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Disclaimer: Olympus Recovery will try to verify your health insurance benefits and/or necessary authorizations on your behalf. This is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. A member of the Olympus Recovery team will be in touch with you to discuss any additional questions in regard to your insurance verification.

Does Insurance Cover Rehab?

If you need treatment for an alcohol or drug addiction, enrolling in a rehab program can help you get your life back. Unfortunately, many people are hesitant to sign up for substance abuse treatment because they worry about how much it costs. While it’s true that financial stability is important, it’s even more important that you get help for substance abuse when you need it most.

Thanks to legal protections outlined in the Affordable Care Act, most health insurance plans now cover treatment for substance abuse and other mental health conditions. Keep reading to learn more about the health insurance coverage available for addiction treatment in Delray Beach, FL.

Mandatory Coverage of Substance Abuse Treatment

In 2010, President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law. The ACA introduced 10 essential health benefits that insurance plans must cover. One of those essential benefits is mental health services, a broad category that includes addiction treatment services. Whether you need inpatient alcohol treatment or outpatient drug treatment, all ACA-compliant plans are required to cover medically necessary services.

Medically necessary services are the services needed to diagnose or treat a health condition. This includes treatment for addiction, which means many insurance plans cover inpatient or outpatient drug and alcohol rehab. If you decide to stay at an inpatient rehab center, your insurance may not cover services that aren’t absolutely necessary for treating your substance use disorder. For example, you may have to pay out of pocket for room upgrades or transportation services.

Insurance Coverage for Alcohol Addiction and Drug Addiction Treatment

Medical Detox

Health insurance companies typically pay for some type of medical detox, outpatient rehab and/or inpatient rehab. Detox is the process of eliminating harmful substances from your body before you begin rehab treatment. During this process, you’re monitored by health care providers who can prescribe medications and give you professional medical advice to help manage your withdrawal symptoms.

Outpatient Rehab

Outpatient rehab is ideal for people with mild addictions or those who’ve exhausted their inpatient treatment options. Some rehab centers offer intensive outpatient program (IOP) treatment options, giving people the structure and support they need to recover from addiction. If you’ve already completed detox, an IOP can help you continue your recovery in a supportive environment.

IOPs are also suitable for people who need dual diagnosis treatment. The term “dual diagnosis” means you have at least two co-occurring mental health conditions. For example, you may have an addiction to alcohol combined with major depressive disorder. When you enroll in an IOP with a focus on dual diagnoses, you’ll work with health care providers who have experience treating both conditions, giving you a better chance at a successful recovery.

Partial Hospitalization

Your health insurance may also cover a partial hospitalization program (PHP) for addiction. These programs fall somewhere between inpatient programs and outpatient programs. You don’t have to stay at the rehab center 24 hours per day, but you spend several hours per day receiving counseling and other services. According to the Substance Abuse and Mental Health Services Administration, PHP programs typically provide at least three hours of treatment per session.

Inpatient Rehab

If you have a severe addiction, staying at an inpatient rehab center can help you get on the road to recovery. Inpatient treatment centers usually offer multiple services, such as medical detox, treatment for dual diagnoses, and medication-assisted treatment for substance use disorders. As long as the services provided are considered medically necessary, your health insurance provider should cover them according to the terms of your plan.

Insurance Coverage for Substance Abuse Treatment

How to Find Out What Your Health Insurance Covers

Your insurance company may offer several plans, all with different coverage limitations. For example, some members choose to save money by enrolling in high-deductible plans that have low monthly premiums. Other members want better coverage, prompting them to enroll in plans that have lower deductibles and copays. If you’re seeking addiction treatment, it’s important to understand exactly what’s available under your particular health insurance policy.

There are a few ways to find out more about your insurance coverage for addiction treatment. One is to check the policy documents provided when you first enrolled. You may have printed coverage documents or access to an online portal that allows you to check what services are covered. Another option is to contact your insurance company by telephone. You’ll have a chance to ask a company representative about the health insurance policies specific to your plan.

You can also fill out the form above and have Olympus Recovery do the verification for you. You’ll need to provide your name, contact information, and the names of your insurance providers to ensure we contact the right people about your coverage for drug and alcohol rehab.

Out-of-Pocket Expenses for Addiction Treatment

Whether you have group health insurance or a plan purchased via the Health Insurance Marketplace, it’s important to be aware of any out-of-pocket expenses associated with treatment for drug and alcohol addiction. Depending on the terms of your plan, you may have to pay for some or all of the following:

  • Deductible: In insurance lingo, your deductible is the amount of money you have to pay for covered services before your insurance provider starts to pay.
  • Copays: A copay is a flat fee or percentage of the cost of each service. You may have to pay a copay for laboratory tests, counseling sessions, and other services provided at addiction treatment centers.
  • Coinsurance: Coinsurance is the percentage of covered costs you pay out of pocket. If your plan has an 80/20 split, your insurance pays 80% and you pay 20%.

Begin Your Recovery Journey

Olympus Recovery offers partial hospitalization and intensive outpatient programs, giving you the opportunity to enroll in an addiction treatment program that meets your unique needs. We also have experienced, compassionate staff members available to help you understand why you use substances to cope with difficult circumstances. To break free of drug or alcohol addiction, call Olympus Recovery at (866) 305-7134.

 

Start a new journey!

For immediate help call us confidentially at (866) 305-7134. Our admissions specialists can answer all your questions, and put you on the road to recovery.

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