Addiction treatment and recovery can be lifelong endeavors. It can also be more complicated if you don’t have an insurance policy that covers it. Thus, you need to start by checking if your insurance policy covers addiction treatment before you decide to seek treatment.
The good news is that addiction treatment is enlisted as an essential health benefit. This means that most insurance companies have it as part of their plans. But there’s more you need to learn about addiction treatment insurance, and this article will be an excellent resource.
Here’s everything you should know about getting addiction treatment with health insurance.
Insurance Coverage for Addiction Treatment
It is critical to understand your addiction treatment insurance. Although addiction comes with a stigma, the efforts to make it a diagnosable medical condition have been fruitful. It’s easier to get medical care if your insurance company offers an addiction treatment health plan.
Today, 43 states in the US require insurance companies to cover addiction treatment. However, most insurance companies might not advertise this fact to the public. But that doesn’t change the fact that you have the right to coverage as a policyholder if you need addiction treatment.
Also, it’s worth knowing that discriminating against addiction patients is illegal. The Mental Health Parity and Addiction Equity Act of 2008 requires insurers to treat all patients equally. It means insurers should offer addiction insurance at parity with standard medical conditions.
But this will depend on the specific treatment options you need. It also depends on the rights that the insurance company gives people fighting addiction. You can find out this by reading the insurance company’s terms and conditions and learning more about the laws of your state.
Sometimes you might realize that your insurance company doesn’t have favorable laws for addiction treatment coverage. The best option will be to find an insurance company that will offer you the best policy. This way, you won’t fight with your current insurer over the issue.
Does Insurance Cover Addiction Treatment?
Yes, health insurance covers addiction treatment. You only need to enroll in a treatment facility that partners with various health insurers. The Heights Treatment works with private insurers in Texas and California. You can consider it and other reliable facilities for affordable addiction treatment.
But finding a reputable facility that specializes in addiction treatment isn’t everything. You must remember that not all insurance companies will offer you coverage for such treatment. Thus you also need to invest your time and effort into finding an insurance company that covers it.
The best thing to do is research different insurance covers. You can visit these providers to learn what they offer. Some will be open to covering outpatient and not in-patient addiction treatment. This means you might have to pay in-patient treatment costs from your pockets.
Sometimes the co-insurance costs you’ll need to pay will be a fixed rate determined by your insurer. Or it could be a specific percentage of the total treatment costs. It would be best if you spoke to your insurer about the co-insurance before you seek addiction treatment, especially for in-patient treatments.
But then, be careful with insurance companies that refuse to cover patients even when they offer the needed coverage. If this happens to you, you’ll need to investigate it and gather enough evidence. Then you can appeal the decision with your insurer to get coverage.
Holding Your Insurance Provider Accountable
You should keep a lot in mind when holding your provider accountable. The first step should be to prove that they violated your rights as a policyholder. This means you must have read and understood the terms and conditions of your healthcare plan including the fine print.
Also, it would be best if you had read the laws governing insurance in your state. Every state has unique requirements that you must understand before approaching your insurer. It will be easier to hold them accountable if you know your rights and can argue out your case properly.
It will also be advisable to have someone who understands the laws to help you. Hiring an insurance lawyer will help because they have the experience you need. They can work with you and your insurance company to ensure they streamline the process and you get coverage.
Alternative Ways to Get Addiction Treatment With No Insurance
You might be wondering what to do if you won’t get covered for addiction treatment by your insurer. There are various options that you can consider. This section will discuss how you can get addiction treatment without insurance coverage.
- Public government insurance – You can consider this option if you already have Medicare and Medicaid. It is an insurance program run by the government and covers addiction treatment. It is ideal for people aged above 65 years old and low-income citizens.
- SAMHSA treatment – The government also sends funds to addiction treatment facilities yearly. You can head on to the SAMHSA treatment website to locate the nearest facility with these funds near you to access low-cost addiction treatment.
- Sliding scale fees – There are addiction treatment facilities that offer this option. In this program, the treatment costs reduce depending on one’s income, expenses, and household size. You can even get financed by a treatment facility if you don’t qualify for this option.
- Non-profit groups – You might also get affordable addiction treatment from a non-profit group. An excellent example of a non-profit group that offers this service is the Salvation Army. You can get treated to recovery without incurring any out-of-pocket costs.
Health Insurance Can Cover Your Addiction Treatment Costs
That’s everything you should know about addiction treatment and health insurance. We have answered the primary question by saying that health insurance covers addiction treatment. But we have also looked into the conditions under which you can get covered for such treatment.
In addition, we have provided the best tips for getting treated without insurance. You can appeal the decision if you think your insurer is unfair. Or, you can consider alternatives like Medicare and Medicaid. Also, non-profit groups and SAMHSA treatment might be helpful.
