How Much Does Rehab Cost If You Have Insurance?

Rehab Cost
May 4, 2016 at 3:00 pm

How Much Does Rehab Cost?

Just about any serious medical condition has the potential to affect a patient, his/her family, friends and acquaintances, but alcohol and drugs addiction take it a step further. Not only is there a physical and emotional toll on the addict, but the toll it takes on those around him/her can be far greater than a physical disease. Addiction is a disease that affects every facet of a person’s life and in many cases has then questioning whether carrying on with life is even worth it.

The fact that different people deal with addiction in their own unique way makes cookie-cutter treatment methods out of the question many physical ailments have been known to respond well to set treatments that haven been proven overtime, but with addiction each treatment must be customized to a certain extend. The same concepts and theories can be effective, but within each protocol, the person must be dealt with as an individual abs after 40.

So how much does rehab cost? The American Medical Association recognizes alcoholism (alcohol use disorder) and substance addiction (substance use disorder) as diseases, forcing health insurance companies to recognize the need for treatment coverage. Also, the 2008 Affordable Care Act and Mental Health Parity and Addiction Equity Act require that, for insurance providers that offer coverage for behavioral health conditions, mental health and substance abuse treatment benefits be comparable to medical care benefits. This means insurance policies – both public and private – must cover substance abuse treatment to the same extend that they cover other medical conditions.

Insurance policies vary in the amount of treatment services that they cover. But most policies will cover assessment (generally fully covered), detoxification (generally most covered, but rapid detox and ultra-rapid detox tend to not be covered), out-patient treatment (generally mostly covered) and in-patient (residential) treatment (generally partially covered). Insurance policies cover addiction treatment to the same extend that they cover other medical conditions. But they will only cover what a professional determines to be “medically necessary”. However, you need to dig into the details of your plan to discover the real information on how much coverage you have. Some of the common stipulations you may see include:

  • Changing coverage based on the length of treatment.
  • Changing coverage based on the type on addiction.
  • Not allowing detox as part of the coverage.
  • Changing coverage based on the type of treatment.
  • Having to use “network” physicians and facilities to ensure coverage.
  • Denying coverage if you have been through rehab before.

As with any insurance policy, there are always some regulations which you must understand if you want to maximize your coverage without any surprises.

Depending on your ability financially, place of work or your liking, there are several types of insurance to cover your rehab costs. These are:

Public insurance

A few treatment facilities are partially or entirely subsidized by the government, and these facilities accept state or federal medical insurance plans for full or partial payment of services. However, there is specific income guidelines put in place for these plans. Make sure to check with the rehab facility you are planning to enroll in or the right public insurance agency to determine whether you are qualified for the services. There are also nonprofit organizations that provide rehab services at economical monthly installment schemes.

Private insurance

This refers to any health insurance plans that are paid for by an individual person or an employer and is not subsidized by the federal government or any of its agencies. Although costly, but the array of healthcare options available to you is more comprehensive than what is provided by public insurance plan.

Group insurance

The Mental Health Parity and Addiction Equity Act of 2008, mandates health insurance companies to balance the alcohol and drug treatment for group plans to the stipulation for standard medical rehab for these situations. The insurance plan usually cover plans for detox, individual and group outpatient support, residential hospitalization, and long-term in-patient treatment.

It is obvious now rehab costs a little less when you have insurance. However, when choosing a health insurance facility that covers rehabilitation services, it’s good to consider:

  • Relapse

Some policies consider repeat visits into treatment as a pre-existing condition that is worthy of being denied treatment. Relapsing happens to many people, and if it has happened to you ensure that you read your policy well to find out if you’re covered.

  • In-patient or out-patient?

Your insurance may cover rehab that is labeled as in-patient or out-patient, though it may cover a variation of the both. It is important to know how much your plan provides for both in-patient and out-patient care, before you start any kind of treatment.

  • Whole-body holistic healing

The holistic approach includes treatments based around art, music, equine therapy and psychodrama therapy. Any rehab facility with this approach is worth visiting as it helps you get rid of addiction completely.

Some rehab facilities include follow-up care to help you when you get back to the society. It is very important to get into such a facility.

The bottom line is, when you have insurance, the rehab costs less. Make up your mind to get an insurance cover for rehab, won’t you?