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Drug Treatment Insurance: Making the Most of Your Coverage

Paying for rehab is a serious roadblock for many addicts in need, but drug treatment insurance can be a great way to lower costs. Although full coverage can be difficult to obtain, healthcare providers and insurance companies are becoming increasingly aware that addiction is a true medical disease. Now more than ever, substance abusers can use their existing insurance contracts to pay for detox, certain therapies, and even full-scale inpatient programs. Overall, addicts who make the decision to seek help should understand as much as possible about how they can pay for drug treatment with insurance.

Expanding Coverage

A few decades ago, most insurance companies and healthcare providers still viewed drug addiction as a matter of willpower. Rehab coverage was hard to come by, and addicts were often treated with prejudice when they filed their claims.

Thankfully, views have changed a great deal within the medical community. With the alarming rise in drug and alcohol abuse, most doctors have come to realize that addiction is a disease that needs clinical drug treatment. In 1996, Congress passed the Mental Health Parity Act – a law that requires insurance companies to give equal coverage to mental and physical disorders. Although addiction certainly involves a large physiological component, this law effectively made it much easier for addicts to pay for rehab.

Detox vs. Long-Term Care

The medical community is relatively unified in the view that hardcore drug dependency is a medical disorder. In most cases, insured addicts will therefore be able to get full or nearly-full coverage for clinical detox procedures. Patients who complete these procedures are typically far more able to handle their cravings and avoid further drug use – in the short term.

However, finding longer-term care is still difficult with some insurance contracts. Despite the Health Parity Act’s mandate for equal treatment of mental disorders, many people still view counseling and other psychotherapies as optional or “elective.” Overall, people with drug problems should seek insurance companies and healthcare providers who treat the entire rehab process as a necessary treatment.

Different Strategies for HMO and PPO

Most people contract for drug treatment insurance through health management or preferred provider organizations. HMOs offer the lowest co-pays and deductibles, but they can be extremely inflexible. On the other hand, PPOs are more expensive but allow their customers much wider selections of physicians, specialists, and clinics.

Addicts with HMO insurance will likely incur fewer costs during rehab, but they may need to make compromises when it comes to selecting their clinics and treatment programs. For example, an HMO may not include any inpatient care providers within its network – but it might offer full coverage for detox and outpatient programs.

Those who contract with PPOs will usually be able to select from a variety of rehab clinics. This is especially helpful for addicts with special concerns, such as co-occurring mental disorders, pregnancy, or behavioral addictions. However, getting treatment outside of a PPOs preferred network can still be expensive. Given the already-higher deductibles, these customers should select rehab providers within their networks whenever possible.

Paying without Insurance

Unfortunately some people can’t get full or even partial coverage for drug rehab. Poor and homeless addicts may not have any insurance at all. Still, these people have several ways to pay for treatment or lower their costs. Even addicts who have damaged their family ties may be able to borrow money if it’s going to be used towards rehab. There are also state-run clinics throughout the country that offer free treatment for those willing to wait for vacancies. Finally, some private rehab centers offer long-term payment plans and reduced-cost programs.

Even if you’re worried about how you’ll pay for drug treatment, you need to seek help as soon as possible. Fill out the insurance verification form to the right of this page now to see if you qualify for one of our payment programs. Don’t let your financial issues get in the way of a better life.

About The Contributor
The editorial staff of Recovery First is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More