Since rehab facilities are expensive, “Does insurance cover rehab?” remains. Health insurance covers rehab partially or even in full. According to the Affordable Care Act, insurance should cover the costs of substance use disorder and mental health conditions. But what services will be covered? Will there be any out-of-pocket costs? This article answers all your questions.
Today, we’ll explore which alcohol rehab insurance benefits are available to you and which are not covered by health insurance. Also, what can you do if your insurance doesn’t cover your rehab costs? Keep on reading.
Which Rehab Services Are Covered by Insurance?
Among many alcohol rehab services, drug detox, inpatient, outpatient rehab, and aftercare services are generally covered by health insurance, depending on your plan.
Drug detox: Detox programs are set to clean patients’ bodies from harmful substances. It’s a necessary step that supports more intensive addiction treatment. Typically detox programs are managed by a team of licensed professionals.
Inpatient rehab: Residential rehab services are often more effective for patients who need 24/7 assistance during their recovery. Inpatient facilities include various services like counseling, therapies, and specialized treatments. It can be much more expensive than outpatient programs and can take several months to a year.
Outpatient programs: Patients can take outpatient treatment and get addiction treatment without staying in a residential facility. They can seek treatment at the nearest rehab facility or participate in virtual therapies.
Aftercare programs: During an aftercare program, patients are connected with support networks, social groups, and individuals to maintain their recovery after they receive addiction treatment.
What Alcohol Treatment Is Covered by Insurance?
Is addiction treatment covered by insurance? Yes!
Affordable Care Act requires private and public insurance plans to cover specific health benefits. These benefits include mental and behavioral health disorder treatments like substance use disorder care. However, the rehab insurance coverage might vary on your plan, where you might need to pay for the deductible, copayment, or coinsurance costs.
For example, Aetna rehab coverage offers benefits depending on the provider and insurance plan. Many rehab centers are available in their network. You can obtain more benefits if you select a provider from their network.
It’s possible that your insurance provider might not cover your rehab costs if you select a service outside their network. So, choosing the right provider is important. Sometimes costs for an in-network provider are much more affordable with insurance.
What Services Are Covered by Health Insurances?
- Addiction treatment
- Intervention
- Medically-managed inpatient care
- Screenings
- Treatment for co-occurring disorders
- Medical detoxification services
- Outpatient services
- Behavioral health care
- Follow-up counseling
- Preventative counseling
- Risk reduction interventions
- Peer support services
- Care management
- Short-term Inpatient hospitalization
- Partial hospitalization programs (PHP)
- Intensive outpatient services (IOP)
- Medication-assisted treatment (MAT)
What Benefits Are Not Covered by Insurance?
While some services may be required for your treatment, they can still be considered medically unnecessary, like holistic treatment in addiction recovery. Your insurance might not carry the costs of particular benefits like this one. We listed a few such services below:
- Recreation programs
- Non-medical amenities
- Holistic care services
- Private treatment services
- Food delivery
- Alternative therapies
Will Insurance Cover Relapse?
Typically health insurance plans don’t cover treatment costs when you relapse. You may rely on alternative care or payment options to cover relapse costs. But again, some insurance providers may cover alcohol rehab relapses.
So, if you relapse, ask your care manager to secure your best interest and get the coverage you need from your insurance plan.
Which Insurance Plans Are for Alcohol Treatment?
Different health insurance plans are available for alcohol treatment, such as HMO and PPO. Rehab costs payment varies based on your plan’s terms, as each plan operates differently.
We’ll go through the most common health insurance plans today, Health Maintenance Organizations (HMO) and Preferred Provider Organizations (PPO). Let’s find out which insurance plan is best for the treatment you seek.
- Health Maintenance Organization (HMO): HMO plan offers limited coverage for regular care, including rehab services. If you have an HMO plan, your emergency care costs will be covered even if you get care outside your insurance provider’s network. But the HMO plan covers your rehab services only when you access the in-network health providers.
- Preferred Provider Organization (PPO): PPO is much more flexible than HMO but might cost you more monthly. With PPO, you can use in-network providers and spend less money. You can also get care from outside providers using PPO with added costs.
Now, it’s time to address your last lingering question.
What to Do When Insurance Does NOT Cover Your Rehab?
Since rehabs are costly treatment, if your insurance doesn’t cover it fully, here’s what you can do:
- Get a medical or non-medical loan
- Ask local organizations for financial assistance or grants
- Consider private pay options
- Check whether your Employee Assistance Program (EAP) covers any rehab treatment
- Look for free or affordable rehab services in your area
- Join support programs like The Tempest
- Look for mobile app solutions that offer therapy support
Blanchard Institute offers outstanding rehab programs in North Carolina facilities. If you’re seeking a trusted rehab facility managed by caring and experienced medical professionals, contact us at Blanchard Institute today!