Does Insurance Cover Rehab?
Home – Does Insurance Cover Rehab?
- Written By
- Jean
- February 4, 2021
Clinically reviewed by Linda Whiteside
Medically reviewed by Dr. Ryan Peterson
Yes, insurance can cover rehab services for substance abuse, including alcohol rehab. Under the Affordable Care Act (ACA), health insurance plans are required to include coverage for essential health benefits, which encompass substance abuse treatment. This means that insurance plans purchased through the Health Insurance Marketplace must provide coverage for addiction treatment, including rehab services.
Does Your Health Insurance Cover Substance Use Treatment?
Yes, insurance can cover substance abuse treatment. Each plan specifies the extent of coverage, which may include various treatments such as inpatient rehab, outpatient therapy, and medication-assisted treatment.
It’s crucial for policyholders to review their coverage details or contact their insurance provider to understand the specific treatments and services covered under their plan.
What Types of Rehab Does Insurance Cover?
Insurance typically covers various types of rehab for substance abuse, but the specifics depend on the individual insurance plan. Commonly covered rehab types include:
- Inpatient Rehab: Residential treatment where individuals stay at a facility for a duration, receiving round-the-clock care.
- Outpatient Rehab: Treatment involving regular visits to a clinic or facility, allowing individuals to maintain daily responsibilities.
- Partial Hospitalization Programs (PHPs): A step down from inpatient care, offering intensive treatment for several hours each day, but allowing patients to return home at night.
- Intensive Outpatient Programs (IOPs): Less intensive than PHPs, these programs still provide structured therapy while accommodating work or school schedules.
- Detoxification Programs: Supervised medical detox, often the first step in addiction treatment, to manage withdrawal safely.
- Medication-Assisted Treatment (MAT): Combines behavioral therapy with medications to treat substance use disorders.
- Dual Diagnosis Treatment: Addresses co-occurring mental health disorders alongside substance abuse.
Coverage For Essential Health Benefits
However, it’s important to note that the extent of coverage may vary depending on the specific insurance plan and the insurance provider. Different plans may have different levels of coverage, including factors such as inpatient or outpatient treatment, duration of treatment, and types of therapies or services covered.
To determine the exact coverage provided by your insurance plan, it is advisable to contact NuView Treatment Center directly. Our staff can provide detailed information about the specific benefits, limitations, and out-of-pocket expenses you may be responsible for.
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Can I Have Multiple Insurance Providers?
Yes, it’s possible to have multiple insurance providers, a situation often referred to as “dual coverage.” This occurs when an individual is covered by more than one health insurance plan. Here’s how it works:
- Primary and Secondary Insurance: One plan is designated as primary and the other as secondary. The primary plan pays first, and the secondary plan may cover some of the remaining costs.
- Coordination of Benefits: This is a system insurers use to determine which plan pays first. It avoids overpayment or duplicate payments.
- Increased Coverage: Dual coverage can reduce out-of-pocket costs, as the secondary insurance might cover expenses not fully paid by the primary insurance.
- Covered Services: It’s possible to have a broader range of covered services with two plans.
However, there are considerations:
- Cost: You may have to pay premiums for both plans.
- Complexity: Handling claims and understanding benefits can be more complicated with two insurers.
It’s important to understand the details of each plan and how they work together to ensure effective coverage and avoid issues with claims processing.
Drug Addiction Coverage and Cost
Coverage and cost for drug addiction treatment through insurance can vary greatly depending on the specifics of your insurance plan.
- Types of Covered Treatments: Most plans typically cover a range of services, including detoxification, inpatient and outpatient rehab, therapy, and medication-assisted treatment. The extent of coverage for each can vary.
- Cost-Sharing Elements: Your out-of-pocket expenses will depend on your plan’s deductible, copayments, and coinsurance. Some plans may cover the majority of treatment costs, while others require significant cost-sharing.
- In-Network vs. Out-of-Network Providers: Costs can be significantly lower if you use in-network treatment facilities and providers, as insurance plans negotiate rates with these providers.
- Preauthorization Requirements: Some plans require preauthorization for certain treatments or medications, meaning you need approval from your insurance company before they agree to cover the costs.
- Limitations on Coverage: There might be limits on the length of stay for inpatient treatment, the number of therapy sessions, or types of medication.
- Affordable Care Act (ACA) Impact: Under the ACA, insurance plans offered through the marketplace are required to cover mental health and substance use disorder services as essential health benefits.
- Medicaid and Medicare: These programs also offer coverage for addiction treatment, but specifics vary by state (for Medicaid) and by the particular plan (for Medicare).
