Does Your Health Insurance Cover Substance Use Treatment?
Yes, the Affordable Care Act considers behavioral and mental health to be essential health benefits in the U.S. Therefore, your health insurance must cover rehabilitation (or rehab) for substance use and co-occurring mental health conditions.
NuView offers outpatient rehab programs, which are more cost-effective than residential care programs, as they do not involve hospital stays. So, your insurance can cover a greater number of sessions as well. You can contact your insurance provider to verify the extent of your insurance coverage. We can do this for you as well and ensure you receive the maximum benefits out of your insurance policy. You only need to reach out to us at (323) 307-7997.
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:
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.
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 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.
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.
Behavioral Health Coverage and Cost
The cost of substance use treatment can vary significantly based on your insurance plan. It's important to understand how your plan covers various services.
Types of Covered Treatments: Most insurance plans typically cover a range of services, including 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.
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.
Medicare: These programs also provide coverage for substance use treatment; however, the specifics can vary depending on the individual 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.
One of the most common questions is whether a specific mental health disorder will be covered by insurance. Parity laws do not specify exactly which mental health conditions must be covered. However, similar to substance use treatment, it is generally impractical for health insurance companies to make fine distinctions between conditions when determining coverage.
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.
Southern California Rehabs and Insurance Coverage
There are many types of treatment available for substance use disorders, each catering to different levels of severity. Individuals with co-occurring mental health disorders often require specialized, integrated treatment. Substance use treatment is delivered in a wide range of settings, and health insurance companies are required to cover a variety of treatment approaches.
With over 14,500 treatment centers across the United States, it’s no surprise that there is variation in their methods and approaches. Southern California, in particular, is an ideal place to seek recovery, as it has the highest number of treatment centers per capita, offering diverse and specialized options for individuals in need.
Treatment at these centers typically involves a combination of behavioral therapies and medical interventions. Rehabs also aim to address various aspects of an individual's life to ensure comprehensive recovery from the effects of substance use. These components include:
- Addressing substance use issues
- Healing and building healthy relationships
- Long-term aftercare and continued therapy
- Assisting with employment opportunities
- Securing safe and stable housing
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 behavioral health 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 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 behavioral health treatment. We provide clients with individualized treatment plans that are designed to address their personal history and circumstances.
At NuView Treatment Center, our highly qualified and compassionate staff make use of the latest evidence-based treatment modalities. Our services include:
- In-depth substance use assessments
- Substance abuse counseling
- Progress assessments
- Cognitive-behavioral therapy
- Substance Use education
- Medication-assisted treatment (MAT)
- Dialectical-behavioral therapy
- Drug screening
- Dual diagnosis treatment
- Group therapy
- Court-ordered/DUI rehab
- Life Skills Training
- Mindfulness-based therapy and other holistic therapies
- Telemedicine
- Relapse Prevention
Questions About Treatment Options For Substance Use Disorder?
Our admission specialists are available 24/7 to listen to your story and get you started with next steps.
Seeking Assistance but Finding It Difficult to Have a Conversation Just Yet?
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- Valuable resources on substance use and recovery
- Insight into our nurturing treatment approach
Remember, we are available 24/7 to address any concerns or inquiries.
