Does Your Insurance Affect Your Drug Rehab Choices?

By: 
JP Chastain
December 3, 2019

For most people, the cost of certain medical procedures are a major concern as the coverage for insurance can vary among providers. Unfortunately, the question for the cost of a drug treatment facility is no different. Perhaps you or a loved one are struggling with an addiction and now you are wondering what the cost may be and whether or not it is covered by your insurance.

It is never a good feeling when someone has to wonder whether or not they can afford the cost of going to rehab for an addiction to drugs or alcohol, but if you do find yourself in that situation, just know that you are not alone. According to the Substance Abuse and Mental Health Services Administration, 19.7 million Americans aged 12 and older suffered from a substance use disorder in the year of 2017. Furthermore, out of those 19.7 million people who had reported having an addiction in 2017, only 19% of them had received substance abuse treatment of some kind. If you are one of those many americans still suffering, then we are here to help! There are many treatment options available.

If you are wondering if your insurance company can help cover any of the cost for treatment, then do not worry, thankfully, through the Affordable Care Act, every health insurance provider must offer coverage for substance use disorder services.

What is the Affordable Care Act?

The Affordable Care Act (ACA), also commonly referred to as Obamacare, was first signed into legislature in March of 2010. It defines 10 essential health benefits, one of them being services for substance abuse disorders and behavioral health, meaning that health insurance companies could no longer deny coverage for these type of services. It also extended coverage to millions of uninsured Americans and helped to lower the cost of health care. Also, due to the passing of this health reform, people cannot be denied based upon pre-existing mental health conditions or substance abuse disorders.

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How Health Insurance Affects Rehab Choices

While having health insurance is a benefit when looking for drug and alcohol treatment, it can still affect your choices for a drug rehabilitation facility. There are many reasons why your insurance may affect your choice when thinking about admitting a loved one or yourself for treatment, one of them being the amount of coverage that is offered by your specific insurance plan and the individual insurance benefits that come along with it. Some insurance companies may have out-of-pocket expenses or additional copays, while others may cover the cost of treatment completely. Be sure to speak with your provider for more details.

Cost of Rehab

The cost of drug rehabilitation alone can greatly affect the options someone may have when considering drug rehabilitation. The cost for treatment can depend on many factors, including;

  • Whether the patients level of care requires inpatient rehab or outpatient treatment
  • How long the person needs to stay in the program
  • Whether the provider is a government funded program, a hospital program, or a privately funded facility
  • If the patient has a dual diagnosis or co-occurring mental health disorder that also needs to be treated
  • The type of amenities and luxuries offered at the facility, such as private rooms or spa treatments
  • Where the facility is located, i.e. if it is next to a beach or another desirable location
  • Travel costs to get there

The type of insurance you have, the deductible and copay can play a huge role in selecting the treatment facility that is best suited for your or your loved one.

In-Network/Out-of-Network

Another thing to consider when looking for the best option available is whether the specific treatment facility is considered to be in-network or out-of-network. In-network health insurance means that the specific provider has been approved for coverage and is typically contracted at a specific rate, helping to reduce costs. Out-of-network facilities have not been approved for coverage so it will not help in reducing cost for treatment. However, if there is a preferred option that is out-of-network, cash may cover any additional expenses needed to attend.

Length of Stay

The length of stay can also have a huge impact on where a person decides to check into for drug rehabilitation. While most insurance companies only offer coverage for 30 days, medical professionals at rehab facilities will work with insurance companies to extend that coverage for the needed stay for the intended individuals to have a full and healthy recovery.

How to Get Treatment Without Insurance

Statistics show that one of the many reasons why people do not seek treatment when it is needed is because they do not have insurance. What they may not know is that sometimes insurance is not necessary in order to get treatment. Here are some ways to get treatment without insurance:

  • There are many free, or low-cost, sliding scale, payment plan facilities and alternative programs that offer payment assistance
  • Many faith based organizations offer free rehab services to those in need
  • The government offers grants through the Substance Abuse and Mental Health Services Administration
  • Medicare and Medicaid
  • S. Department of Veteran Affairs
  • State and locally funded treatment programs

Research suggests that for every dollar spent on substance abuse treatment, it saves $4 dollars in medical expenses and $7 in law enforcement and criminal justice costs. Finding a way to pay for treatment not only helps to save your life but will also save you money in the long run on expenses like medical treatments, court costs, and further loss of income related to drug use.

The sooner you reach out for help for either yourself or a loved one, the sooner the healing process can begin. There are many treatment services available that are designed to fit the needs of the individual. We will work with you, with or without insurance, to ensure that you are getting the best care needed for you or your loved ones recovery.

(888) 249-2191

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About The Author: 
JP Chastain
Paul Chastain is a psychology graduate from Columbia University in the City of New York, who has helped countless people with addiction journalism since 2008.

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