Does Health Insurance Cover Mental Health and Anxiety Treatments?
The answer to this question depends on the type of health insurance plan you have. Some plans may offer some coverage for mental health and anxiety treatments, while others may not include any coverage for these services. It is important to review your health insurance policy carefully so that you understand what types of services are covered.
In many cases, you may be able to purchase additional coverage for mental health and anxiety treatments if needed. Additionally, some insurance companies are beginning to offer more comprehensive plans that include coverage for mental health services. It is important to shop around and compare different policies to find the plan that best fits your needs.
Does Insurance Cover Comorbid Mental Health Conditions and Treatment Medications?
According to the National Institute on Drug Abuse, approximately half of all people with addictions experience a mental health disorder at some point, and vice versa. Mental illness and addiction are so intertwined that it can be impossible to treat one without treating the other as well.
The Affordable Care Act not only requires health insurance companies to cover addiction treatment, but the legislation also guarantees that people with mental health conditions get the same level of care as they would normally get for a physical ailment. This policy, which is known as parity, means that if a visit to a doctor for cold costs a patient $20, then visiting a doctor about depression must also cost $20. Parity laws apply to all kinds of health insurance plans, including employer-based health insurance plans, Medicaid and CHIP, and plans bought through health care exchanges.
One of the most common questions is whether or not a specific mental health disorder will be covered. Parity laws don’t specify exactly which types of mental health conditions plans must cover. However, as with drug addiction, it is simply inefficient for health insurance companies to make fine distinctions.
Rather than specifying which conditions are covered and which are not covered, plan administrators generally provide blanket coverage. While it is generally best to discuss the specifics of your case with your case manager, any diagnosed mental health issue is almost guaranteed to be covered.
Health insurance companies also recognize that many people who need addiction treatment are dual diagnosis. The term dual diagnosis refers to clients diagnosed with a substance use disorder and one or more additional mental health disorders. Covering treatment for comorbid conditions is in the client’s best interests, but it is also in the insurance company’s best interests.
If a mental health disorder is left untreated, it can easily cause a client to relapse and return to substance abuse. This means they will need to return to treatment again — costing the health insurance company more money. For clients with comorbid conditions, health insurance companies strive to treat both conditions simultaneously.
Comprehensive treatment for comorbid mental health conditions is offered by many outpatient rehabs for addiction. It is known as an integrated treatment. When outpatient rehabs offer integrated treatment, they provide dual-diagnosis clients with evidence-based behavioral therapies to address their addictions and mental health conditions. In many cases, they also prescribe medications to alleviate the symptoms of one or more of these conditions.
Southern California Rehabs and Insurance Coverage
There are many types of addiction treatment available. Different treatment approaches can effectively help people on different ends of the addiction severity spectrum. People with comorbid mental health disorders also often require specialized treatment. Drug and alcohol addiction treatment is delivered in a wide variety of settings. Health insurance companies are required to cover a wide range of addiction treatment approaches. Given the sheer number of rehabs in the United States (more than 14,500 nationwide), there is no surprise that there is variation in their treatment approaches and methods. Southern California is a great place to get sober because there are more drug rehabs per capita than in any other region of the United States. This means there are many different rehabs to choose from, ensuring that individuals can get the specialized treatment they require. Addiction treatment at a rehab generally involves a variety of treatment modalities. Most commonly, rehabs offer a combination of behavioral therapy and medical treatment.
Rehabs also strive to comprehensively address many components of a person’s life to help them recover completely from the effects of addiction. These components include:
- Their substance abuse
- Seeking employment
- Healing and developing relationships
- Finding safe housing
- Long term aftercare therapy and treatment
It is important to choose a rehab that offers this kind of comprehensive treatment. For most people, simply getting physically sober is rarely enough. It is crucial to develop coping skills and relapse prevention techniques, to address underlying mental health issues, and to rebuild one’s life from the ground up.
Quality rehabs covered by health insurance provide effective, integrated, and comprehensive treatment to ensure that clients get sober and stay sober.
Find Outpatient Treatment Covered by Insurance Near You
If you or a loved one suffers from a substance use disorder, getting treatment as soon as possible is important. Many people are reluctant to seek addiction treatment because they believe they must be “strong” and manage their substance abuse independently. Others feel intense shame around their substance use disorder — or around the idea of asking for help.
It is important to recognize that substance use disorders are not personal failings; they are legitimate mental health disorders that are covered by health insurance plans. While there are many reasons why people are sometimes reluctant to get help, finances should not be one of them.
