How Does Health Insurance Cover Alcohol Detox?

Rehab for drug and alcohol addiction can get expensive. Of course, the cost one could incur will depend on the type of facility, the treatment services rendered, the available amenities, and the location of the facility. The reason the cost of treatment matters so much is because it can become a barrier that stops people from seeking treatment.

If they can\’t afford to go to rehab, their choices become limited. They can choose to try to stop on their own, or they might opt to not stop at all. Neither choice is a good one. If they try to stop on their own, the likelihood of chronic relapses is very high. If they don\’t stop at all, their lives will start to deteriorate. There is good news when it comes to managing the costs associated with treatment. You see the Affordable Care Act of 2009 (ACA) established that healthcare insurance providers have to cover the costs of rehab in much the same way they would cover other medical treatments. Furthermore, the ACA also made it illegal for insurance carriers to say no to coverage based on preexisting condition claims.

This became the first time in history that addicts had access to an affordable way to pay for rehab. As long as you have followed the law and maintained healthcare coverage, you are entitled to some level of care. If by chance you have not been carrying healthcare insurance, you will have to consider other ways of paying for treatment. Some other options you might want to consider include:

  • Seeking a personal loan or assistance from family and friends
  • Use credit cards or pursue a personal loan from a private/commercial lender
  • Seek assistance in the form of a grant or scholarship from a charitable organization
  • Use you personal savings
  • Ask about financing from the rehab facility

While any one of these options might be viable, paying for treatment through your healthcare insurance is still your best option even with a copay. What is most important is you find a way to get the help you need. The only caveat to the health insurance option is the ACA does not dictate the extent of coverage. The insurance company is merely required to cover the basic costs related to treatment. In the next section, we will detail what insurance companies are required to cover.

Coverage Requirements for Addiction Tratment

While insurance companies have to cover rehab, they do have some leeway in terms of coverage. They can place certain restrictions on what they will cover and the extent of coverage they will give. For the most part, the law requires that insurance companies cover what is considered basic rehab costs. The question is, what does that include? Here are the line items that the ACA dictates insurance companies must cover at a minimum:

  • Detox programs
  • Any prescription medications related to the addiction treatment process
  • Basic inpatient treatment up to 90 days (excludes the cost of luxury rehab facilities and alternative treatments)
  • Outpatient treatment programs
  • Ongoing outpatient counseling after treatment

As far as coverage limitations, insurance companies are supposed to offer the same percentage of coverage that they are offering for other medical treatments. For what it\’s worth, some insurance companies will offer to pay 100% of outpatient care. Why? To encourage customers to choose outpatient care over the more expensive inpatient options. If you have any questions about how your insurance company handles addiction treatment coverage, you can read your insurance summary. If that\’s too confusing, you might want to ask for clarification from an insurance company customer service rep. If you still have questions, the rehab facility\’s administrative staff should be able to verify coverage with your insurance company on your behalf.

This is often the best option because rehab administrators spend a lot of time dealing with insurance companies. We hope you find this information useful. We don\’t want anything standing in the way of you getting the treatment you need. For our part, we will do whatever we can to help you figure out how to pay for treatment. We are in the business of helping people, and we want to help you. When you are ready for treatment, you need to call us at 833-610-1174. During your initial call, we will be happy to answer questions about our facility and treatment options.

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