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Addiction treatment can be expensive, especially if you intend to go to a nice facility with a skilled team of professionals. Drug or alcohol addiction is serious, and you should take the time to find a program that will give you the best chance of long-term success. The issue is that it may not be affordable without insurance. What is the best insurance for drug rehab or alcohol rehab?
Rehabs Of Armerica can help you to figure out your insurance coverage for drug and alcohol rehab. Before you apply for a spot at one of the best facilities, here is what you should know about health insurance and how it covers these essential health benefits.
Many people struggling with drug or alcohol addiction may qualify for free coverage through their state’s Medicaid program. This is an income-based program that offers coverage to individuals who have a low income. The specific income limits for Medicaid vary depending on what state you reside in.
Keep in mind that while Medicaid can be a decent option for your substance abuse treatment, it will limit where you can go. Providers are not often as keen to accept Medicaid insurance due to lower reimbursement rates and increased administrative costs.
There is some good news for those who do not meet the criteria for Medicaid in their state. The Affordable Care Act passed in 2010 made it mandatory for health insurance policies to cover addiction treatment and mental health services. It became easier for people to buy an insurance policy in the health insurance marketplace formed under the Affordable Care Act.
These are now considered essential health benefits, meaning that insurance companies must cover the cost of addiction treatment. The insurance company must handle it no differently than if they were treating a physical health condition. With that being said, that does not necessarily mean that your health insurance will cover all treatment centers.
You may still owe out-of-pocket costs depending on the treatment center and the level of coverage that you purchase. Health insurance coverage is roughly broken into four levels ranging from bronze to silver to gold to platinum. The insurance company often offers a plan at each of the four levels.
Bronze covers the lowest percentage of your treatment while platinum covers the highest. As you might expect, bronze comes with a lower monthly payment and higher deductible while platinum is more expensive but features a lower deductible. Silver and gold plans fall somewhere between the two extremes.
You can enroll in insurance coverage through the ACA Marketplace during Open Enrollment from November 1 through January 15 or if you meet a special enrollment period (change in household size, loss of coverage through a job, or a move might qualify you).
If you want the best insurance for drug rehab, you should take some time to explore which facilities are part of the coverage you purchased. Insurance companies typically contribute toward your treatment at certain in-network facilities. You need to know which facilities you want to attend before enrolling in health insurance.
For those who already have insurance and want it to cover drug and alcohol rehab, then you may have to compromise on where you want to go. To give an example of a limitation, some plans may only cover in-state facilities which could limit where you can go.
The good news is that most mental health facilities, including rehabs, will accept a wider array of private health insurance options compared to those that accept Medicaid. If you have well-known private insurance such as Blue Cross Blue Shield, Aetna, Humana, or Cigna, you will find far more options available to you compared to Medicaid users.
There is no single “perfect” private health insurance plan for rehab as each person’s needs will be unique. Be sure to consider how much the plan costs you and what it covers before you enroll.
Regardless of which insurance plan you decide to go with, chances are that you will have some out-of-pocket costs for your treatment. The insurance coverage will cover a hefty portion of your drug and alcohol addiction treatment, but it may not cover it entirely until you meet your out-of-pocket maximum for the year (which depends on your plan).
Here is what you can expect to pay based on the level of coverage you purchase through the health insurance marketplace:
Knowing that you may pursue substance abuse rehab in the upcoming year should dictate which level of insurance plan you decide to pursue. Platinum will be more expensive month to month, but it may mean a lower total cost to you for extended inpatient treatment options or medical services such as detox.
Even if you have trouble raising money for rehab, there may be some wiggle room at different facilities. Be sure to inquire about sliding scale fees based on income if your insurance plan does not cover the facility that is the best match for you.
You may also find that there are grants and scholarships that you could apply for to help minimize costs. Always ask about payment plans or other arrangements that can make your treatment more affordable and manageable for you financially.
If you have a hard time finding health insurance plans that will cover a rehab facility for an inpatient stay, then you might want to contact them about outpatient addiction treatment. This could minimize your total out-of-pocket cost and keep you paying a much smaller copay for each visit you make to a medical professional or licensed therapist.
Under the Affordable Care Act, you can consult with other types of therapy instead of just inpatient facility stays. Some of the other alternatives for inpatient care that are covered by private insurance plans include:
Plans should also cover those who are coping with a dual diagnosis of other mental health conditions along with their substance use. With private insurance, you will have far more options when it comes to healthcare providers.
Some plans may also cover medication-assisted treatment which makes it less likely that you will relapse.
Keep in mind that you may require a referral for some of these services. That can come from your primary care physician if you have one. Make sure you know the ins and outs of your mental health and substance use coverage before you enroll in any plan.
Rehabs Of Armerica can help you understand your coverage and benefits before you make the important move to transition to a facility. No matter what type of insurance you have, we can help facilitate the connections necessary to keep your out-of-pocket costs for treatment as low as possible.
Even if you currently do not have insurance, we can help refer you to a facility that meets your needs. We can help you understand the resources available to you such as sliding scale fees, grants, and more. Do not delay seeking treatment just because you are not covered by insurance. Let Rehabs Of Armerica help you to understand the health insurance coverage needed for rehab, and let us help you find options to start your recovery today!
Anna M. joined Find Addiction Rehabs with extensive experience in the field of addiction treatment. As a former Nurse Practitioner in Miami, she found her passion for addiction treatment when a family member was lost to his disease. With each article and resource, she hopes to save other families from experiencing the anguish of a loved one’s passing due to drinking or drugs.
