Many insurance policies help cover rehab costs! However, we simply need to verify your insurance coverage first.
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Insurance for Rehab
Perhaps, you’ve taken steps to rehabilitation and recovery from drugs or alcohol. But, now you may be wondering is if your insurance will help pay for rehab.
We understand that the road to recovery isn’t cheap and it isn’t free. Cost is going to factor in when choosing which treatment center is right for you.
Is Rehab Insurance Affordable?
The Affordable Health Care Act debuted in 2010 and made health care accessible to more Americans than ever. More people are now eligible for insurance that will pay for rehab. Individuals can get coverage for:
- Alcohol addiction treatment
- Drug abuse treatment
- Mental health disorders linked to addiction
What is the Affordable Care Act (ACA)?
The ACA has become a more and more popular method for paying for rehab. The Patient Protection and Affordable Care Act is a law that provides addiction treatment coverage. If you are seeking help with drug abuse or alcohol addiction, the ACA will help when it comes to cost.
Under this law, addiction is not a pre-existing condition. This Act also expands funds and options for treatment that are available to Americans who have Medicaid and Medicare coverage. The fees and qualifications for Medicaid and Medicare are different than the qualifications of the Marketplace medical insurance coverage options.
What All Does This Insurance Cover?
With the ACA, addiction treatment coverage has to be just as complete as any other medical procedure. Some elements included within the ACA insurance plans are:
- Anti-craving medication
- Addiction evaluation
- Clinic visits
- Home health visits
- Alcohol and drug testing
- Addiction treatment medication
- Brief intervention
ACA health and drug and alcohol insurance plans can even help with inpatient treatments such as medical detoxification programs.
Who is Eligible for Coverage?
Some Americans’ incomes fall between the FPL known as the federal poverty level and 4 x the FPL. They may be able to use the ACA tax credits. If you research, you’ll notice that the FPL amounts change by family size.
Here are a few statistics from Medicaid’s government website outlining federal poverty levels around 2015:
ACA Income Eligibility
Family Size of 1 equals a Maximum Annual Income of $11,770. A family size of 2 equals $15,930. 3 family members equal $20.090. And 4 members equals 24,250.
“Cost-sharing” is an option that is available for some living below 2.5 x FPL. It reduces deductibles and co-payments. Cost-charing also cuts insurance premiums and discounts traditionally high out-of-pocket fees.
What Types of Facilities Does Insurance Cover?
Over 14,500 treatment facilities specialize in rehab in the U.S. according to the National Institute on Drug Abuse. It is great to have a coverage plan that would pay for addiction coverage. However, every drug or alcohol rehab center may not be in the network.
Some coverage packages have unique agreements with carriers of key services. The centers agree to offer a specific sort of care at a specific rate. In exchange, the coverage provider will offer referrals to that facility.
It is always best to ask your doctors for a list of in-network professionals or facilities. Also, most facilities specializing in addiction don’t mind answering questions concerning coverage. A simple call to a provider could be all you need to gain clarity.
There are concerns regarding network coverage, but there are also concerns about addiction care types.
Addiction or rehab treatment facilities have the ability to deliver various kinds of care, such as:
- Outpatient rehab
- Residential rehab
- Partial hospitalization
- Outpatient detox
- Inpatient detox
The type of care and treatment option is dependent upon the severity of each individual’s case. An outpatient rehab treatment may be suitable for some. But it might not work for those who need 24/7 care. These individuals may do better in a residential setting.
Cost holds a chief position in America’s healthcare system. It remains to be an issue for those seeking addiction help or mental health treatments. Yet, these costs vary from person to person because each individual has a different health situation.
Below is a list of key points which influence the cost of treatment:
- The actual clinical diagnosis
- How long of a stay is recommended for treatment
- Does the treatment require any specialized services
- Which method of payment is preferred
A couple of ways patients pay for treatment are:
Insurance generally covers the majority of costs for treatments. This leaves a balance (usually the deductible amount) that is typically paid by private pay.
Some people go with private pay, this means they pay everything themselves without using any insurance.
Here are some insurance-related terms that you might see often:
- Insurance Verification
- Insurance Substantiation
- In-Network Coverage
- Out-of-Network Coverage
- Out-of-Pocket Expenses
Begin Your Recovery Journey Today!
Here at Granite Mountain Behavioral Healthcare, we work to help our clients overcome addiction. So, whether you are dealing with alcoholism or drug addiction, we’re here to help. For more information about using insurance for rehab, just contact us today.