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Finding an Insurance That Covers Rehab: What You Need to Know

One of the biggest barriers to undergoing substance abuse rehab is finding the funds necessary. Out of pocket costs tend to be far too substantial for the average person to take on. As such, they have to rely on healthcare insurance coverage. 

The trouble with health insurance, unfortunately, is that not all health insurance plans cover the costs of rehab. So, the question is: how do you find insurance that covers rehab? 

We’re going to get into that question, helping you find the best insurance coverage for addiction recovery purposes. Let’s get started. 

How Common Is Insurance That Covers Rehab?

Technically speaking, all health insurance policies in the United States cover rehab. This is because the Affordable Care Act (the ACA) and the Mental Health Parity and Addiction Equity Act (the MHPAEA) require them to. 

That said, some insurance policies provide greater coverage than others. In other words, these policies tend to vary greatly in terms of co-pays, deductibles, out-of-pocket maximums, and the like. Some even provide greater coverage for non-rehab health services than they do for rehab-related services. 

What this means is that, when choosing health insurance for rehab purposes, you need to do a good deal of research. You can’t just skim over the highlights of the plan. You have to read the fine print. 

Where Can You Get Health Insurance?

There are several different places from which you can get health insurance in the United States. These include the following: 

From Your Employer

Many jobs (and full-time jobs, specifically) offer health insurance as a benefit. So, if you’re struggling to obtain a favorable health insurance plan currently, you could consider finding a new job. 

That said, it’s important to note that the specifics of an employer-provided health insurance plan are generally dictated by the employer. As such, the insurance you receive from your employer may or may not provide favorable coverage for rehabilitation purposes. 

Directly from an Insurer 

If you aren’t getting insurance from an employer, or if the insurance offered by your employer is sub-par, you can instead opt to buy insurance directly from an insurer. Every health insurance company is bound to have several plans to choose from, and could very well have one that suits your particular situation. 

To find health insurance companies in your state, simply search Google for something to the effect of “health insurance companies near me”. This should return a list of websites, all of which you can browse through and contact as needed. 

From the Healthcare Marketplace

Another option is to purchase a health insurance plan from the government’s Healthcare Marketplace. This is a great option for many, as it provides credits and rebates based on income and family size. Those with low income might even be able to obtain premium-free health insurance. 

In order to be eligible for this insurance, you’ll need to submit information through Healthcare.gov. Follow the directions contained within that link and, if you’re eligible, you’ll be set to select from a variety of different plans. 

From the Government

If your income is low enough, you might be eligible for government-provided health insurance. This refers to Medicaid, specifically. 

Medicaid offers full coverage for essentially all rehabilitation services, and costs nothing to those who are using it. You can sign up for Medicaid by sending in an application through their website

Questions to Ask Your Prospective Insurance Provider

If you’re in the process of finding suitable health insurance, there are a number of questions you’re going to want to ask. These include the following:

Will My Policy Cover Detox Programs?

Detox is generally the first component of drug rehabilitation. This involves residing in a rehab center for a set period of time while you stop the use of the substance you’re addicted to. It’s important to do this under professional supervision, as there needs to be assistance available in the event that something goes wrong. 

You want your insurance to cover the cost of detox programs, as they can be fairly expensive otherwise. So, make sure to ask your prospective insurer whether your policy will cover such programs. 

Note that your selected policy might not cover the entirety of the cost. However, it should cover enough to ensure that you’re not financially hamstrung. 

Will My Policy Cover Drug Addiction Treatment After Detox?

After you’ve gone through detox, it’s wise to remain under professional supervision while you build suitable coping mechanisms. In fact, drug rehab centers can help you build these coping mechanisms through therapy sessions, medical checkups, and the administration of medication. 

There are both inpatient and outpatient rehab programs available out there. You never know which one might work for you. This is why, prior to purchasing insurance, you need to ask your insurer whether your drug addiction rehab will be covered. 

Again, your policy might not provide full coverage. However, it should provide enough coverage to keep you financially comfortable in the long run. 

Will My Policy Cover the Cost of Addiction Medications?

Oftentimes, when a person has an addiction problem, they can struggle to stay off a drug, even after they’ve initially kicked it to the curb. Rehab teaches these individuals coping mechanisms to help them resist illicit substances. However, therapy alone doesn’t work for everyone. 

See, some individuals need to take medications in order to drop their drug dependency for good. As you might expect, when paying out of pocket, some of these medications can be expensive. This is why it’s important to have an insurance policy that covers them for you. 

So, before choosing a specific policy, make sure to ask the insurer about the specifics of medication coverage. Again, you’ll want the policy to cover enough of the costs to leave you financially comfortable. 

What Is the Premium and Copay?

Two of the most important figures to consider when choosing health insurance are the premium and the copay. The premium refers to the monthly payment of the policy. The copay refers to the amount that the policyholder has to pay when it comes to utilizing health services. 

For instance, you might have a premium amount of $200. You’ll need to pay this every month to keep your health insurance. 

At the same time, you might have a 50% copay for each rehab visit. Or, you might have a copay of 25% for each medication purchase. In these cases, you, as the policyholder and patient, would have to pay 50% of the total cost and 25% of the total cost, respectively. 

These will affect how much you pay for medical services overall. As such, you need to analyze them carefully when choosing the best insurance for your situation. Make sure to ask your prospective insurer about both figures before making a purchase. 

What Is the Out-of-Pocket Maximum?

Another figure you need to know is the out-of-pocket maximum. This refers to the maximum amount of money you might have to pay over the span of your insurance coverage period. You’ll only pay this much in the event that you use enough medical services to justify such. 

Out-of-pocket maximums can range anywhere from $0 to $8,000, and even beyond that. If you’re going to be going to rehab, you’ll want to keep this figure as low as possible. Once you reach this figure, you won’t have to pay any more money out of your own pocket, even if the cost of the medical services rendered far surpasses it. 

Make sure to inquire about out-of-pocket maximums prior to choosing a policy. This figure can have a huge effect on your future bank account. 

Do the Policy Cover Costs at All Rehabilitation Centers? 

Oftentimes, health insurance companies won’t cover the costs of all hospital and wellness center charges. In many cases, they require their policyholders to go to specific facilities as a means of receiving insurance coverage. In other words, they require their policyholders to choose providers in their network. 

As such, before you choose an insurance policy, you need to ask your prospective insurer whether the policy covers costs at all rehabilitation centers. At the very least, you need to ensure that it covers the costs at the rehabilitation center of your choice. 

If it doesn’t cover the cost, and you end up going to that rehabilitation center, you’re going to have to pay substantial amounts of money out of your own pocket. The only way to ensure you’re covered is to ask your insurance company and verify. 

Looking for an Addiction Recovery Rehab in Camarillo, CA?

And with that, we’ve helped you find insurance that covers rehab. As you can see, there are options out there. So, do your due diligence and you’re sure to come up with something to minimize your costs. 

Are you looking to check yourself or a loved one into addiction recovery rehab? Are you looking for a rehab in Camarillo, CA? If so, Altitude Recovery Community has you covered. 

We offer a variety of substance abuse programs, from detox to inpatient treatment to aftercare planning and more. Contact us now to discuss your rehabilitation needs!