If you are considering addiction treatment for yourself or someone you care about, one of the first questions you’ll face is how to pay for it. Does insurance help pay for rehab? Does it cover residential treatment? How do you find out what your plan covers?
Planning for rehab can be a challenge. Not only is there lots of planning to be done, but the situation is bound to be emotionally charged. You’ve found out your daughter or son has a problem with drugs. You want to be certain to get them the best help available, and you want to utilize your health insurance to do it. It can be hard even to know where to begin. Here we will answer all those questions and more for you.
Does Insurance Cover Alcohol Treatment?
Health insurance covers alcohol treatment as well as drug treatment; this wasn’t always the case, however. When the Affordable Care Act (ACA) was passed in 2010, it brought some big changes to healthcare in America. One of the most important was how it transformed access to treatment for drug and alcohol addiction. The ACA made it a requirement for health insurance providers to offer coverage for substance use disorder (SUD) treatment.
It also extended the 2008 Mental Health Parity and Addiction Equity Act which required insurers to provide addiction treatment coverage on par with other services. This extension means that no matter what health insurance plan you have, there is some coverage for substance use disorders (including alcohol); this would not necessarily have been true prior to the passage of the ACA.
How Much Treatment Can We Get?
One of the first questions people ask is how much time they can get in a rehab facility. The answer isn’t always simple. And it’s why contacting the admissions department is a great place to start.
In a nutshell, insurance works by authorizing a certain number of days of treatment at a certain level of care. The levels of care include detox, residential, partial hospitalization and intensive outpatient. It’s not important to exactly understand what each one is to know how long of a stay is possible. If you want to learn even more about these levels of care, though, the ASAM continuum has a thorough explanation.
It is important to understand is that the length of stay in treatment isn’t pre-determined. As the person moves through treatment, the clinical staff communicates with your insurance company about the patient’s progress and results. Then the insurance company authorizes additional days or weeks of care based upon that information. The treatment center will always try to get the patient the best care possible with their insurance plan.
There are people whose job is to advocate for the patients’ needs, so don’t worry. You will get as much care as possible. The multiple levels of care also make it possible to provide more overall days in treatment because most people do not need treatment at the highest levels of intensity for the entire time.
What to Ask Your Admissions Advisor About Insurance
Now that you know your health insurance must offer coverage for addiction treatment, you’ll want to know how health insurance helps you. Let’s face it; insurance can be complicated and hard to understand sometimes. Deductibles. Co-pays. Out-of-pocket. In-network. Out-of-Network. What does it all mean? Usually, the best place to start is with an insurance verification by the admissions department; this doesn’t cost anything or obligate you to anything, and it’s completely confidential.
The treatment center just contacts your insurance company to verify benefits for treatment. Once they’ve done that, they will know what is covered and what your upfront costs would be. The admissions advisor can explain that to you in layman’s terms to help you decide.
Here are some helpful questions to ask your admissions advisor:
- Does your facility accept my insurance?
- What are my deductible and co-pay? What will I need to pay upfront?
- Is detox covered under my plan? (if detox services are needed)
- Does insurance cover residential treatment under my plan?
- Do I have out-of-network benefits? (Promises Brazos Valley is in-network with BCBS)
There is a lot to learn, but this is a great place to start. You don’t have to be an insurance expert to get treatment for yourself or the one you love. Knowing the answers to questions like “does insurance cover residential treatment” or “does insurance cover alcohol treatment” will help put your mind at ease. A conversation with your admissions advisor is a great idea. Treatment options for addiction are diverse, so there is a path forward for just about anyone who wants help.
If you have Blue Cross Blue Shield, you should know that Promises Brazos Valley is in-network for you. That means even if you have an HMO without out-of-network benefits, we can likely work with your insurance here. You can even submit your insurance information for verification here. As always, you are welcome to call us at (844) 667-8240 with questions, and we’ll be happy to help. We look forward to being of service to you!