Insurance Options for Rehab to Alcohol & Drug Addiction

Does insurance cover drug rehab? Ultimately, it depends.

Insurance typically covers a range of treatments including detoxification, outpatient counseling, residential treatment, medication-assisted treatment, and ongoing aftercare. The extent of coverage can vary, and some treatments may only be partially covered.

So, does insurance cover alcohol rehab fully? It depends on your specific policy. While your insurance may cover the cost of treatment, it might not cover all of it. You may be responsible for co-pays, deductibles, or out-of-pocket maximums. Some plans may also have limitations on the duration or type of treatment covered.

If your insurance claim is denied, you have the right to appeal the decision. Your insurance company is required to provide a reason for the denial. It could be due to a clerical error, a misunderstanding about the treatment, or a disagreement about the necessity of the treatment. You can request a review, and in some cases, an external review by an independent third party.

Maybe you’re not asking “Does insurance cover rehab?” Maybe your question is, “What if I don’t have alcohol rehab insurance?”

If you don’t have insurance, you may still have options. Some treatment centers offer sliding scale fees based on income, or financing options. There are also state-funded programs and non-profit organizations that can provide assistance.

The use of benefits should not directly impact your premium costs. The Affordable Care Act prevents insurers from charging higher premiums based on health status, which includes whether you’ve sought treatment for substance use disorder.

New Directions for Women works with both “in-network” and “out of network” plans. When a provider is “in-network” like we are, that means the insurance company has approved of New Directions for Women as a provider to deliver services to the members of their plans. Also, there is a rate that has been negotiated and applies to the members who go through our addiction services.

An “out of network” provider has not been contracted with a rate to deliver services to the members of their plans. It is rare for us not to be contracted, but on those rare occasions, we work with the family and insurance provider to offer treatment and work with both on the payment arrangement.

“In-network” simply means that New Directions is one of the providers that has been included as proprietary with your particular insurance plan. Insurance plans do not cover every single possible location for treatment, regardless of the treatment type. You should check with your provider or research on their website to see if New Directions is “in-network” for you or not. Regardless of network status, we are committed to providing a plan that will provide competitive value for anyone who could benefit from our services.

Women seeking treatment for their addiction often wonder, “What does insurance cover?” or “Does insurance cover drug rehab?” The answers vary by insurance plan. A person’s policy may cover a certain service but not another. In general, many California insurance plans cover women’s rehab services. 

New Directions for Women is in-network with many rehab insurance providers which can reduce the cost of treatment services for the women in our program. Contact our insurance specialists so we can verify your insurance and give you more information.

If a person has health insurance that covers substance abuse treatment, it very well may pay for inpatient rehab. Of course, it’s more expensive than outpatient programs most of the time. This is mainly because residential addiction treatment is generally more intensive than other treatment programs. Also, it requires clients to live at the facility where they are receiving treatment.

However, this truth shouldn’t deter individuals who think it’s the best option for them. New Directions for Women offers residential treatment, which is a part of our inpatient rehab programs. If we feel a potential client is the right match for residential treatment, we will recommend it. This makes it more likely for insurance to cover it in full, or at least a portion of it. 

Alcohol is legal, so does health insurance cover alcohol rehab in California? It does in many cases. Medical professionals are fully aware of the danger behind alcohol. However, in 2019, only 7.2% of people with an alcohol use disorder received treatment. We are in-network with many health insurance providers, so contact us directly to see if your policy covers alcohol rehab and treatment services. 

If you are living with co-occurring disorders, you may be wondering, “does insurance cover mental health services?”

More and more insurance companies are offering supplemental “mental health” and rehabilitation coverage in addition to traditional offerings. Many insurance providers are also now considering “mental health” coverage as a standard part of their holistic health offerings.

As many clients receive coverage from their employers, it’s important to note that most employers now consider mental health paramount to overall health. They’re also adding supplemental care such as free counseling sessions and similar perks. Don’t let fears about rehab insurance keep you from seeking help for you or a loved one.

Also known as “Obamacare” in some states, the Affordable Care Act was an important step towards providing treatment opportunities for all Americans. For a client’s protection, mental health care is listed as one of the 10 health benefits that all plans in the exchange must cover. 

The 10 essential health benefits Marketplace health insurance policies cover are: 

1. Coverage of outpatient services (ambulatory services) 
2. Emergency services (insurance can’t charge clients more for an out-of-network emergency room visit) 
3. Newborn, prenatal, and maternity services 
4. Substance use disorder and mental health services 
5. Prescription medications 
6. Rehabilitative/habilitative services and devices (help for people with disabilities or chronic conditions) 
7. Lab services 
8. Preventative services (to prevent people from getting sick or sicker) 
9. Hospitalization (for both overnight visits and surgery) 
10. Medical services for infants to adolescents (pediatric care) 

The Affordable Care Act specifies that insurers might not place spending limits on annual or lifetime amounts in the plan. A plan that is purchased with your state should provide coverage on substance abuse or mental health services.

Substance use disorders treatment is one of the 10 essential health benefits that insurance plans must cover in California. With that said, does Obamacare or the Affordable Care Act cover drug rehab? The answer is yes. However, a policy might not cover drug rehab services in full. 

Luxury amenities may not be covered by certain plans. But the Affordable Care Act ensures health insurance covers many drug rehab services, like detox programs. We can interpret a policy to help clients get the help they need.

While we are in-network with many private health insurances associated with Obamacare, we cannot work with Medicaid and Medicare policies.

We’re always happy to help clients get the help they need. The cost of treatment should never deter people from overcoming their addiction. 

The costs for our treatment at New Directions for Women will vary depending on the individual woman and what her needs are. Some of the factors that determine this include the level of care, type of addiction if detox is necessary and the duration of treatment needed.

For all women using their in-network benefit, this price has been predetermined by your insurance company and you will only be responsible for out-of-pocket costs.

While the cost of rehab treatment can be high, research shows the cost of not receiving treatment — in dollars, lost lives, and ruined families — can be even higher. Our costs are well within or lower than the standard market value.

 We believe that the benefits of treatment at New Directions for Women far outweigh whatever costs you may incur. Whether your rehab insurance provides full, partial, or no coverage, we are committed to providing great value for clients and seeing their success through to the end.

The “out-of-pocket” cost is a term used to describe the amount of money that the client will pay on their own after the insurance is applied. Every California insurance policy is different, which means the “out-of-pocket” amount will vary depending on the person’s individual plan. Usually, this covers what is left on your deductible and any copay requirements. While some plans will only leave a “copay” to the client, some may have a high “deductible” that leaves clients responsible for 20% or more of the overall cost.

These costs may be subject to change from year to year or depending on what costs have been incurred towards your deductible elsewhere. For example, if you had surgery this calendar year and the cost was $5,000, that may have fulfilled your “deductible” and left you with no more “out-of-pocket costs” until that amount refreshes in the new calendar year.

While this can lead to confusion, we are committed to making sure that there are no hidden costs. We’ll work with clients and providers to have an accurate idea of the total cost before treatment begins. Keep in mind that treatment can span months or even years. “Out-of-pocket” expenses can also vary greatly depending on outside circumstances.

This 2008 law ensures that insurance companies that are covering substance abuse or mental health services may not treat those benefits in a different way, or less favorably than other surgical or medical benefits.

Specifically, this means that insurance companies may not enforce lifetime or annual payment limits on mental health care that they wouldn’t place on other forms of care. We are thankful that more insurance providers are using this legislation to continue expanding mental health and rehabilitation service coverage.