What Parts of Addiction Recovery Are Covered Under Insurance

If you’re interested in exploring the benefits of joining an addiction recovery community, you may be wondering whether or not your insurance will cover addiction programs.

In this article, we’re taking a look at one of the most common questions we hear from people in the community – what parts of addiction recovery are covered under insurance?

What Parts of Addiction Recovery Are Covered Under Insurance?

Addiction recovery, like many other health care items in the United States, is a piece of health care covered partially by insurance companies, in different ways, throughout the country. Some businesses cover all aspects of drug treatment partially, others only cover rehab or medication. Some help is only available through the government, while other states have excellent private insurance providers.

The exact details of what kind of health insurance you’re looking at depend on where in the country you are, and what kind of treatment you require.

So, what parts of addiction recovery are covered under insurance?

Insurance and Addiction

Most insurance providers today understand what addiction is – a treatable medical condition with more untreated patients than most other diseases and conditions. America is in a situation where every hand needs to help, and insurance providers are doing their part by making it easier than ever to seek funding and financial aid for any inpatient/outpatient program in the country.

What Insurance Does and Does Not Cover

Insurance providers will not be able to guarantee that they can cover the cost of your treatment or rehab in its entirety – but there are some things that are generally fully or mostly covered by most insurance providers:

  • Professional Assessment: A professional assessment of you or your loved one’s addiction is typically fully covered by health insurance.
  • Detox: Most rudimentary medical detoxification is covered by your health insurance, although special facility-specific treatment types (such as rapid detox) may not be covered by most insurers unless specified.
  • Outpatient Treatment: Outpatient treatment is generally covered, although rarely in its entirety.
    Inpatient Treatment: Inpatient/residential treatment is partially covered, but is also the most expensive type of treatment available.

When determining how much of your costs can be covered, be sure to assess what levels of care you’re availing for (whether you’re seeking help to finance a partial hospitalization program or intensive outpatient program) and what your options are regarding co-pays and deductibles. The more of the final cost you can carry, the lower your premiums will be.

Seeking Public/Private Insurance

The pros and cons between private insurance and public insurance are simple – one option is typically cheaper, and the other option allows for a much larger coverage, and thus a much wider pool of treatment options. Understanding the severity of addiction and the possible application of different treatment options can help you better make an informed decision on whether to seek private or public insurance.

The market for private insurance companies can be competitive, driving the prices down. However, private insurance is still pricier than what the government can offer. If you are sure that a state-based solution is inadequate in your case, and that you need a more specialized treatment to truly help your loved one, then the investment in a different insurer is worth every single penny.

Speak With Your Insurer

If you already have an insurance provider, then the right course of action is to phone them or send them an email asking for further information. Health insurance in the 21st century does cover addiction treatment, but only to a degree. Be sure to keep detailed notes of any conversations you have with your insurance provider, down to the name of the representative you have been calling with.

Paying Your Dues Without Insurance

Insurance providers are not going to be the ultimate saviors in dire financial situations – like any business, they are built to make a profit and aim to do so without causing a massive upset. While your insurance provider may cover some of the cost of your drug treatment or rehab, both therapy and outpatient/inpatient care can be far more expensive than what most insurance plans offer to cover.

If you have trouble paying off the rest of your dues, then don’t worry – most facilities have other options available to people to help in financing their treatment. Here are just a few options commonly available in facilities across the country, if you’re having trouble coming up with ways to pay for the addiction recovery treatment.

Medicaid: If things are dire enough financially, the government aid may be your best shot towards covering the costs of your addiction treatment. Eligibility for Medicaid depends on what state you live in, and whether your information and total income places you below the poverty line.

Personal Financing: Some drug treatment facilities offer personal financing, covering a part of the cost of treatment or rehab while creating a financial arrangement to collect the payment in installments over the course of the foreseeable future.

Sliding Scale Facilities: Some drug treatment centers change their rates on the basis of a patient’s financial situation, in order to offer affordable services to those who need them the most. The reality of addiction is that it hits low-income families the hardest, both because it is a bigger problem in poverty areas due to the struggles of economic hardship, and because addiction itself is expensive and can suck a small family’s income dry, sending people spiraling down a path of debt and further insecurity.

There are resources online dedicated to helping people find the treatment center they need. Addiction treatment is far more understood today than ever before, but we collectively have a long way to go until treating addiction as a medical issue becomes a social norm and not a rarity. Most people struggling with addiction still lack the help they need to get better.

These reasons and more are why so many treatment centers are doing the best they can to make drug recovery information and health care available to as many people in the country as possible, even if it eats into their bottom line. Addiction is a severe issue in the United States, especially as the opioid overdose death toll continues to grow.

If you or your loved one is struggling with addiction, seek help immediately. No matter what your situation, no matter where you are or what you have to your name, chances are that there will be a place for you to get better, and a plan for you to pay your dues and get proper, professional help.