Using Commercial Health Insurance for Addiction Treatment

Addiction can be a frightening time for everyone, including loved ones, coworkers and others who have seen you at your worst and now want to welcome you back to your best. Getting help for your addiction is the first step that you can take to getting back to being the best person that you can be but you have to be willing and able to accept that help before any changes can be made.

Of course there are many questions and concerns that you might have about treatment including which kind will be best and how you will pay for that treatment. For most people, insurance will cover at least some of the costs of treatment so that you can focus on your actual recovery.

 

The Levels of Treatment

A good first step is getting an idea of what level of treatment you will need and then discussing this with your insurance provider. While you probably have the insurance company's information about coverage, the forms are usually pretty difficult to read for the average person especially when they are under stress. Never hesitate to speak to your insurance rep who should be able to cut through the jargon and give you clear answers that are specific to your situation.

Most insurance companies do cover all types of addiction without designating between drugs, alcohol and other addictions so there are less hoops to go through there. But, not all insurance types will cover all levels of treatment and this is where things starts to get a little tricky. There are several levels of treatment:

  • Inpatient
  • Outpatient
  • Maintenance

A person with a serious addiction or one who has already relapsed on several attempts at other treatment may need to go to a qualified inpatient treatment facility. Here they will get medical and mental health support twenty four hours a day. They will be able to safely detox with medical supervision and medications that help control their symptoms. A person with a mild to moderate addiction or one that has reached the point of needing help for the first time may be able to do outpatient treatment which requires more of a commitment and more personal responsibility but offers fewer restrictions and more freedom of movement.

Maintenance treatment is for the people that are working on changing their behaviors but may need some help dealing with physical cravings that may push them back to their drug of choice. These treatment plans offer specific types of medications that reduce those cravings and help the person to refocus their energy on their recovery plans.

Any treatment plan does require the dedication of the person and works best when they have support outside of the facilities and treatment centers.

 

Out of Pocket Costs for Insurance

Many insurance plans have a co-pay and deductibles. Some co-pays happen with every event, for instance you might pay $10 for every doctor's office visit. Other plans have a co-pay that ends when you meet your deductible amount for the year. It is important to know how much your deductible is, how much your co-pays are and when they will be due as well as how much of each service and/or medication will be covered by your insurance. Again, you will also need to know which types of treatment your insurance will cover.

 

Restrictions for Use Of Insurance

Some insurance plans put restrictions on certain types of treatment and medications. These can be for year or lifetime. Other insurance plans do not use any type of restrictions on these benefits so that you can use them any time you need for as long as you hold that policy. This should be spelled out in the benefits information packet but the insurance provider should answer any questions that you might have.

Treatment is stressful but worth the effort. It is important that you get yourself back to your full health, free from your addiction and ready to face the rest of your life, strong and positive. There is no shame in reaching your hand out for help. That brave first step will be the first of many that you take down the road to recovery.

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