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Is Your Substance Use Treatment Covered by Insurance?

 Most health insurance providers today cover the cost of substance use treatment. However, each plan varies in terms of this coverage. It falls on the policyholder to know which treatment options are covered and to what extent.

Terms to Know

When speaking with an ambetter rehab near you, there are certain terms to know. The deductible is the amount out of pocket that must be paid before the insurer will pick up any of the cost of treatment. Coinsurance refers to the percentage the patient must pay once the deductible is met. Co-pays are made once the deductible has been met, and the premium is the monthly or annual fee for the policy.

Doctors may be in- or out-of-network. In-network doctors have an agreement with the insurer and provide care at a lower cost. Out-of-network doctors do not have an agreement with the insurance provider and charge higher fees. Out-of-pocket costs are those expenses the insured is responsible for, although many policies have an out-of-pocket limit, which is the maximum amount the insured will be required to pay in a single year. Covered expenses above this limit are handled by the insurance company.

Substance Abuse Treatment

When looking into substance abuse treatment, a person needs to consider the costs. One provider might be in-network while another isn't. The patient will pay less if they choose the in-network provider. The insurance provider can help a person find in-network treatment options if needed.

What Types of Rehab Might Be Covered?

Many treatment options exist today. One person might be looking for medication-assisted treatment while another would benefit more from an inpatient program. Insurance companies often cover both. They might also cover an outpatient program, medication maintenance, continuing care, and intensive outpatient programs. Medical detox and co-occurring mental health treatments may also be covered under the insurance policy.

A person looking at substance abuse treatment options should always talk to their insurer. A representative of the company can help them determine which treatments are covered and what their share of the treatment cost will be. Reputable treatment providers can do the same.

Substance Abuse Coverage

Many insurers today list substance abuse treatment as a covered cost. Several factors play a role in the cost of this treatment, including the level of treatment and how long the treatment will take. Individuals with a marketplace plan will find addiction care is covered, and the same is true of many private plans today. Fortunately, these plans don't distinguish between different drugs. For example, an addiction to prescription medications will be covered, along with an addiction to methamphetamines. There is no distinction between different types of addiction when it comes to coverage.

Addiction comes with a high price tag. The drug affects the person's body in multiple ways, leading to the need for both physical and mental health care. The cost of treating these individuals, however, should not be part of the discussion. Rather, a person needs to look at the cost of not treating these individuals and the impacts of addiction on society, the addict's community, their family, and their friends. An alumni program like Recreate Behavioral Health Network ensures that you stay on track to a healthy lifestyle.

Addiction leads to a loss in productivity, criminal activity, and premature death. Experts estimate over $500 billion a year is lost to addiction. It's no wonder insurance companies cover treatment. Doing so not only saves money, but it also saves lives. No price can be put on that.

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