Does My Insurance Cover Alcohol Addiction Treatment?
Insurance coverage for substance use disorder (SUD) treatment, including treatment for alcohol addiction, has become more widespread and accessible for individuals and families. However, it is often still limited in terms of the types of services and the length or amount of those services.
Is Rehab Covered By Insurance?
Many health insurance providers cover all or part of the costs of substance use disorder (SUD) and alcohol addiction treatment. The passing of the Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) greatly broadened this access to SUD treatment for millions of Americans.
The MHPAEA ensures that health insurance providers and group health plans (like Medicare and Medicaid) that offer mental health and SUD treatment do not impose greater limitations on these benefits than they would on other medical and surgical benefits. While beneficial for many, the act has varying impacts on private employment-based health plans, so it’s important to know the specifics of your health insurance plan to know what coverage is available to you.
Many Americans who are insured by providers under the MHPAEA do not know that their addiction treatment is covered by their insurance. In the 2015-2018 National Survey on Drug Use and Health, 37.6% of participants admitted they were unaware that treatment for drug and alcohol addiction was included in their coverage.
Cost of treatment varies depending on the level of treatment, length of stay, insurance coverage, and other unique factors. The amount of coverage is based on an individual’s specific insurance policy, which means out-of-pocket expenses will vary.
What Benefits Are Provided By Health Insurance For Addiction Treatment?
Successful recovery from alcohol addiction has been achieved through many methods of treatment. Fortunately, many of these treatment options can be covered or partially covered by a person’s health insurance plan.
Program benefits and details all depend on your specific insurance plan, but addiction treatment programs covered often include:
Which Insurance Policies Cover Rehab?
Most available group health insurance plans and plans purchased through the Healthcare Marketplace fall under the MHPAEA and Affordable Care Act (ACA), ensuring those plans cover addiction treatment to varying degrees.
It is important to know that plan exceptions do exist though, and include:
• Self-insured non-Federal governmental plans that have 50< employees
• Self-insured small private employers that have 50< employees
• Group health plans and health insurance issuers that are exempt from MHPAEA based on their increased cost
These plans may still include coverage for SUDs but can have more specific criteria to meet before accessing coverage. Private or employer-subsidized plans may also have specific care guidelines that seek to ensure that treatment is medically/clinically necessary, require prior authorization of requested services, and request transition to lower levels of care (e.g., from inpatient to outpatient) as quickly as possible.
Alcohol Rehab Guide is not affiliated with any insurance.
How Does ACA Coverage Work?
The ACA requires addiction treatment to be as complete as any other medical procedure. Under the ACA, alcohol and other drug addiction is not considered a pre-existing condition and treatment for it cannot be denied. Addiction and mental health treatment are given the same weight as any other physical ailment, also known as parity.
Parity protections for mental health and substance abuse services means that limits applied to these services cannot be more restrictive than limits applied to medical and surgical services.
The difference between state and federal insurance plans is based on how each state defines who is covered under Medicaid or Medicare. These plans are based on age and income for the family or household size.
Most people who are not covered under Medicaid, Medicare, or an employer plan, can buy an ACA plan on the health insurance marketplace after meeting certain requirements such as being a US citizen or legal resident, living permanently in the US, and not being incarcerated. People who make low to moderate incomes can receive subsidies through the ACA that help lower the costs of deductibles, premiums, co-payments, and other health-related expenses.
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Does Your Health Insurance Cover Alcohol Addiction Treatment?
The extent to which your insurance will cover rehab depends upon your policy’s particular behavioral health benefits, the treatment facility, and your specific needs, as well as other factors.
Your health insurance plan will determine how much of your treatment is covered by insurance, as well as how much you will be required to pay out-of-pocket.
There is rarely a simple “yes” or “no” answer when it comes to what insurance companies will or won’t cover. It’s essential to research your specific insurance plan to learn what is and is not included. It is always advisable to check with your insurance provider before trying to enter a treatment program for substance use issues to understand the details of what is and is not covered under your plan.
Most alcohol addiction treatment facilities and programs have staff whose job is to determine what a person’s insurance policy will and will not cover. It’s important to contact the facility you wish to attend to find out what treatment options are covered under your insurance plan.
What If You Do Not Have Health Insurance?
If you don’t have private health insurance, you still have access to treatment.
There are various free or lower cost and state-funded alcohol rehab options available to you. States may offer financial assistance for those who have no insurance and need free or low-cost addiction treatment.
Other Options For Paying For Alcohol Rehab
Most addiction treatment facilities and programs have self-pay options where people can pay out-of-pocket. Some have a set rate for different types of treatment and others have a sliding scale based on individual or family income.
Financial Support From Family Or Friends
Though asking for help can be difficult, you may be surprised by how many people may want to support your treatment via donations or loans. Asking family and friends for financial support can make a substantial positive difference, but always make sure that the arrangement is agreed upon and understood by all parties involved.
Loans Or Payment Plans
Many treatment centers provide financing and payment plan options that allow you to pay for the cost of treatment in fixed increments over time.
Some treatment facilities offer scholarships to those in need to cover all or part of the cost. Some states and counties also offer scholarships and grants to those with addiction who need help paying for treatment.
End The Cycle Of Addiction Today
Suffering from an alcohol addiction can make you feel like you have no other choice, but help is available. By selecting your insurance provider here, you can view treatment facilities that are covered by your insurance plan.
Talk with a treatment provider today to explore what options are available to you on your road to recovery from alcohol addiction. Start your journey today!