Health Insurance and Rehab

Many addicts will resist the idea that they have a problem with drugs or alcohol (Read How to Deal with Denial) so half the battle is often simply getting them to accept the truth and agree to go to rehab at all (Read Intervention: Is It Time?). But if you are lucky enough to either recognize a problem in yourself (Read Self-Evaluation: Is There a Problem?) or to be the loved one of an addict who is willing to go to treatment, the next most common difficulty is figuring out how to pay for the person’s stay at an inpatient rehab facility (Read Substance Abuse Treatment Options). In an unfortunate number of situations, this hesitation frequently means that the person will not get the help that they need as all stakeholders talk themselves out of the importance of rehab because they are intimidated by the expense (Read Common Excuses for Not Seeking Treatment).  If the person who needs the treatment has health insurance, it is definitely worth looking into all of your coverage options before giving up (Read The Cost of Rehab: Is It Worth It?). 

Am I covered for drug rehab?

If you selected coverage on your own, you may have opted to omit coverage related to drug rehab, probably because you didn’t anticipate that it would be necessary (most people don’t). However, if you are covered by Anthem Blue Cross and Blue Shield, Aetna, Kaiser, United Health, Wellpoint, or any of the other major health care insurance providers for physical conditions, there is a relatively good chance that you would also be covered for a stay at a drug or alcohol treatment program because addiction is a medical condition.  Recent legislation has made it a requirement that, under certain conditions, insurance companies must treat physical and mental health – including treatment for an addiction – equally (Read The Mental Health Parity Act: How the Bailout Might Help You). You may have to stay within the provider’s approved network to avoid paying a larger copayment, but you probably will have a number of local and even national options to work with.  If you are not sure about the details of your coverage – including copayment amounts, annual deductibles, and lifetime maximums – you can either call your insurance agent or look for this information on the provider’s website, which often allows you to access your personal insurance and health information.

What if the facility I want to go to will not accept my insurance?

Feeling comfortable in your treatment environment can be an important component to the success of a program.  If the rehabilitation facility will not accept your insurance (or insurance at all), you should first contact your provider and ask whether any portion of the amount would be reimbursed if you chose to pay the out-of-pocket expenses up front.  If the answer is “no,” you don’t necessarily need to cross the program off your list.  Most realize that rehab isn’t part of people’s financial planning and may offer payment plans or other options (Read Paying for Rehab).  Although some may find the topic uncomfortable, it may be worthwhile to ask your employer if they offer any type of assistance or partial pay during the period you would be in rehab.