Insurance Coverage for Drug Rehab Programs: What you should know

Written by Chloe Nicosia

Searching for types of health insurance coverage for addiction? Let BetterAddictionCare.com help you.

You or someone you love may realize a detox and drug rehab program is the best step to break free of addiction, but you might be wondering: “Is drug rehab covered by insurance?” This is one of the most important questions to research as you are trying to choose a treatment facility that would be best for you. Having some type of health insurance coverage for drug rehab programs may help decrease a substantial segment of the total rehab cost. In addition, having insurance could alleviate any stress of possibly not completing a program in full because of nonpayment or because the price is just too high.

So, what types of health insurance coverage for addiction currently exist? Currently, the Affordable Care Act considers substance abuse and mental health treatment as part of its “fundamental” health benefits. These two segments were added to the health benefits list back in 2014. Addicts will find that many of the insurance programs under Obamacare do cover some portion of addiction treatment. The question is how much, and can you afford the remaining amount? In addition, certain health insurance carriers will only cover certain types of addiction treatment and only for a specific period of time.  For example, most insurance companies will not cover a rapid detox program (as it isn’t considered medically necessary), but they may cover a traditional detox program. This is why it is best to first reach out directly to your carrier or to an insurance and billing specialist at the rehab you are considering.

Another area to research regarding health insurance that covers substance abuse is whether outpatient, inpatient, or both types of treatment plans are covered. Many insurance carriers typically cover outpatient services; inpatient truly depends on the provider.

Once you determine the programs that are covered under your insurance (if applicable), the next determination will revolve around cost. If your provider doesn’t cover the entire cost of treatment, it may cover a specific percentage. This could leave you with a co-pay or payment plan to cover the rest of the bill. Depending on which program you enter, your individual out-of-pocket cost could range between $10 and $150 per day.

Having health insurance that covers substance abuse doesn’t always guarantee the carrier will cover treatment for you. In some cases, you may get a denial. If this occurs, you can appeal against the company’s decision. Every insurance carrier has its own appeal process, so you would have to reach out to the specific carrier and get more information. Remember to have supporting information and solid documentation when appealing an insurance company’s decision.

If all else fails when it comes to the types of health insurance coverage for addiction discussed above, you can reach out directly to the rehab facility and determine if they have sliding scale fees, financing options or some type of payment plan. In addition, there are some government assistance programs such as Medicaid that may cover certain addiction treatment costs.

To learn more about health insurance that covers substance abuse, read more on our site, and call us today at 1-800-429-7690 – we’ll answer any questions and help you find a treatment facility.