How Does Insurance Work for Addiction Treatment?

November 16, 2015 - , - 0 Comments How Does Insurance Work for Addiction Treatment?

Addiction treatment often has a stigma to it because it’s seen as a weakness or indulgence instead of being a medical ailment. In the past, health insurance providers didn’t normally cover addiction treatment programs because they weren’t deemed as medically necessary. Today’s health insurance providers cover a large amount of these costs, but you must verify your particular coverage before entering rehabilitation.

Federal Marketplace Health Insurance

With the Affordable Healthcare Act enforced, every United States citizen has access to addiction treatment. Basic federal marketplace insurance covers nearly every aspect of addiction recovery. You can have a preexisting condition and still receive treatment coverage. Visit an inpatient or outpatient facility with no spending limits. The federal government refers to addiction recovery coverage as essential health benefits. You should be able to take care of your mental and physical health without drug addiction being omitted from insurance policies.

Average Health Insurance Providers

When you have private health insurance, your policy can be incredibly varied. In general, most policies cover 70 to 75 percent of a treatment facility’s costs. Although this percentage is relatively large, there’s still a substantial out-of-pocket balance to cover the remaining amount. You can invest in a supplemental insurance policy and reduce your out-of-pocket expenses. Asking your family for a temporary loan might be necessary, so that you can complete the treatment and move on with your life.

Getting the Facts

It’s important to understand that every insurance policy has its own legal sections regarding addiction recovery coverage. In fact, insurance policies even differ among the various states and their coverage statues. Ideally, speak to your insurance provider about the coverage. They can explain the information in layman’s terms for complete transparency. When you select a treatment center, you’ll know exactly what is covered or not. You don’t want any payment surprises while you’re concentrating on your sobriety.

Stay Within Your Network

As you research different treatment centers, verify with your health insurance that they’re within your network of caregivers. In-network caregivers will offer you the best coverage from your insurance. You might need 28 days within an inpatient program and 10 weeks with an outpatient service, for example. An in-network treatment center will have most or all of their costs covered by the insurance. Working with a facility that’s unknown to your insurance will only cost you extra in the long run.

If your health insurance denies a claim that should be covered by your policy, you have the ability to appeal the decision. Speak to an insurance expert and your addiction treatment facility. These experts can testify on your behalf that the treatment was warranted. In the end, your only worries should be about sobriety and continued success at work, home or school.

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