Receiving addiction treatment is the only way for people with a substance use disorder to overcome their addiction. It is almost impossible to recover from addiction on one’s own due to the changes to the brain and body that occur during active addiction. This is why comprehensive treatment is a necessity when it comes to addiction.
More often than not, treatment does require payment. Drug rehab insurance is a way for people to get the help they need. Moreover, drug rehab insurance can cover the cost of treatment and other associated expenses.
Here at Achieve Wellness and Recovery, we accept various private insurance plans. These include plans from Cigna, Humana, United Healthcare, and other insurance providers. To verify if we accept your insurance plan, contact us for verification of coverage.
The Mental Health Parity and Addiction Equity Act (MHPAEA)
The MHPAEA is a federal law, passed in 2008. It requires group health plans and health insurance providers who offer mental health or substance use disorder (SUD) benefits to do so in a way that is no more restrictive than the way they handle physical health benefits.
In other words, this law requires insurers to provide the same level of coverage for mental health and addiction treatment as they would for any other medical condition. Further, in 2010, the Affordable Healthcare Act (ACA) was amended to include individual health insurance coverage. Currently, all plans must include the following:
- Behavioral health treatment
- Mental and behavioral health inpatient treatment services
- Substance use disorder treatment
Depending on your insurance provider, part of treatment or all of treatment may be covered. It is also important to note that drug rehab insurance in NJ will not necessarily cover the entire cost of care. Often, a deductible must be met before coverage kicks in. In addition, there may be copays or coinsurance required.
What is Drug Rehab Insurance?
Drug rehab insurance is health insurance that helps to cover the cost of addiction treatment. It can pay for detox, inpatient programs, therapy, and other care.
Drug rehab insurance is a part of your regular health insurance, not separate insurance. Depending on the type of insurance you have, the provider may cover the costs associated with rehabilitation.
The Difference Between Private and Public Health Insurance
There are two main types of health insurance: public and private health insurance. Private drug rehab insurance is provided by companies, while public drug rehab insurance is government-funded. Individuals may purchase a private plan through the state or federal marketplace, or enroll in a group plan with their employer.
In the United States, the most common type of public health insurance is Medicaid. Eligibility for Medicaid is based on income and other factors. These factors include:
- If you have a disability
- Whether you are pregnant
- Your dependant status, such as whether you are a parent or carer for a child
- Your age and whether you are 65 or over
If you qualify for Medicaid, it will cover the cost of addiction treatment. However, each state has different rules about what types of treatment are covered. Additionally, not every treatment center accepts public health insurance.
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What Services Does Drug Rehab Insurance Cover?
Every insurance plan is different. Depending on the insurance plan, drug rehab insurance may cover all or part of your addiction treatment. This includes any of the following treatment programs and clinical interventions:
Detox is a process of ridding the body of drugs and alcohol. It is often the first step in addiction treatment and can be done in an outpatient or inpatient setting.
Inpatient rehab is a type of drug treatment where people live at the facility while they receive care. This allows them to be away from triggers and get around-the-clock care. During an inpatient program, you will take part in individual and group therapy, as well as other activities that help you recover.
Outpatient rehab is a type of drug treatment where people do not live at the facility but come for treatments during the day. This option is often less expensive than inpatient care, but may not be as effective for those with severe addiction. You will typically go to the facility for a few hours each day to participate in therapy and other activities.
Intensive outpatient programs, otherwise known as IOPs, are a type of drug treatment that is similar to outpatient care but with more hours required each week. IOPs typically require 9-12 hours per week and are a good option for those who cannot commit to full-time inpatient care.
Partial hospitalization programs, or PHP, are another type of drug treatment that is similar to outpatient care but with more hours required each week. PHP typically requires 4-6 hours per day, 5-7 days per week.
Around 50% of individuals with an addiction also suffer from a mental illness. This is known as a dual diagnosis, and treating both the addiction and the mental illness can be vital to long-term recovery.
Sober living homes are drug-free housing options for individuals in recovery. These homes typically have rules and regulations that residents must follow, such as no drug use or alcohol use on the premises.
