How to Get Insurance to Cover Drug & Addiction Rehab Treatment
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How to Get Insurance to Cover Rehab Treatment

Written By Legacy Healing Center - Apr 14 2022

How to Get Insurance to Cover Rehab Treatment

Table of Contents

If you or a loved one are searching for rehab options for a substance use disorder (SUD), you may wonder how you can afford to pay for treatment. One of your first questions may be, “Does insurance cover rehab?” And if it doesn’t, how you can you afford rehab without insurance. Here are some guidelines that may help you get insurance to cover your rehab treatment.

If you have questions regarding health care coverage and rehab in South Florida, contact us today for help starting your journey towards recovery.

Is Rehab Covered by Insurance?

Since substance use disorder is considered a disease, many health insurance providers cover the cost of rehab either partially or fully. Just like diabetes or cancer, SUD requires treatment. However, not all insurance policies are the same and the amount of coverage may vary widely among providers and policies.

The Affordable Care Act

Health insurance hasn’t always covered substance use disorders, which meant that many people went without the necessary treatment. Once the Affordable Care Act passed in 2010, it expanded coverage to more people. By 2014, insurance plans were required to cover specific categories of health benefits, which included both substance use disorders and mental health services.

The Affordable Care Act also prevented insurance companies from denying coverage due to pre-existing conditions. SUD and dual diagnosis disorders are often labeled as pre-existing if you have sought treatment in the past. With the changes in healthcare, you can now receive coverage for the illnesses.

The healthcare act required coverage for SUD to be comparable to general medical care. Because of the requirements, many policies cover inpatient and outpatient rehab as well as other services. While improvements have been made for those seeking rehab treatment, exclusions still exist for insurance coverage. It’s best to work with an insurance specialist to understand what your policy covers.

Where to Find Insurance to Cover Addiction Treatment

Along with the marketplace insurance plans, Medicaid also covers addiction rehab. Private insurance policies are also required to provide this coverage. However, the amount of coverage may vary by state and by the plan you choose.

Many plans don’t cover what is known as luxury rehab. They may provide partial coverage, but it’s not guaranteed. Luxury rehab is generally more expensive than traditional rehab and may include private rooms and personal trainers.

Services Typically Covered by Health Insurance

While it is expected that most insurance companies contain similar coverage for substance use disorders, you will want to check your policy to find out what is covered. In general, you can expect the policy to cover outpatient addiction treatment, which allows you to continue with work or school and to live at home.

Most health insurance policies cover inpatient addiction treatment, which requires you to live onsite at a rehab facility during the treatment. Detoxification is also usually covered, which is the process of cleansing the body of the substance before treatment begins.

Psychotherapy is also covered by insurance, which includes meetings with a therapist to address issues that may impact addiction. During this treatment, the therapist helps you develop skills to cope with triggers that cause you to turn to substance use.

Getting Insurance to Cover Addiction Rehab

If you’re concerned about getting insurance to cover addiction rehab, you should start with your insurance provider. You can also call the rehab center to find out what health insurance providers they accept. Most rehab facilities accept some insurance plans, but the plan can list them either as in-network or out-of-network.

When you seek treatment with an in-network rehab, the insurance plan will likely pay all or most of your care. You may still be allowed to go out-of-network to a rehab facility if you prefer but be prepared to pay more of the expenses out of pocket.

When you contact your insurance provider or the insurance specialist at the rehab, find out what is covered by your plan and whether you will have to pay for any additional expenses on your own. Your treatment provider can often help create a treatment plan that is covered by your insurance, so you aren’t left with an expensive bill.

Get Help with Your Substance Use Disorder

If you or a family member are suffering from a substance use disorder, you can get help. Contact us today at Legacy Healing to find out how we can help you with the right treatment plan. We’re here to answer your questions about drug addiction treatment, including how to pay for drug rehab without insurance. Let our rehab specialists help you get started on a new path.

FAQs

Can you get life insurance if you have been to rehab?

If you are in recovery from drug or alcohol rehab, you can still get life insurance. You will likely be asked about your medical history, which would include substance use disorder. Your rates may be higher based on your medical history as well.

What does ACA mean in rehab?

ACA is the Affordable Care Act, which was passed in 2010. It requires health insurance providers to include coverage for ten health categories, including substance use disorders. This helps to ensure that people with this condition who have health insurance can get the care they need without paying for the cost of drug rehab out of pocket.

Is rehab the same as recovery for insurance?

Rehab and recovery may be used interchangeably, but they can also refer to various aspects of treatment. Rehab usually refers to the initial treatment, which can be either inpatient or outpatient. Recovery may include ongoing therapy and drug treatment to help the person maintain their rehabilitation.

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