There are many people, who need detox services, that won’t pursue any help for their addiction. Since the price of this kind of treatment can be high, people become afraid of the cost they may ultimately need to handle. There are even some that don’t want their employer to find out about their addiction, so they don’t seek help for it. While it’s understandable for the concern that you may be feeling, it’s still important to use your insurance plan, when possible, to help bring the price down to something more manageable for you. In this article, we’ll explore some of the things you need to know about using your health insurance for detox services.
There are different health insurance plans and which ones your employer has will vary. If you’re looking to get signed up for a detox program, you should be aware of your insurance options and what kind of coverage you could get. Here’s some information you should know about using insurance for your detox treatment:
Many Health Insurance Providers Provide Coverage for Detox
Not all insurance providers offer coverage for detox treatments, but most of them do. Each carrier that does has different copays and deductibles, so each person’s coverage will vary with their own individual plans. It’s important to talk with your insurance carrier to find out what they cover and how much they intend to pay. Also, you will need to find out what requirements they have for getting that coverage. For example, some plans ask that you get a physicians referral for the type of treatment you’re looking to get.
The Affordable Care Act started several years ago, enables certain provider plans to cover rehab and treatment as they would cover other mental or health-related conditions. Some items you may find covered under the ACA are:
- Addiction medications
- Counseling sessions
- Alcohol and drug testing
- Assessments for addiction
This opens many opportunities for getting insurance coverage for treatments that previously had none. Now, more providers are getting on board and offering at least a small portion of the treatment programs so that more people can get the help they need.
Some Insurance Providers May Cover Treatment at a Specialty or Luxury Clinic
There are some providers that have predetermined clinics they allow your treatment to take place in. These are usually in-network facilities the insurance company accepts as being a provider of the service you’re getting.
There are, however, some that will accept a specialty or luxury clinic as your treatment facility. In these cases, they’re generally considered being an out-of-network clinic. That would mean they cover a little less of the services you receive and you would have to pay a little more out of your own pocket.
Some Insurance Providers May Cover Inpatient Services
If treatment for your addiction requires inpatient services, all is not lost. Some insurance carriers will cover at least a portion of inpatient services. There may be certain requirements you must meet before you receive those benefits, however.
Inpatient programs are more expensive due to the necessary treatments that will take place during your stay. This raises eyebrows with insurance companies. Some may ask that you try outpatient treatment first before allowing coverage for an inpatient program. Others may be okay with it.
Insurance Providers Shy Away from Holistic Practices
While there’s nothing wrong with pursuing a holistic program for your addiction, you should know many providers will deny coverage in most cases. Holistic treatments are great for providing help with your physical, mental, and spiritual health. Many people have met their addiction-free goals using one of these centers.
However, insurance companies don’t see some of those treatments as medically necessary for a person entering detox. So, they often deny coverage for most services if not the whole program. Check with your provider to see if your plan will cover a holistic type of treatment and what benefits you will receive from it if they do.
Private Insurance Companies May Offer More
In most cases, private insurance plans cost significantly more than a public insurance would. Even though they tend to charge higher monthly premiums, they make up for it with their broader coverage options for your medical and detox needs.
Private plans often will let you choose from more facilities and receive coverage for more types of treatments. They also will pay much more of the program services than a public insurance plan would. With that said, you still must check with your provider to be sure they will cover your detox.
Some Insurance Providers May Cover Detox if You Have Mental Health Treatment As Well
Each insurance plan will be different with what they will and will not cover. They’ll also vary with the requirements they place on people who are seeking detox treatment. Some of these companies may ask that you add a mental health treatment program, of some type, to your detox service.
Insurance carriers recognize the importance of long-term treatment for addictions. Detox services that help the addiction, initially, could cause some serious withdrawals and side effects, so a treatment program that adds mental health may be necessary. Once the two programs are combined, they could cover a good portion of the service.
Using health insurance to keep the cost of detox down will ease the stress you otherwise would have otherwise worried about how to pay for it. Even though each plan is different in what items they cover and how much coverage they provide, still pursue finding out what yours will do for your detox needs. Don’t assume that they will cover any part of the program. Ask first and get all the information you can. It’s also important to note that there are still payment options available if you need help paying for the remaining amount that insurance doesn’t cover. If you’re confused about your plan or if you have other questions you need answers to, call us at 866-754-9113. We’ll be glad to help you out.