Those struggling with addiction face various barriers that hold them back from getting the treatment they need. For many, it’s their willingness to change that holds them back. Other factors that can influence the way they feel are social issues such as the stigma surrounding rehab, responsibilities that seem to prevent you from taking a break from everyday life to seek recovery, and not knowing where to start. Unfortunately, one of the most common concerns that hold someone back from treatment is the cost they will incur as a result.
Treatment costs in the United States are expensive, and addiction treatment requires long-term care. While the payment is high, the U.S. has solidified itself as an international leader in modern treatment techniques. Since addiction is a chronic disease, it is not going to heal on its own without it being addressed. The disease will slowly spread from one part of your life to another until it affects your finances, your career, health, and relationships that you’ve spent a lifetime developing. Addiction can also lead to stiffer consequences such as legal issues and infectious diseases. If you are dealing with a substance use disorder, the cost of treatment should not be a deterrent to receiving the help you need. Your life is worth much more.
With all that said, there are always solutions to these problems you may be facing. Admittedly, it’s extra work, but the hoops you jump through to make sure you satisfy your addiction is much more time consuming and dangerous. Addiction is a disease that is both chronic, as well as treatable, and insurance companies have come to accept that diagnosis. Many insurance companies offer coverage for drug and alcohol addiction treatment, and many addiction treatment centers accept coverage from private insurers.
Navigating through insurance, however, can still be challenging, and there are a few things that you should know that simplifies the process for you.
Understanding Your Substance Abuse Insurance Coverage
Insurance providers fall under two basic categories – private and federal insurance. Federal insurance providers include programs such as Medicare and Medicaid, and government-funded insurance providers are easier to afford and qualify for. Unfortunately, they are much less comprehensive in terms of what they offer. Federal insurance plans are accepted in select treatment programs and government treatment providers.
Private insurance providers are independently funded companies that offer insurance that is often more expensive and difficult to qualify for than federal options. Fortunately, they typically cover more and allow for more options. Many high-quality addiction treatment centers accept most private insurers.
If you have a private insurance policy, you are more than likely to be covered for at least a portion of your addiction treatment. There are thousands of specialized treatment centers in the United States, and several treatment modalities to consider. While private insurance carriers offer robust coverage for addiction treatment, they may not cover all therapy options. It is in their best interest to cover the most effective treatment. If you complete treatment one time successfully, they are less likely to pay for treatment a second time.
Since addiction treatment is highly individualized and focuses on your specific needs, insurance companies don’t always possess the expertise in helping someone find that individualized treatment. For this reason, it can be of high value to speak with an insurance representative when seeking treatment. You must search for other professional opinions as well, including your doctor or an addiction specialist.
If you do not have private insurance or if you don’t qualify for a private policy, federal assistance can be a good alternative. It’s worth noting, however, that the best quality of treatment will be under private addiction treatment.
What Does My Addiction Treatment Insurance Cover?
Discovering what your insurance provider covers depend on the specific policy that you possess. However, insurance companies look for many things when they are considering accepting your coverage. They generally look for effective treatment, a proven track record, and methodologies backed up by science. Other factors they consider include:
Significantly Addictive Substances
There are various types of addictions that many people struggle with that aren’t powerfully addictive chemical substances. The more that is learned about addiction, the more we know how things such as the internet and cell phones can also cause addictive behavioral issues. To this point, though, research has focused primarily on substance use disorders involving psychoactive substances. Insurance companies gravitate toward these issues because they have shown to be precise and proven needs.
Some substances are more addictive than others. Meth, alcohol, heroin, and certain prescription drugs pose a more significant threat when it comes to addiction. While it is not impossible, it is more difficult for individuals to find treatment for substance use disorders that involve marijuana, many psychedelics, and drugs with lower addiction possibilities. It is possible to get treatment covered if those substances are used in conjunction with other addictive drugs, or if a person has co-occurring psychological or medical disorders.
Immediate medical needs such as drug withdrawal, infectious diseases, and other medical conditions that are a part of addiction are often covered, at least partially, by your insurance. Medical needs also require more intensive care, which includes medical detoxification or inpatient type services. Substance use disorders that involve alcohol, benzodiazepines, or barbiturates are more likely to be covered by insurance because of the risk of deadly withdrawal symptoms.
Evidence-based treatment refers to therapy methodologies that have proven effective in scientific studies. Evidence-based therapies can also be recreated in various settings. Insurance companies look for these treatment centers because they offer a foundation of evidence-based services that have shown to be more effective than alternative options. There are many alternative therapy options like yoga, meditation, and art therapy that have reportedly helped many people, but their effectiveness has not been proven in studies. While it’s ok for a treatment program to use alternative therapy types, insurance companies need to see a company that primarily uses evidence-based options such as cognitive-behavioral therapy.
How Long Will I Be Covered?
The length of time spent in treatment will vary from one person to another. Addiction treatment is not an exact science, and it’s crucial to remember that each person requires a different level of treatment. There are guidelines, however, set in place by the National Institute on Drug Abuse (NIDA) that states, “ research has shown unequivocally that good outcomes are contingent on adequate treatment length.” According to the research, clients achieve the most effective treatment outcomes after 90 days from inpatient to outpatient services. It may be challenging to get your insurance company to cover you for that long.
The length of time in treatment will be dependent on your specific needs. Your treatment center should work with your insurance company to get you the time required for effective treatment.
Call Our Experts At Desert View Recovery Today
Finding addiction treatment coverage and navigating your insurance policy can be challenging and confusing, but you don’t have to go through it alone. Our addiction treatment specialists can help determine your eligibility for treatment under your insurance provider, work with your insurance company to determine coverage, and calculate any out-of-pocket expenses. If you enter a treatment program at Desert View Recovery, we will also handle billing through your insurance company while you focus on recovery.