Is Alcohol Rehab Covered by Insurance?

The Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline is a free referral service that provides information about mental health and substance use disorder treatment programs. It is available in English and Spanish, and text messaging service 435748 (HELP4U) is currently only available in English. If you are uninsured or underinsured, SAMHSA can refer you to state-funded treatment programs or facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, it is recommended that you contact your insurer for a list of participating providers and healthcare facilities.

Alcohol and drug addiction can have a devastating effect on the entire family. It is important to understand how substance abuse treatment works, how family interventions can be the first step to recovery, and how to help children from families affected by alcohol and drug abuse. Many health insurance providers can cover all or part of the cost of alcohol or drug rehabilitation. The cost of rehabilitation varies depending on the patient's treatment level, length of stay, insurance coverage and other unique factors.

The amount of insurance coverage or acceptance is based on the insurance policy that covers each patient. This means that out-of-pocket costs will vary. reports that plans participating in the insurance marketplace must provide care in 10 essential health categories, one of which is addiction care. Most insurance policies don't separate drugs into “covered” and “not covered” categories. If treatments for addiction are considered a covered benefit, then care is provided to anyone who has an addiction, regardless of the cause of that addiction.

This is the same model that health insurance programs use to treat other medical conditions. Alcohol rehabilitation services can be expensive, but health insurance does cover them, partially or completely. Coverage depends on your plan, but you may have more options than you think. There are many treatments and rehabilitation options for people with substance use disorders. Fortunately, many insurance companies cover the cost of addiction treatment because they are well aware of the physical and mental traumas of substance abuse. The Affordable Care Act (ACA) considers addiction treatment an “essential health benefit” (EHB) that must be covered by new plans in the Health Insurance Marketplace.

Medicare and Medicaid plans will only cover these drugs if their use is considered vital to the ongoing health of the person in recovery. As with most medical problems, only part of detoxification or substance abuse treatment is covered by insurance. After you make the decision to seek help for substance abuse treatment, the next step is to determine if your treatment is covered by insurance. The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorders with data-driven content on the nature of behavioral health conditions, treatment options and their related outcomes. People who want to recover from their toxic abuse patterns may be covered for detoxification, inpatient rehabilitation, or partial hospitalization services, depending on the plan they have chosen. On the other hand, an outpatient program allows you to live at home or near you and visit the treatment center several times a week to attend recovery classes, talk to your counselor, and receive any medications prescribed for you. Before deciding on a rehabilitation center, check the benefits of your Blue Cross Blue Shield (BCBS) policy to determine what costs your insurance plan will cover and what will be out-of-pocket. The private health insurance plan you have will determine how much of your treatment is covered by your insurance plan, as well as how much you will have to pay out of pocket.

Medicare Part D provides coverage for drugs that doctors deem medically necessary for the treatment of a member's alcohol addiction. Depending on the plan you select, ACA-sponsored policies cover 60 to 90 percent of the cost of rehabilitation services incurred at a drug treatment center. You can also file an appeal with your insurance provider if you are denied coverage for alcohol treatment. Although insurance companies cover different levels of treatment services, they may not fully cover treatment for relapses.

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