Given the number of rehab programs in the United States, and in Southern California in particular, it is important to choose one that meets your unique needs. NuView Treatment Center, an outpatient drug rehab in Los Angeles, is an outpatient rehab that offers all levels of care, including acute care in our partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs), and more flexible care in our outpatient programs (OPs) and aftercare planning.
At NuView Treatment Center, we believe that there is no one-size-fits-all approach to addiction treatment. We provide clients with individualized treatment plans that are designed to address their personal history and circumstances.
Does Insurance Cover Comorbid Mental Health Conditions and Treatment Medications?
According to the National Institute on Drug Abuse, approximately half of all people with addictions experience a mental health disorder at some point, and vice versa. Mental illness and addiction are so intertwined that it can be impossible to treat one without treating the other as well.
The Affordable Care Act not only requires health insurance companies to cover addiction treatment, but the legislation also guarantees that people with mental health conditions get the same level of care as they would normally get for a physical ailment. This policy, which is known as parity, means that if a visit to a doctor for cold costs a patient $20, then visiting a doctor about depression must also cost $20. Parity laws apply to all kinds of health insurance plans, including employer-based health insurance plans, Medicaid and CHIP, and plans bought through health care exchanges.
One of the most common questions is whether or not a specific mental health disorder will be covered. Parity laws don’t specify exactly which types of mental health conditions plans must cover. However, as with drug addiction, it is simply inefficient for health insurance companies to make fine distinctions.
Rather than specifying which conditions are covered and which are not covered, plan administrators generally provide blanket coverage. While it is generally best to discuss the specifics of your case with your case manager, any diagnosed mental health issue is almost guaranteed to be covered.
Health insurance companies also recognize that many people who need addiction treatment are dual diagnosis. The term dual diagnosis refers to clients diagnosed with a substance use disorder and one or more additional mental health disorders. Covering treatment for comorbid conditions is in the client’s best interests, but it is also in the insurance company’s best interests.
If a mental health disorder is left untreated, it can easily cause a client to relapse and return to substance abuse. This means they will need to return to treatment again — costing the health insurance company more money. For clients with comorbid conditions, health insurance companies strive to treat both conditions simultaneously.
Comprehensive treatment for comorbid mental health conditions is offered by many outpatient rehabs for addiction. It is known as an integrated treatment. When outpatient rehabs offer integrated treatment, they provide dual-diagnosis clients with evidence-based behavioral therapies to address their addictions and mental health conditions. In many cases, they also prescribe medications to alleviate the symptoms of one or more of these conditions.
Southern California Rehabs and Insurance Coverage
There are many types of addiction treatment available. Different treatment approaches can effectively help people on different ends of the addiction severity spectrum. People with comorbid mental health disorders also often require specialized treatment. Drug and alcohol addiction treatment is delivered in a wide variety of settings. Health insurance companies are required to cover a wide range of addiction treatment approaches.
Given the sheer number of rehabs in the United States (more than 14,500 nationwide), there is no surprise that there is variation in their treatment approaches and methods. Southern California is a great place to get sober because there are more drug rehabs per capita than in any other region of the United States. This means there are many different rehabs to choose from, ensuring that individuals can get the specialized treatment they require.
Addiction treatment at a rehab generally involves a variety of treatment modalities. Most commonly, rehabs offer a combination of behavioral therapy and medical treatment. Rehabs also strive to comprehensively address many components of a person’s life to help them recover completely from the effects of addiction. These components include:
- Their substance abuse
- Seeking employment
- Healing and developing relationships
- Finding safe housing
- Long term aftercare therapy and treatment
It is important to choose a rehab that offers this kind of comprehensive treatment. For most people, simply getting physically sober is rarely enough. It is crucial to develop coping skills and relapse prevention techniques, to address underlying mental health issues, and to rebuild one’s life from the ground up.
Quality rehabs covered by health insurance provide effective, integrated, and comprehensive treatment to ensure that clients get sober and stay sober.
