On many occasions, we may wonder if insurance covers alcohol rehab because it is a disease people have to deal with. Usually, insurances offer coverage for alcohol rehab, either fully or partially.
This disease requires treatment, just like heart disease or cancer. But, many factors influence the amount and type of coverage each insurance plan provides for treatment.
Sometimes, there will be no insurance coverage, and personal loans can help bridge the gaps by making treatment more financially feasible for those who require care.
Cost is a barrier to alcohol rehab
Typically, patients who do not seek medical care for alcohol addiction do so because the costs are too high. This causes many people to think that these treatments are beyond their financial means.
In addition, many people suffering from alcohol abuse are unemployed or struggling financially. However, even people with stable incomes may find the cost of rehab prohibitive when compared to other financial responsibilities.
How do you find insurance plans that offer coverage?
The only way to verify if an insurance plan has this type of coverage is to call the insurance company and ask about the types of addiction treatment they offer. Private insurance plans usually have more comprehensive coverage but tend to cost more.
Employer-provided group insurance plans can become expensive and are often subject to restrictions. The Affordable Care Act Marketplace is available for self-employed people or people not insured through work.
There are also state exchange plans that offer options for addiction treatment coverage. If a policyholder seeks alcohol addiction treatment for the first time, the insurance plan may offer coverage for rehab.
However, if the person relapses and needs to return to treatment, insurance plans may exclude additional treatment, so they will not offer coverage in these cases.
Is addiction considered a pre-existing condition?
As stated in the Affordable Care Act, which has been in effect since 2014, insurance companies cannot deny or charge more when pre-existing conditions exist. Previously, insurance companies used pre-existing conditions as a reason to deny coverage.
For this reason, people could not access health insurance that offered coverage for alcohol rehabilitation. They also used to charge much higher insurance rates, prohibiting the cost of obtaining insurance.
Can I go to rehab without insurance?
If you do not have insurance, you may opt for state-funded health plans that can help you with the cost of rehabilitation. Plans include Medicare and Medicaid to help with the rehabilitation process for patients.
Moreover, most treatment centers will accept payment options such as payment plans, loans, and public assistance. For this reason, looking into the options, the state offers will always be a good option to get as much versatility as possible.
How does Medicare work for alcoholism?
Medicare has different parts that we will have to consider, parts A and B being the ones that are related to addiction treatment. Part A will help us pay for inpatient hospitalization for substance abuse, while Part B will partially cover outpatient hospitalization.
On the other hand, Part D provides coverage for medically necessary medications to treat the policyholder’s alcohol addiction. However, some medications, such as methadone, are not covered.
How does Medicaid for alcoholism work?
Medicaid is a public health insurance program funded between the states and the federal government and is intended for low-income families. It will cover the basics of recovery from alcohol dependence.
Hospital care, outpatient visits, and more are offered within the coverage. In most states, there is no co-payment for addiction treatment services, although not all facilities will accept Medicaid as a form of payment.
What costs should be considered for rehab treatment?
Many insurance plans cover a good portion of alcohol rehab treatment expenses. However, we must also consider some out-of-pocket costs such as:
- Premiums: this will be the cost of having insurance.
- Coinsurance payments or co-payments: a lower fee that allows access to a doctor or service.
- Deductibles: a certain amount the policyholder is expected to pay before coverage begins.
- Lifetime limitations: In some insurance plans, coverage will only pay up to a certain point. For this reason, the policyholder will be responsible for costs beyond the policy’s coverage.
How can insurance be used to pay for alcohol rehabilitation?
The first step is to verify the coverage levels that our specific policy has, and from there, we will need to follow these steps:
- We must talk to a doctor to determine our treatment needs and who will be in charge of determining the degree of abuse or addiction of the patient.
- We will have to find a rehab program that is appropriate for our needs and verify that the program provides professional medical treatment so that insurance will cover it.
- Next, we will need to determine the ability to use the insurance, verifying that they will accept the specific plan we have with our insurance company.
- Finally, we will need to work with the rehabilitation center to determine insurance coverage, and the center’s specialists will tell us what is and is not covered by our insurance plan.
In most cases, we will be able to find coverage for alcohol rehabilitation. However, each patient will always have to be analyzed case-by-case basis to see if we are eligible for insurance coverage.