Therapy is a key part of addiction treatment. It can help people understand their addiction, process emotions, and develop coping skills. These clinical interventions can include the following types of therapy:
- Individual Therapy: Patients meet with a therapist one-on-one to discuss their addiction and progress.
- Group Therapy: Patients meet with a group of people in similar situations to discuss their addiction and progress.
- Cognitive-behavioral Therapy: A type of therapy that helps patients identify and change negative thoughts and behaviors.
- Family Therapy: Family members meet with a therapist to discuss their loved one's addiction and how it has affected them.
- Holistic Therapies: Therapies that focus on the mind, body, and spirit, such as yoga, meditation, and art therapy.
- Contingency Management: A type of therapy that uses rewards to motivate patients to stay in treatment and abstain from drug use.
- Motivational Interviewing: A type of therapy that helps patients explore their motivation for change and develop a plan for treatment.
Common Drug Rehab Insurance Terms to Know
When it comes to insurance, there are a lot of terminologies that can be new to you or confusing. Here are some common terms you should know and what they mean:
- Medical Necessity: A clinical determination that a patient’s drug rehab treatment is necessary to prevent serious deterioration of their physical or mental condition.
- Utilization Management: A process that insurance companies decide to use if the treatment you want is deemed a medical necessity, aka it has been proven to be effective.
- Pre-certification: A review process that some insurance companies require prior to drug rehab treatment in order to make sure the services are medically necessary and will be effective.
- In-network vs. Out-of-Network: In-network providers have a contract with your insurance company that says they will only charge a certain amount for services. Out-of-network means that your insurance company does not have a contract with that provider, so they may charge more.
- Step Therapy: When an insurance provider requires that you try a less expensive form of treatment before proceeding to a more expensive prescription or service.
Knowing these terms can empower you to make the best decisions for yourself. This can include choosing an insurance provider or treatment program.
What is the Cost of Drug Rehab Treatment with Insurance?
The cost of drug rehab with insurance will vary depending on the type of coverage you have and the specific services that are covered. Often, there is a deductible that must be met before coverage begins. In addition, you may be responsible for copays or coinsurance.
How Do I Know if My Insurance Will Cover Drug Rehab?
The best way to know if your insurance will cover drug rehab is to contact your insurance provider directly. An insurance agent will be able to talk you through your plan and explain what it covers. If you have drug rehab coverage, they will also be able to tell you what your out-of-pocket costs may be.
What Should I Do If My Insurance Doesn’t Cover Drug Rehab?
If your insurance does not cover drug rehab, there are still options available to you. There are many drug rehab centers that offer sliding scale fees based on income. There are also drug rehab centers that accept Medicaid or offer scholarships.
Is There a Limit to How Much Insurance Will Pay for Drug Rehab?
Most insurance plans have a limit on how much they will pay for drug rehab. This limit is called the lifetime maximum benefit. Once you reach this limit, your insurance will no longer cover drug rehab. However, there may be other options available to you, such as Medicaid or scholarships.
Insurance Coverage and Achieve Wellness and Recovery
Addiction is a progressive disease. This means that it gets worse over time without intervention. Drug rehab is often the best option for those struggling with addiction. It can help them achieve sobriety and live a healthy and productive life.
Here at Achieve Wellness and Recovery, we offer comprehensive addiction treatment to help our patients overcome the deadly disease that is addiction. We offer a variety of services such as detox, inpatient treatment, outpatient treatment, and much more. We also accept most major insurances to help make drug rehab more affordable for our patients.
Contact us today to learn more about the drug rehab insurance we accept and how we can help you today.
Megan began her career working in substance use treatment at an inpatient setting where she found her calling for helping the young adult population. Megan has a Master of Science degree in Clinical Mental Health Counseling from Monmouth University with a specialty in Addiction Studies. She is currently a Licensed Associate Counselor and is awaiting her credentialing to become a Licensed Clinical Alcohol and Drug Counselor. Megan has a history working in the mental health and addiction field utilizing CBT and MI approaches within her clinical practices.