Addiction disorders create chaos and disaster in the life of those who suffer from them. The only way that most people can get well is with the intervention and guidance of a professional addiction specialist. However, many people are held back from treatment and wonder, “Does insurance cover rehab?” Thankfully, health insurance companies recognize that substance abuse disorders are medical conditions that require professional treatment. Thus, most policies will offer coverage for drug and alcohol rehab. This may include many different treatment options including medication assisted treatment, therapy, and more.
Does Insurance Cover Rehab? Understanding Your Policy
Many people assume the answer to the question, “does insurance cover rehab?”, is no. Thankfully, the answer to that question is actually yes. When someone develops an addiction to drugs or alcohol it is diagnosed as a substance use disorder. Individuals with this diagnosis struggle with both physical and psychological side effects. Thus, addiction falls into a similar category to other chronic illnesses such as diabetes, heart disease, and autoimmune disorders.
The Affordable Health Care Act (ACA) requires that insurance companies include coverage for addiction treatment services in all of the policies that they offer. Furthermore, Medicaid and Medicare plans must also provide coverage for individuals in need of alcohol or addiction rehab. Addiction treatment falls under the coverage for behavioral and mental health treatment. This is due to the fact that around half of the individuals who struggle with addiction also have at least one co-occurring mental health disorder. Consequently, they are able to receive coverage for treatment for both diagnoses under most health insurance policies.
The first step to answering the question “does insurance cover rehab?” is to understand your particular policy. You can begin by looking at the paperwork for your policy which is normally mailed to you and accessible through your online portal. Your explanation of benefits should outline the coverage that is available to you and what your out of pocket costs could be. It will also go over the types of providers you can see and your deductible information.
It is also important to contact your insurance company to see if you need a referral or prior authorization before entering into a treatment program. Some policies require referrals or pre-approval before reimbursing the cost of rehab.
What Types Of Services Does Insurance Cover for Rehab?
There are a multitude of options for rehab treatment in the United States, which provides individuals with many choices on the type of program that they can enter into. Does insurance cover rehab from beginning to end? The answer is yes, but it does depend on the type of program. Insurance policies cover the following categories of treatment:
- Residential (live-in facilities)
- Dual diagnosis treatment
- Partial Hospitalization Program (PHP)
- Intensive Outpatient Program (IOP)
- Outpatient Program (OP)
- Psychotherapy and counseling
- Group Therapy
- Medication assisted treatment
Insurance companies do not offer coverage for sober homes or oxford houses. If someone is living in a sober or oxford house, then they normally pay a low weekly rent amount. Additionally, health insurance companies will not reimburse for services that are experimental or not medically necessary. They may also set limitations on how long or how much they will pay for certain services and programs.
What Happens Once Someone Is Admitted To Rehab?
People don’t just wonder “does insurance cover rehab?”, they also ask “what happens in rehab?”. The answer to the second question depends on the type of program and the level of care that a person is in. For example, detox programs focus on helping individuals safely go through the withdrawal process, while residential programs focus on healing both the mind and body.
Overall though you can expect certain services to be provided at all levels of care. Both inpatient and outpatient programs offer a variety of evidence based addiction therapy services including:
- Individual counseling
- Group therapy
- Family therapy
- Trauma therapy
- Holistic treatments
- Medication-assisted treatment
Each type of addiction treatment service holds its own value in the overall treatment plan. Once an initial evaluation has been completed you will work with your counselor and doctor to come up with the right combination of therapies that will meet your individual needs.
Addiction Treatment in Fort Lauderdale, FL
Are you struggling with addiction, but you are being held back from getting help because of finances? Have you wondered, “does insurance cover rehab?” Thankfully, the answer is yes. Your insurance should provide at least one type of addiction treatment care. Contact The Healing Center in Fort Lauderdale, FL today and we can help you understand your insurance coverage for rehab treatment. We will walk you through your benefits, obtain prior authorization for you, and help you get a referral if you need one. Get started on your healing journey today. Our admissions team is here to help you 24 hours a day and 7 days a week. Contact us today!