Monday, January 30, 2023

Insurance and Rehab Coverage Options

If you have insurance and need to go to rehab, it must be a relief to know you do not have to bear the entire cost of the treatment. Rehab services can be expensive, more expensive than most people can afford. On the other hand, controlled substances are usually affordable and available, and there is always something for someone looking hard enough. That is why there is a growing trend of getting ‘high’ and becoming addicted in the process.

Millions of Americans are in dire need of rehab services, but they do not get the help they need because of costs. Therefore, the government has made it a law that insurance companies must provide some sort of financial support to cover the cost of rehab. So, you can access rehab services if you need to without breaking the bank. However, before going all out to find the best rehab in your area, it is crucial to know what your insurance covers and what it does not.

First, contact your provider and discuss with them. Table your rehab needs and ask for specific information on what your policy covers. You may also want to know whether or not your provider covers your rehab option. If they do not, you may want to find out what rehab facilities they cover, research them, and see if they offer the specific services you need. Visit https://www.samhsa.gov/ to find the nearest treatment center to you.

What Rehab Services Do Insurance Plans Cover?

The Affordable Care Act stipulates that insurance plans must cover addiction treatments. These treatments vary, from inpatient programs to psychotherapy, and the needs of one patient may not be the same as those of the next. The main types of addiction covered in the Act are drug and alcohol addiction, not necessarily one addiction, so the recommended treatment may not be the same.

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However, the benefits of the health plans depend on the insurance provider and the facility of choice. In other words, what you find in one rehab center may not be exactly the same as the next. These benefits may also change every year, so it is crucial to make a list of potential rehabs to use and the accruing benefits. Then, you can carefully review each one for the most suitable one.

Some of the services that your health insurance may cover include:

  • Intervention. Some families and loved ones may stage an intervention for an individual who needs to go to rehab but is reluctant to acknowledge it.
  • Screening. For most addiction and substance abuse treatments, there is usually a need for screening. The rehab will determine whether or not it is necessary.
  • Behavioral healthcare services. Most rehab centers offer behavioral healthcare services such as psychotherapy and counseling.
  • Inpatient treatment. Health insurance usually covers inpatient treatment, which is when a patient has to live within the facilities for a specified period. This type of treatment tends to be the most expensive because of the requirements. Many times, inpatient care needs medical services.
  • Outpatient treatment. Not every addiction case requires inpatient care; some only need the individual to make frequent visits to the rehab and go home after each treatment. Some outpatients may also need medical attention.
  • Dual diagnosis treatment. A dual diagnosis is when a patient has both a substance abuse disorder and a mental health issue. Some call it a co-occurring disorder and there are special treatments for such cases.
  • Detoxification. Any inpatient program supports detoxification, which is the removal of toxic substances from the body. In this case, the process removes the abused substances left in the patient’s system.
  • Other addiction treatments. If there are other addiction cases, say addiction to medication, you will find rehab centers that offer treatment options.
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These are the primary services that your insurance policy covers. But these policies come in different packages costing varying amounts. So, you may want to know what is on offer based on your specific plan. Take a look at this article if you want to know more about the options available to you.

Other Possible Services Under Insurance

Apart from the key services mentioned above, the rehab you choose may offer a few other services. However, whether or not you are eligible depends on the policy in your name. The services include:

  • Aftercare services. Some rehabs offer services to help patients cope with life after rehab. They provide guiding steps and tips to overcome temptations.
  • Counseling for prevention and follow-up. Apart from providing tips to stay away from drugs, alcohol, and other substances, the service may include counseling on how to prevent destructive lifestyles and habits. Also, the center may want to follow the patient up to know about their general well-being and how they are coping with life without dependence on substances.
  • Peer support. You may get connected to peer groups that keep you accountable as part of your rehabilitation process.
  • Medication. Some addiction treatments require constant medication. Alcohol addiction is one that may need the patient to take some medication. This type of treatment needs careful observation, so it costs money.
  • Intensive outpatient services. Outpatient treatments do not generally need intensive care. However, in some cases, there may be a need for intensive care without getting the individual admitted.
  • Inpatient hospitalization. Not every rehab facility offers medical care, even though most of them have medical staff on hand. However, some severe addiction cases may require inpatient hospitalization and the facility may offer the service.
  • Interventions for risk reduction. Recovering addicts are more likely to go back to old ways than other people. Therefore, it is crucial to have plans in place to reduce this risk as much as possible.
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Your health insurance plan may not cover these services, but they are not essential for every patient. You can visit Humana Health rehab for more examples of coverage options.

Services Not Covered

The following are examples of treatments that your insurance does not typically cover, even though the center may offer them:

  • Holistic treatments
  • Fine dining or food delivery
  • Alternative therapy
  • Recreation services
  • Amenities that are not medical
  • Other private treatments

Conclusion

Insurance has become a way out of various financial predicaments, including medical emergencies. Addiction is one such emergency, and if you or a loved one needs help, there are many rehabs to select. Ensure you verify the coverage options and compare them to the needs of the patient before checking into a facility.

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