If you or a loved one is struggling with drug or alcohol abuse, you’re far from alone. Substance use disorders are one of the most common health problems in the United States. In fact, the 2020 National Survey on Drug Use and Mental Health shows that some 40.3 million Americans qualify as having a substance use disorder.
For that reason, insurance companies are required by law to treat substance use disorders as a temporary disability. This means that you are legally entitled to healthcare and mental healthcare for drug addiction problems. However, the amount and type of coverage offered from provider to provider can vary quite a bit.
The first step to getting your insurance provider to pay for drug rehab is to figure out what they actually cover. For example, while your insurance provider is legally required to cover drug addiction treatment the amount and the specifications can vary quite a bit from provider to provider.
Therefore, the best way to get answers is to call your provider. Here, you should have a specific list of questions on hand. You may be able to answer many of them by checking your provider’s website to see what they offer. In addition, you might feel ashamed to ask about addiction coverage. Don’t. It’s a normal medical problem and your insurance provider is used to it.
Here, you can ask specific questions like:
Here, many insurance policies include specific coverage and percentages per provider based on type of care and whether they are or are not in the preferred network. This means that you may have to shop around to find a rehab clinic your insurance provider will optimally cover.
In most cases, you can expect to get 20-90% coverage for your drug rehab care. If you choose an outpatient program, you’ll likely get maximum coverage from your provider. On the other hand, if you choose an inpatient program, especially a luxury one, you’ll likely see percentage of coverage drop or cap at a specific amount.
The more “premium” your insurance policy, the more likely it is that it will cover inpatient programs. However, every insurance provider has its own policies, provider networks, and standards. You’ll have to talk to your provider to get that information.
In most cases, your insurance provider will be happy to cover at least some part of any rehab center you choose. In other cases, that won’t be true. However, if you’re attending a 90-day medical program, costs can be quite high. If your insurance provider isn’t covering enough of it, you may have to resort to funding your treatment in other ways. If your insurance provider refuses to offer coverage at all, they are breaking the law.
If none of those options work, many local governments and cities offer grants and financial assistance to help people attend rehab. These may be granted on a first-come first-serve basis, may be restricted to certain types of rehab, or may be based on “merit”. However, most states have at least a few of them, meaning you can ask for assistance, even at your local city hall.
Over 40 million Americans have a substance use disorder. If you or a loved one is looking for help, it is there. And, your insurance is legally required to cover at least part of that care. If you still need help after, looking into employer-sponsored or state-sponsored programs can be another option – however, most of us prefer to choose the program we go to. Good luck getting treatment.
Asana Recovery offers detox, residential, and outpatient addiction treatment services at our center located in Orange County, California. Please contact us today to speak with one of our experienced addiction treatment team if you have any questions about our programs.