Will My Insurance Cover Detox and Rehab Services?

When you realize the need to seek treatment for a 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 treatment may result in lost jobs and broken relationships.

Health Insurance, Detox and Rehab Services

The cost of treatment is another important factor. Facilities like Virtue Recovery Center specialize in helping people get free from 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 program will add up quickly. Fortunately, in many cases, health insurance 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 treatment for a successful recovery. Doctors and psychologists understand that repeated use of addicting substances makes changes to the reward centers of the brain. With treatment, these changes will reverse over time, and the addiction will be easier to manage.

However, a full recovery requires intensive treatment interventions. The detox process includes medical 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 Treatments for Addiction

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 treatment 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 rehab centers include life skills training as part of the program.

Will my health insurance cover detox and rehab services?

Most health insurance providers have some measure of addiction treatment coverage. 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 insurance companies 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 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, 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 issues 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 insurance companies to cover pre-existing conditions. 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 treatment.

Health Insurance Limits

If you are looking for a detox and rehab facility, you must understand the limits of your insurance. 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 treatment. 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 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.

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 treatment centers accept patients with this insurance. If you are looking for a detox and rehab 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 facility’s 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 wellbeing. To avoid these consequences, you want to find a rehab center that provides a range of treatment options.

Virtue Recovery Center in Chandler takes an expansive approach to addiction recovery. Our team of 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, we are happy to verify if your provider works with our program. Feel free to reach out to us today.

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