Will my health insurance plan cover the cost of alcohol and drug addiction treatment?
That’s a question we often hear from prospective clients and their families. Thankfully, the answer is a qualified “yes,” meaning that depending on their insurance provider, some people will get partial benefits while others will get 100 percent coverage.
That’s because the American Medical Association (AMA) defines alcoholism and drug addiction as medically diagnosable and treatable “substance use disorders,” with the result that health insurance companies must offer treatment coverage to their members.
At Beach House, we seek to make drug or alcohol treatment affordable for everyone who asks for our help. We do this because of our conviction that just as anyone can find freedom from addiction, anyone should be able to receive the treatment they deserve. We therefore accept most private insurance plans. Below is a partial list of the insurance plans we regularly work with that cover inpatient and outpatient drug and alcohol addiction treatment.
And others such as ComPsych, MVP Healthcare, GEHA Health plans, APS Healthcare, Medical Mutual, Greatwest, Value Options and many more.
Verifying Your Insurance Coverage for Drug and Alcohol Treatment
Verifying your insurance coverage for drug and alcohol treatment is quick and easy. Our admissions counselors are here to help and can usually complete verification in under 45 minutes. As part of our commitment to making substance abuse care as affordable as possible for you and your family, we work with various providers to maximize your insurance coverage, so that you receive all of the benefits to which you are entitled.
In addition to these private insurance plans, Beach House also accepts some state-government organized plans (the so-called “Health Insurance Marketplace” plans).
Drug and Alcohol Rehab Services Covered by Private Health Insurance
Health insurance policies differ in the amount of drug or alcohol treatment they will cover, but typically, they’ll cover (either partially or fully) one or more of the following rehab services that Beach House provides:
- Psychiatric screening and assessment
- Residential treatment
- Outpatient treatment
In most cases, your health insurance will fully cover an initial screening and assessment. In turn, an official diagnosis of a substance use disorder will be critical to determine how much coverage you will receive for drug and alcohol detox and treatment services.
To what degree a procedure or intervention is medically necessary will dictate how much your health insurance will cover. The bare bones of residential treatment may receive 100 percent insurance coverage, but add in extra amenities like a private room or linen-change service, and you may end up paying significantly higher out-of-pocket expenses.
Insurance Coverage: Substance Use Disorders and Other Mental Health Conditions
The 2008 Affordable Care Act and Mental Health Parity and Addiction Equity Act strengthens and expands this health insurance requirement by requiring that behavioral health conditions like substance use and other mental health disorders receive treatment coverage that’s comparable to other medical health conditions. In other words, insurance companies, whether public or private, must now cover substance abuse treatment to the same extent that they cover other medical conditions.
The Affordable Care Act offers some additional good news to those with substance use disorders and/or other mental illnesses who don’t have health insurance. That good news is this: If you’re looking for help covering the costs of drug or alcohol rehab, you now can apply for an insurance plan that will help you allay those expenses, without worrying about being denied coverage on the basis of a pre-existing mental health condition. This provision can drastically cut down your out-of-pocket costs of treatment.
Other Non-Insurance Options
If you don’t have a private health insurance or health insurance marketplace plan, don’t despair. There are other ways we can work with you to ensure you’re able to afford the costs of treatment, such as via affordable self-pay rates. Or, we can point you in the direction of other resources that can help, such as health care financing options and payment plans. A future free of addiction is, after all, priceless. We will work with you to help you get the care you need.
Learn more about Costs of Treatment.