Insurance Coverage for Addiction Treatment

Insurance Coverage for Addiction Treatment

Everybody, regardless of their gender, race, sexual identity, etc., should be able to reach out for help when they are faced with a physical or mental health problem. In the United States, healthcare and how it works is hotly contested on a regular basis. Even bringing up the topic of healthcare can solicit deep sighs of frustration, eye rolls, and even tears. Of course, there are many people who are insured and who like the plan they have, however there are many who are dissatisfied with the type of healthcare they can or cannot receive because of their circumstances.

On top of what is widely considered a healthcare crisis in America is an addiction crisis. More than 21 million Americans are addicted to drugs or alcohol and are currently suffering the consequences of their disease. Unfortunately, between misconceptions, loopholes in coverage and insufficient funds, insurance (or the lack thereof) is one of the most common barriers to treatment for those in need.

How to Get the Most Out of Your Insurance

If you are addicted to drugs or alcohol and need professional treatment, nothing should stand in the way of that. Addiction is a deadly disease, especially when the appropriate level of treatment is not obtained. That is why it is imperative that you know how to get the most out of your insurance prior to enrolling in an addiction treatment program. There are several ways that you can do this, from verifying your benefits with the desired addiction treatment facility to speaking directly with a representative working for your insurance company.

Verify your benefits

If there are one or more addiction treatment centers you are considering attending, the simplest thing you can do is call to have your benefits verified. You will need to provide basic information, including your name, insurance company, and policy number. From that point forward, the administrators at the facility will begin working to see if your insurance is accepted, what type of plan you have, and any other information pertaining to your coverage. This service (which is offered at most addiction treatment facilities) eliminates the leg work that you would otherwise have to do. By the time that you are ready to get help, keeping up with phone calls to the insurance company and keeping record of important details may not be possible, so utilizing this service can be life-saving.

Know what plan you have

Just because you have a specific insurance provider does not mean that you can go to any addiction treatment center you wish that accepts that provider. That is because you may have a plan that covers services from specific facilities and not others. For example, you may have a plan that allows you to enroll in any addiction treatment program you want, regardless of if they are in-network or not, because you can fill out a waiver after the fact to get coverage. You may, however, have a plan that does not allow you to go anywhere but in-network, limiting your options. This can be confusing, but most insurance companies are willing to help explain your plan to you in the fullest of detail, so calling to gather that information is critical.

Be aware of your potential portion of payment

You may find that your insurance provider and the plan you are under offers coverage for your addiction treatment. However, there may be limitations to how much coverage can be provided for a specific treatment, leaving you with the rest of the bill. For some people, this is not a big deal and their out-of-pocket payments may be minimal. But for others, especially those who are obtaining an extensive amount of addiction treatment, the percentage of the bill they need to pay is much heftier. By calling and speaking to a representative, you can ask about how much coverage you can receive for the types of addiction treatment you will be getting. This can give you a good idea of what your future bills may look like, helping to avoid sticker shock.

Request in-network list from provider

When you call your provider, request an in-network list of addiction treatment facilities that you can attend. Most insurance providers have these lists readily available online, making this part of the journey a little less overwhelming. You or someone you love can look through this list and research more into the addiction treatment programs that may work best for your needs. From there, you can call the treatment facility of your choosing and begin the intake process without having to wait on insurance verification.

The Relationship Between Insurance and Addiction Treatment

In 2008, the Mental Health Parity and Addiction Equity Act mandated that insurance companies must provide equal coverage for substance abuse and addiction treatment just as they would any other medical health condition. Still, the Parity Act does not mean that all services related to addiction treatment are covered. In many cases, only some types of therapies are covered while others are not. This has regularly created a barrier to treatment for millions of people who may require a specific type of therapy but do not get it because it is not covered.

Most insurance companies provide full or partial coverage for detoxification, outpatient services, and some inpatient programs. Within certain treatment programs, however, such as inpatient and outpatient programs, there may be one or more types of therapy that a person seeks to obtain that is not covered. For example, someone in outpatient therapy may be directed to seek couple’s therapy but their plan does not cover that type of therapy. This is where insurance and addiction treatment can get complicated, as there are several limits put in place across the board.

Thankfully, however, the insurance coverage that is provided today for addiction treatment is far better and more extensive than it ever has been before. If you are ready to get treated for active addiction, speak with your insurance company right now to gather as much information about your insurance plan as possible.

Addiction Treatment in Ohio

We know how difficult it is to live with an active addiction. We also know how hard it can be to ensure that everything is lined up perfectly prior to being admitted into a program. By calling us right now, we can verify your benefits to determine if your insurance provider and plan can cover your treatment with us.

Do not let anything stand in your way of getting the help you deserve. Call us today at 800-481-8457.

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