How Does Insurance Cover Drug Treatment?

The cost of addiction treatment should never prevent somebody from getting the help that they need. Unfortunately, it often does. The price of healthcare in the US is extremely high, and that includes the cost of addiction care. Paying for addiction treatment out of pocket could cost you tens of thousands of dollars. However, if you have health insurance, a lot of your treatment options are likely covered in your plan.

How Does Health Insurance Work?

Health insurance can get complicated and frustrating, so let’s try to simplify some of the process and terms. First, if you have insurance, you know that you pay a monthly premium for the service. In exchange, your insurance company pays for certain medical costs. Health insurance works in the same way for drug addiction as it does for any other health condition. Addiction treatment usually gets the same types of coverage as diabetes or asthma treatment.

In addition to your monthly premiums, you probably also have something called a deductible, which is the amount of money that you pay out of pocket before your insurance “kicks in” and pays for anything. For example, let’s say that you have a $500 deductible, and you haven’t spent money on any medical costs this year. If you stay in a hospital, and that stay costs $600, you’d have to cover $500 of that cost before the insurance company covered anything. There are other terms and complications attached to health insurance, but generally, this is how insurance works.

Will My Treatment Be Covered?

same way that they cover treatment for other chronic illnesses. If your plan does cover addiction treatment, then you should absolutely use that coverage. After all, that’s why you’re paying for insurance in the first place.

If you bought your insurance through the Marketplace (sometimes called “Obamacare”), then your treatment will definitely be covered, at least to some degree.

Every plan in the Marketplace has to include at least some level of addiction treatment coverage. Furthermore, health insurance doesn’t make distinctions between one addiction and another. Under the same insurance plan, a person who is addicted to heroin will get the same coverage as a person who is addicted to alcohol.

Do you need treatment for an addiction? Call 800-492-QUIT for help.

What Kind of Treatment is Covered?

Insurance companies cover all sorts of addiction treatments. These treatments include the types on the list below:

  • Medical detox
  • Inpatient rehab
  • Outpatient rehab
  • Other therapy and counseling
  • Some medications

Medical detox is often the first step in addiction recovery treatment. When you stop using drugs, you still have a buildup of drugs in your system. When those drugs start to exit your body, you’ll have entered a process called detox. With some drugs, you can detox from home. However, if you are addicted to alcohol, opioids, or benzodiazepines, you should detox in a medical facility. These drugs have dangerous and difficult withdrawal processes, and medical detox can keep you safe and comfortable while the drugs exit your body.

Next, you can go to either inpatient or outpatient rehab. Some rehab facilities even have medical detox facilities on site so that you don’t have to travel to two different places for treatment. Whether you choose inpatient or outpatient rehab will depend largely on your drug of choice and your level of support at home. If you’re addicted to an especially dangerous drug and/or have a limited support network at home, inpatient rehab will likely provide the best choice. These residential programs provide highly structured therapy far away from potential triggers. Outpatient rehab provides many of the same therapies, but patients live at home and go to the rehab center during the day for treatment.

After rehab, you should at least consider talking to a therapist on a regular basis. Addiction treatment, like asthma treatment, is a lifelong process, and continued therapy can help you stay on track with healthy coping techniques. Furthermore, your doctor may prescribe medications to help you manage any underlying mental health conditions such as depression.

What If I Need More Financial Help?

If you don’t have health insurance or don’t have enough coverage for your addiction treatment, you do have other options to help you fund your treatment. For example, many rehabs offer payment plans so that you can pay for your treatment in manageable payments as opposed to one lump sum. Some rehabs offer scholarships. If you’re a religious person, you might consider attending faith-based rehab, which is sometimes free or low-cost.

If You Need More Information

If you need more help or advice about insurance and treatment options, allow the caring experts at Rehab Info to help. We understand that you have to dig through a lot of information when you start seeking treatment, which is why we want to help you understand that information and make the choices that will work for you.

If you want to overcome a drug

or alcohol addiction, call us today at 800-492-QUIT.
Have HMO or PPO insurance? Get a list of 5 Star Rehab Centers that work with your insurance!
Call now (866) 734-3807