How Do You Find Out If Your Health Insurance Covers Rehab?

One of the questions to keep in mind as you consider rehab is whether or not your health insurance will cover the treatment. While the answer to this question depends on various factors, the simple answer is that different insurance providers cover rehab, while others do not. You’ll need to look into the details of your individual insurance plan to determine if you have coverage for alcohol and substance abuse.

Start by reviewing your insurance policy to determine if you will be covered for seeking treatment at a rehab center. Call your insurance provider directly to ask about the details of your coverage. It will help to be prepared with a list of questions that will help you get all the pertinent information you need. Keep the following questions in mind:

  • Will the insurance coverage include all phases of alcohol and/or drug rehab?
  • Will the policy cover the medications that are prescribed during rehab?
  • Does the policy cover counseling programs typically included as part of rehab treatment programs?
  • What will the deductible or copay be when I receive treatment for addiction?
  • What treatment programs will be covered with my current policy?
  • Does my policy allow me to seek treatment from a provider network?

While determining the details of your insurance coverage regarding rehab can be a complicated process, asking the right things will help you arrive at the answers you need.

Addiction Treatment Covered By Insurance

The types of addiction treatment covered by a specific insurance provider are specific to that particular coverage plan. As a general answer, most insurance companies cover detoxification. This service is most likely to be covered for patients that will experience fatal withdrawal symptoms during the recovery process if they experience detox outside of a rehab facility. The coverage for inpatient or outpatient rehab will vary between different insurance plans. Most policyholders expect that their insurance provider will mitigate the costs of addiction treatment with partial coverage. This is the ideal situation as most treatment programs are too expensive to pay for out-of-pocket.

Types of Insurance to Consider When Seeking Treatment

There are several different types of insurance options to consider before seeking addiction treatment. By choosing private insurance or managed care options like PPO, HMO, or point of service plans, you’ll be able to find a policy that will best suit your needs.

  • Private Insurance: Private insurance may be purchased as part of a group plan or individually. While it’s more expensive than other options, it typically has the best options for rehab coverage.
  • HMO: An HMO plan works with various insurance providers to provide care within a network of medical professionals. With this coverage, patients will rely on the network-approved physician to take care of general medical needs. Individuals in need of a specialist will go to one that is within the network. While it is typically more affordable, an HMO plan only covers care with providers inside the network.
  • PPO: With a PPO plan, individuals also have access to a network of providers. Members can take advantage of discounts with deductibles and premiums. While there are similarities between PPO and HMO plans, having a PPO plan allows customers access to medical professionals outside of their local network. With a PPO, you’ll likely have to pay upfront for addiction treatment and then seek reimbursement later.
  • Point of Service: This type of plan allows you to choose a PPO or HMO plan any time you need care. This plan has the most flexibility.

Costs You Will Encounter in Rehab

Going through recovery in a rehab center is worth the investment, but it is still quite expensive. With all the costs associated with recovery and rehab, it can be challenging to consider paying for your treatment out-of-pocket. While researching your options in rehab and your insurance policy, keep the following expenses in mind:

  • Detox: During the detox period of your recovery, you’ll go through withdrawal. This part of recovery is quite dangerous and should be experienced in a rehab or hospital setting.
  • Treatment: There are several various methods for treatment during recovery. The costs of these treatments can start at $1,000, with some of the more expensive options priced at $25,000.
  • Medication: Medication is often prescribed to help patients through treatment. These medications help with cravings and any other withdrawal symptoms.

If you’d like to further discuss rehab and insurance coverage, call us now at 833-762-3739. Our counselors are available 24 hours a day.