substance abuse and addiction to be a moral failure. They assumed that addicts just needed to use their willpower to conquer the problem. Relapses were a product of a weak will and poor choices.
Thankfully, the modern medical world recognizes that addiction is an issue that requires rehab treatment programs for a successful recovery. Doctors and psychologists understand that repeated use of addictive substances makes changes to the reward centers of the brain. With treatment, these changes will reverse over time, and the drug addiction will be easier to manage.
However, a full recovery requires intensive treatment interventions. The detox process includes medical detoxification treatments that prevent harmful withdrawal symptoms. The recovery portion of inpatient treatment includes therapy sessions that get to the root of the addiction. Life skills counseling gives patients the tools they need to handle stress without relapsing.
Common Addiction Treatment Services
The extent of medical treatments for detox depends on the type and seriousness of the addiction. Mild addicts may only have a few uncomfortable days as they step away from their substance. Other people may need medical observation as they detox. Tremors, anxiety, and pain can all be responses to the withdrawal process. The medical team may provide non-addictive medicines to ease these symptoms and prevent serious issues.
The rehab portion of inpatient care is a mix of personal therapy and life skills counseling. There are many reasons that people turn to drugs and alcohol. In therapy, the mental health staff can determine if there are secondary issues like depression or anxiety that fuel the addiction. They will also help you understand the roots of addiction in your life.
Sometimes, it is easier to replace a drug habit with a healthy habit. Healthy diet and exercise practices can go a long way in helping you regain your life. Many alcohol and drug rehab centers include life skills training as part of the program.
Will my health insurance cover drug and alcohol treatment?
Most health insurance providers have some measure of coverage for addiction treatment. Because they see addiction as a medical issue, they provide resources for recovery. However, each insurance company takes a different approach to detox and rehab coverage. You will want to fully understand your benefits before you dig too deeply into a program. Some insurance companies offer better coverage for facilities that are in their network. You do not want to enter a program only to discover that you cannot afford the stay.
At Virtue Recovery Center, we work with several major insurance providers such as Humana, Aetna, and Anthem Blue Cross.
By partnering with these providers, we can offer the best care for our clients. However, coverage can depend on the type of plan in which you participate. A PPO plan will have different benefits than an HMO plan. It is always best to call a representative at your company to learn how the coverage works in your situation.
Substance Abuse and the Affordable Care Act
In 2010, the Affordable Care Act changed the way that most insurance companies treated addiction. In many cases, this transition was already underway. More companies were recognizing substance abuse as a mental health condition that deserved coverage.
Also, long-term addicts frequently develop secondary health conditions. For example, alcoholics may end up in the hospital with pancreatitis or cirrhosis of the liver. Treating the addiction early will lower a patient’s health costs over time. For this reason, health insurance companies were moving to addiction coverage as a preventative measure.
The ACA made it a requirement that insurance companies provide coverage for several mental health conditions including addiction. By mandating coverage, the act takes away some of the shame associated with substance abuse. When patients can be open about their addiction issues, they will receive medical treatment that takes the substance into account.
Another important part of the ACA was its requirement for health insurance companies to cover a pre existing condition. In the past, some companies had denied coverage if a patient had a long-term issue with substance abuse. Now, relapse is considered another occasion for seeking addiction treatment.
Health Insurance Limits
If you are looking for a rehab facility in Arizona, you must understand the limits of your health insurance plan. While the ACA demands coverage for substance abuse treatment, it does not spell out how much companies should cover. Like all medical procedures, insurance plans handle addiction treatments in unique ways.
Frequently, plans have out-of-pocket deductibles that you must pay before the insurance coverage kicks in. Knowing the amount of your deductible will prevent you from being surprised at the end of the rehab treatment program. Other plans use a co-pay system. For outpatient treatment, the plan might require you to pay a small fee for each counseling session. Most plans also limit the amount that a patient will have to pay out-of-pocket expenses in a given year.
People who participate in HMO plans have another set of coverage limits. If you are in an HMO, you receive the best coverage if you work with a provider within an approved network. Also, you will typically need to get a referral from your primary care physician. Going out of the network or entering a program without a referral will generate costs that you must handle.
Drug Rehab, Medicaid, and Medicare
The federal government provides a couple of health insurance programs for people who need assistance. The Medicaid program is geared toward lower-income individuals and their families. Because of the Affordable Care Act, Medicaid must also cover addiction and mental health services. However, not all drug rehab addiction treatment centers accept patients with this insurance. If you are looking for a rehab treatment center for you or a loved one on Medicaid, check with the facility before you try to register.
Medicare is federal health insurance for people with disabilities or who are 65 and older. It is important to be aware of the limits of this type of insurance. Medicare only covers treatments that a facility deems medically necessary. In some situations, this arrangement means that the insurance will not cover every part of a drug rehab program. Medicare also acts as an HMO, so you will need to work with a facility that is approved by the program.
Gaining Freedom from Addiction
Addiction is a mental issue that you cannot ignore. Chronic substance abuse has damaging effects on your physical and mental health. It will also strain your relationships, slow your career and damage your financial well-being. To avoid these consequences, you want to find an addiction rehab center that provides a range of drug and alcohol rehab treatment options.
Virtue Recovery Center in Chandler takes an expansive approach to addiction recovery. Our team of addiction rehab specialists provides medical and psychiatric care as well as group therapy and life skills education. We want to prepare you for a sustainable substance-free life. If you have questions about your insurance policy, we are happy to verify if your health insurance covers rehab at our facility. Feel free to reach out to us today.
1. Does health insurance cover drug and alcohol rehab?
Yes, most health insurance plans cover some form of drug and alcohol rehabilitation. However, coverage can vary widely depending on the specific plan and provider. Therefore, verifying your benefits with your insurance company is essential to understand what types of treatments are covered.
2. How can I verify if my insurance covers rehab services at Virtue Recovery Center?
To verify your insurance coverage, you can contact Virtue Recovery Center directly. They offer a service to check your insurance benefits on your behalf. You must provide information from your health insurance card, and a representative will liaise with your insurer to confirm your coverage details.
3. What types of addiction treatments are typically covered by insurance?
Insurance plans commonly cover a variety of addiction treatments, including:
- Inpatient Rehabilitation: Intensive treatment where patients stay at the facility.
- Outpatient Rehabilitation: Treatment that allows patients to live at home while attending therapy sessions.
- Partial Hospitalization Programs (PHP): Structured daily treatment but not overnight.
- Intensive Outpatient Programs (IOP): More frequent therapy sessions than standard outpatient care.
- Detoxification (Detox): Medically supervised withdrawal from substances.
- Medication-Assisted Treatment (MAT): Use of medications along with counseling and behavioral therapies.
4. Are there any limitations or conditions on insurance coverage for rehab?
Yes, there can be several limitations or conditions, such as:
- Pre-authorization Requirements: Some plans require pre-authorization before starting treatment.
- In-Network vs. Out-of-Network Providers: Using in-network providers usually results in better coverage and lower out-of-pocket costs.
- Coverage Limits: There may be limits on the number of treatment days or sessions covered.
- Deductibles and Co-pays: Patients may need to meet deductibles or pay co-pays for services.
5. What should I do if my insurance denies coverage for rehab?
If your insurance denies coverage, you can appeal the decision. You can submit an internal or external appeal, providing documentation to support why the treatment is medically necessary. Additionally, consider exploring alternative options such as sliding-scale payment plans, government-funded programs, or non-profit organizations that offer financial assistance for addiction treatment.