Find Outpatient Treatment Covered by Insurance Near You
At NuView Treatment Center, our highly qualified and compassionate staff make use of the latest evidence-based treatment modalities. Our services include:
- In-depth addiction assessments
- Cognitive-behavioral therapy
- Dialectical-behavioral therapy
- Group therapy
- Mindfulness-based therapy and other holistic therapies
- Substance abuse counseling
- Drug and alcohol education
- Drug screening
- Court-ordered/DUI rehab
- Telemedicine for addiction
- Progress assessments
- Medication-assisted treatment (MAT)
- Dual diagnosis treatment
- Life Skills Training
- Relapse Prevention
Recovery from addiction and comorbid mental health disorders is possible at NuView Treatment Center. Our treatment programs are also covered by most health insurance plans. Health insurance companies that cover addiction treatment at NuView Treatment Center include:
- Sharp Usable Administrators
- Sanford Health Plan
- Quartz Health Solutions
- Prominence Health Plan
- Presbyterian Health Plan
- Optima Health
- Coastwise
Frequently Asked Questions
Yes, health insurance can cover outpatient rehabilitation and alcohol treatment. The coverage may vary depending on your specific insurance plan and provider. It is recommended to contact your insurance company or review your policy to understand the details of coverage for outpatient rehabilitation and alcohol treatment services.
Yes, most drug rehabs accept insurance for teens. This can be very beneficial in terms of cost as it can significantly reduce the overall financial burden of treatment. Depending on your health insurance provider, they may cover some or all of the costs associated with drug rehab.
It is important to contact NuView in advance to determine exactly what types of services we cover and any applicable limitations.
The answer is yes, recovering drug addicts can have life insurance. Life insurance companies recognize that addiction is a treatable condition and may offer coverage to those who are able to demonstrate long-term sobriety. The amount of coverage and the premium will depend on various factors, including the individual’s health, age, lifestyle, and other risk factors.
It is important for those in recovery to be honest about their history of substance use when applying for life insurance, as the insurer will consider this in determining eligibility. Those who have been sober for at least two years may find that they are eligible for more coverage or a lower premium.
The cost of drug rehabs with insurance will vary based on your insurance plan, the type of coverage your plan offers for addiction treatment and other factors. Generally, if you have health insurance that covers drug rehab costs, you may pay a copay or coinsurance for each medical service you receive.
Some insurers may also require you to meet a deductible before they cover the cost of your treatment.
- Limited coverage for mental health and substance abuse treatment,
- High deductibles and Out-of-pocket expenses,
- Preexisting condition exclusions
- And limitations on the number of covered days or sessions.
Some health insurance providers known to cover addiction treatment include
- Blue Cross Blue Shield,
- Aetna,
- Cigna,
- UnitedHealthcare,
- and Humana.
However, coverage can vary depending on the specific plan and policy.
Preauthorization for treatment is a process where the insurance provider reviews the treatment plan to determine its medical necessity. The treatment facility or healthcare provider usually submits the necessary documentation and obtains approval before proceeding with the treatment.
If your insurance claim for rehab treatment is denied, you can appeal the decision by providing additional information, documentation, or medical necessity evidence. Working with the treatment facility and seeking guidance from an advocate or healthcare professional can help navigate the appeals process.
Contact NuView at 323-307-7997 directly to find out exactly what your current insurance plan covers regarding rehab. Our staff can provide information on coverage, network providers, deductibles, copayments, and any limitations or exclusions specific to your plan.
Yes, a history of substance use can potentially impact your life insurance coverage. Life insurance companies may consider substance use as a risk factor when determining premiums or coverage eligibility. Factors such as the type and duration of substance use, current treatment or recovery status, and overall health condition will be taken into consideration. It is advisable to disclose your history of substance use accurately and honestly when applying for life insurance to ensure transparency and avoid any issues with coverage.
- 1-month drug detox: $250 – $800 per day
- 3 months – outpatient care: $1,400 – $10,000
- 1-month intensive outpatient program (IOP): $3,000 – $10,000
- Residential treatments start from $5,000 and go up to $80,000 (depending on how long you stay)
Insurance plans often have a network of preferred providers or facilities. It’s important to check if a rehab center is in-network with your insurance plan to maximize coverage. Out-of-network options may result in higher out-of-pocket costs.
If insurance doesn’t cover the total rehab cost, strategies to manage the remaining cost can include negotiating payment plans with the treatment center, exploring financial assistance programs, seeking grants or scholarships, or considering personal loans or assistance from family and friends.
Insurance coverage for aftercare or follow-up appointments post-rehab can vary. Some insurance plans may cover continuing care services, including therapy or support groups, while others may have limitations.
Insurance can typically be used for outpatient treatment or partial hospitalization programs, but coverage details may vary. It’s essential to review your insurance plan to understand the coverage and any limitations for these types of programs.
Insurance coverage for detox and rehab can differ. While detoxification may be covered as part of the initial treatment process, the coverage for rehab programs, such as inpatient or outpatient treatment, can have different criteria, limitations, or authorization requirements.
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