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The National Institute on Drug Abuse (NIDA) reports that drug addiction treatment can save society and individuals around $12 for every $1 spent on rehab when you factor in costs related to healthcare, the legal system, criminal justice, accidents, theft, and workplace productivity that are all impacted by the disease of addiction. With the implementation of the Affordable Care Act (ACA), treatment access and insurance coverage for mental and behavioral health issues, including addiction, have improved. In many cases, these services are now required to be covered at equal rates to other necessary medical or surgical services, which is called parity. So, in short, yes, insurance can cover rehab. Detox services, inpatient and outpatient treatment programs, medications, therapy, counseling, maintenance, and follow-up care may be covered by insurance.
As the National Survey on Drug Use and Health (NSDUH) reports that in 2014 over 21 million American adults battled addiction, this is great news. It is important to fully understand insurance coverage and how to use it toward rehab services, however. Not all facilities may accept insurance as a form of payment, for example. While many public addiction treatment programs often accept any and all people regardless of their financial situation, private rehab facilities may not. These programs may still accept insurance for at least portions of the treatment provided, however.
Insurance providers may pay for treatment services with specific rules and regulations in place as well. For instance, many insurance policies will only cover outpatient treatment services or only detox services. Some policies require individuals to seek a referral from a primary care provider before covering services and may only provide coverage for residential treatment programs after an individual has first attempted outpatient treatment.
Treatment must also generally be deemed “medically necessary” before insurance will cover it. Insurance plans may only provide coverage for services rendered at “approved providers” in many cases as well. Some policy’s coverage may be more comprehensive than others. Both the insurance company and the professional staff at a rehab facility can be great resources for understanding how to make the most out of the coverage available.
Insurance coverage contains a lot of nuances and specifics, and it is essential to understand some of the language used when it comes to insurance. Common insurance terms and their definitions are outlined below.
The following are examples of different types of insurance plans that may be used to pay for rehab:
Navigating insurance coverage to defray the cost of rehab may seem daunting initially, but there are several things people can do to make the process easier.
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