Have you ever wondered if insurance covers rehabilitation? We`ve got the answers.
If you or someone close to you is suffering from addiction to alcohol or drugs, addiction rehab centers offers you the greatest chance of long-term recovery. The staff at Better Addiction Care advise that Similar to any medical treatment addiction rehabilitations can be costly, which is why you are probably hoping the insurance plan will cover at least a portion of the costs. The simple answer to the question, “Does insurance cover rehab,” is yes, it does, but the reality is a little more complicated. In 2014, key provisions of the Affordable Care Act (commonly known as “Obamacare”) came into force that affected the insurance coverage of substance abuse treatment. Although mental health and substance abuse coverage is currently a vital health benefit does not mean your insurance will cover the treatments you require. It`s important to understand the specifics of your insurance policy covers before you go into rehab so you are not left with costs for medical expenses you can`t afford.
Certain factors can impact your rehab insurance
You can avail substance abuse insurance if you have insurance through an ACA marketplace. The amount of coverage, and how much of the substance abuse treatment you`ll have to pay for yourself, is determined by many variables. The specific coverage you receive for rehab will depend on the state that you live in and the health plan you select. Different plans can differ in many ways, such as the following:
Relapses
Prior to 2014, insurers were able to refuse to pay for treatment due to already existing medical conditions. This was the case for treatment for drug and alcohol abuse. Many insurance companies determined that any person who received counseling or treatment for substance abuse in the past, and who was currently experiencing a relapse, fell under the pre-existing statute. This isn`t the case now; even if you are experiencing a relapse after treatments in the past, your treatment may be covered, provided you`re within the different guidelines for treatment coverage.
The guidelines for insurance coverage for addiction treatment contain strict guidelines on the days and visits that are covered. It is possible that you have completed your coverage for the year if you have just completed treatment.
Deductibles and co-pays
The insurance policy for addiction treatment is likely to have a yearly deductible and out-of-pocket amount that must be met prior to your insurance paying for care. If you have a higher deductible, the addiction treatment center could allow you to set up the payment plan you need to pay your costs.
Inpatient vs. outpatient care
The insurance for addiction treatment usually allows for a combination of inpatient and outpatient therapy. Both kinds of therapy work and inpatient rehab permits you to focus more on recovery. Inpatient rehab is significantly more expensivebecause it requires 24-hour care and intensive therapy in a residence. Because outpatient treatment is individualized and can be customized to your budget and your requirements.
Care management
You may need undergo a pre-authorization procedure based on the insurance coverage you have prior to being able for rehabilitation. It can be a long process that the treatment center is required to be involved in since the rigorous approval process demands answers to questions about the diagnosis and treatment, and could involve a peer-to -peer review. The insurance carrier may also make it clear that you are only able to seek care from physicians who are in the network.
Types of therapies
Certain insurance plans have strict guidelines on the types of treatments that they are willing to pay for. Many insist on evidence-based treatments such as treatment for addiction. If the addiction rehabilitation center you choose relies more on holistic approaches like Acupuncture and does not have any track record of helping people overcome addiction, the insurance company might not be able to cover the costs.
Self-pay options
If your insurance provider will not cover rehabilitation at the addiction center you select, don`t be discouraged. There are a variety of recognized addiction rehab centers. You should be able to find one that can provide the kind of treatment that gives you the best chance to recovery . They will also work with you so you are able to pay for any amount of treatment the insurance doesn`t cover.