Health Insurance Benefits For Addiction Treatment
April 26, 2023
Drug addiction, also called substance use disorder, is a mental illness. It impairs people’s ability to self-regulate. It causes them to have a “feel-good-now-regret-it-later” behavior and then feel empty and alone.
The good news is that it’s a diagnosable and treatable medical condition. However, many addiction sufferers won’t seek potentially life-saving treatment, mainly due to a lack of insurance coverage or expensive treatment costs.
Nothing must get in the way of someone’s drug addiction treatment, including treatment costs. In this article, we’ll provide you with everything you need to know about drug rehab and health insurance for it.
Does Health Insurance Cover Drug Addiction Treatment?
Health insurance plans generally cover not only physical but also various forms of mental health treatment. This includes substance use disorder, which, as mentioned, is a mental illness.
Most health plans cover the cost of treatment addiction treatment. A particular health insurance plan is often calculated depending on how much of one’s treatment is covered by the plan and how much out-of-pocket costs they have to pay.
Moreover, the extent to which the insurance will cover depends on a variety of factors, including one’s particular needs, treatment provider, policy’s specific behavioral health benefits, and type of drug rehabilitation.
Drug Rehabilitation
Drug rehabilitation or drug rehab is a medical and psychotherapeutic treatment for substance abuse, including prescription drugs, street drugs, and alcohol.
Its general intent is to enable patients to stop substance dependence and substance misuse, preventing any psychological, physical, social, financial, and legal consequences that may likely cause.
The rehab mainly involves counseling, medication, behavioral therapy, and case management. Other addiction treatment programs include:
- Outpatient care
- Continuing care (e.g., counseling, therapy)
- Inpatient rehabilitation
- Medical detoxification
- Medication-assisted treatment (MAT)
- Maintenance medication to support ongoing sobriety
- Dual Diagnosis and Co-occurring mental health treatments
A treatment that’s integrated, comprehensive, and long-term, sometimes requiring inpatient treatment services, is more effective. However, it isn’t an option that most people can afford out of pocket. Fortunately, insurance plans can cover all drug rehab or addiction treatment programs mentioned above.
Health Insurance Benefits For Drug Rehab
Health insurance plans offering rehab are beneficial to anyone who’s seeking addiction treatment. They may cover the treatment costs with little to no payment necessary from the policyholder who wants to get rehab. But before applying for one, always shop for quotes and look up the Assurance comparison of the deals presented to you.
With health insurance, the financial burden of recovery on the person seeking addiction treatment and their families can be lightened. This also helps the patient to focus all their energy on recovering rather than worrying about treatment costs. There are also government initiatives that ensure its coverage, such as the Mental Health Parity and Addiction Equity Act (MHPAEA).
Mental Health Parity And Addiction Equity Act
According to the Mental Health Parity Act of 1996 (MHPA), large group health plans can’t place less favorable limitations, either annual or lifetime dollar limits, on addiction and mental health benefits than on medical or surgical benefits.
Additionally, under the MHPA, insurance companies must follow parity requirements. In other words, they must provide the same level of benefits for drug addiction and other mental illnesses similar to other medical conditions.
Remember that it doesn’t mean one will automatically have insurance for substance abuse. Rather, the act ensures that the insurance one will invest in the future can cover drug addiction treatment.
Who Covers Drug Addiction Treatment?
Addiction disorder, specifically the opioid epidemic, has been a significant public health issue in the United States. As a result, the majority of local, state, and Federal government entities offer drug addiction treatment programs. The problem is they may have some limitations.
While Medicare or Medicaid offer insurance coverage for rehab, many rehab centers may not accept them. It’s mainly because of additional administrative burdens and lower payouts than the average private insurer.
Apart from state-funded programs, private and employer-sponsored health plans can offer insurance coverage for substance use treatment. They also cover any medical consequences stemming from the disorder.
Many insurance companies have been including addiction treatment in their plans not only because of the MHPAEA. The Patient Protection and Affordable Care Act (ACA) has been pressing them to follow the parity for its insurance coverage.
Otherwise, they might end up paying for the consequences later. Plus, they may likely cover the physical and mental health issues resulting from untreated substance abuse, which can be disadvantageous on their end.
Available Options For Uninsured People
Even if you’re uninsured, you can still opt for low-cost to free addiction treatment. Search your city, county, or state to find state-funded rehab, insurance policies, and other options or other ways to help those who seek help.
Financing options, such as payment plans or loans, can also be offered by some treatment centers. They allow you to pay the rehab or treatment costs in small increments after treatment or recovery.
If you’re lucky enough, many charitable organizations can cover the costs for you. The only key is perseverance. Don’t let being uninsured stop you from accessing treatment when you’re ready.
Final Thoughts
There shouldn’t be a stigma associated with seeking treatment for addiction or any kind of medical condition. Health insurance benefits are made to make affordable and accessible health care, not make people’s lives more helpless. If you or someone you know is suffering from substance abuse, take advantage of health insurance or no-fee rehab programs to the fullest to help leave addictions behind for good.
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