Addiction Treatment Insurance Coverage
Financial barriers are often a significant concern for people who are seeking treatment. The cost of treatment may be a roadblock to many who need help dealing with addiction. However, the cost of treatment shouldn’t be a barrier to getting the help you need. Remember, addiction affects every aspect of your life including finances, family, and your health. If you don’t get the right treatment for you, the stakes are high. Your life is worth the cost of a results-driven treatment plan.
Ocean Breeze Recovery is happy to accept most health insurance plans and we can work with your insurance company to get the maximum amount of coverage possible for your addiction treatment. Our goal is to help you get the coverage for the treatment you need to achieve lasting recovery.
As we have come to understand that addiction is a disease that affects the brain that can be treated, insurance companies have followed suit by making provisions for people with substance use disorders. So, most health insurance companies will cover rehabilitation to some extent. There are several insurance options available to those who are seeking treatment for behavioral health disorders. The majority of both public and private health insurance providers will cover at least a portion of inpatient and outpatient treatment.
Many private insurers will provide robust coverage options for addiction treatment, to help make your treatment more affordable. They may even cover a portion of high-end rehabs or holistic treatment options. Public insurance options are notoriously less comprehensive than private options but even public insurance provides coverage for addiction treatment.
Understanding Addiction Treatment Insurance Coverage
Types of treatment centers vary across the United States. In fact, the National Institute on Drug Abuse (NIDA) reports that there are more than14,500 different specialized treatment centers in the U.S. alone. On top of that, there are dozens of treatment modalities that are used to treat substance use disorders; some more effective than others. Though insurance companies will cover addiction treatment, they may not cover every facility and therapy.
In some cases, a treatment center may be in a network of approved facilities that already have a relationship with your insurance provider. The process of seeking treatment at one of these facilities tends to be simpler. However, if you feel like another facility is a better fit for you, or if you believe they offer more high-quality services, you still may be able to get treatment outside your network. In that case, your insurance company will look at several factors including whether it is private or publicly funded, in-state or out of state, and more.
However, you don’t have to navigate the ins and outs of insurance verification on your own. Your doctor, insurance company, or the facility can help direct you to helpful information. At Ocean Breeze Recovery, our goal is to make the process of dealing with your insurance as simple and easy as possible in order to get you the help you need.
What Will My Addiction Treatment Insurance Cover?
Different insurance companies will cover different treatments at each point of your recovery journey. Some offer fairly robust coverage for any substance use disorder involving physically addictive drugs. Others are more selective with what they cover. Generally, insurance companies will cover the following for most highly addictive drugs:
- Medical detox, which includes 24 hours of medical care
- Inpatient or partial hospitalization
- Long-term residential care at approved facilities
- Dual diagnosis treatment for substance abuse disorders
Some insurance companies don’t cover detox for every addictive drug. For instance, while heroin and opioid withdrawal can be extremely unpleasant (some describe it as similar to a severe case of the flu), the likelihood of serious, life-threatening complications is extremely low. Some insurance providers deem medical detox for opioid withdrawal as medically unnecessary. Others see it as a necessary precaution.
When it comes to addiction treatment after the medical detox phase insurance, companies want to see two things in the treatment plans they cover, one being evidence-based modalities. While there are a number of new and exciting treatment options that are known to help many people that have not been widely studied, insurance providers prefer to pay for treatment strategies that have been studied and show positive results.
One of the most common treatment options that insurance companies look for is cognitive behavioral therapy (CBT). CBT is the most widely recommended therapy for addiction treatment and involves learning skills that help in relapse prevention. Research supports theeffectiveness of CBT and studies have shown that people who learn positive coping skills through CBT retain those skills after treatment.
Other evidence-based therapies are also commonly used in treatment like motivational enhancement therapy, contingency management, and other behavioral therapies. While many treatment centers offer alternative treatment options, insurance companies want to see a foundation in treatments that have been authenticated by research.
The second thing that research companies look for is forward progress. Your therapists and counselors will be there to guide you forward, but the pace you require is important. You will be helped and encouraged to make progress, but you won’t be pushed beyond your capabilities.
How Long Should I Be in Treatment?
Insurance companies will want to get you out of treatment as quickly as possible. The faster you complete a treatment program the less they will have to pay to cover your stay. However, research has shown that longer treatment is generally more effective. NIDA reports that the most effective treatment plans lasted for90 days or more. Ultimately, the ideal treatment duration depends on your specific needs and your treatment center will work to insure you have the coverage you need.
Need Help Navigating Addiction Treatment Insurance?
If you aren’t sure whether you are covered we can help by:
- Determining your eligibility
- Calculating any out of pocket expenses
- Handling the billing of your insurance company
Verify your insurance coverage by filling out the form on this page. Please be aware that the sole purpose for the information you provide will be to determine your eligibility, and we will never sell or share your information with a third party. If you are seeking addiction recovery help, but you don’t have insurance, give us a call today at 855-960-5341. We can work with you to find a solution.