Does Insurance Cover Drug Programs? Here’s what you Need to Know

Insurance of any kind can leave you scratching your head, even at the best of times. With so many rules, policies and information it can be overwhelming, to say the least. If you or someone you know is thinking about getting treatment for substance abuse, don’t be afraid to ask your insurance provider how much your policy covers based on specific needs. 

Can I Afford Rehab?

When entering rehab, most people are left asking, “can I afford it?”

One of the biggest obstacles for  people seeking treatment is cost.The majority of private health plans usually cover a portion of substance dependence treatment programs, while other plans cover the entire cost of treatment programs.

If you’re unsure how much your insurance carrier covers for inpatient or outpatient treatment programs, you can call them or visit their website to find out more. Some rehab facilities can help to answer your questions by connecting with your insurance provider.

How Insurance Works

Typically, most rehabilitation treatment programs include different therapy programs to help those inpatients and outpatients as they transition to life after recovery.

Most insurance providers do cover both drug and alcohol rehabilitation programs. Since 2010 with the creation of The Affordable Care Act (ACA) requires all providers to offer coverage for addiction treatment programs.

Depending on the insurance provider, there can be some limitations, so it’s best to check what you’ll need to be eligible for this type of coverage.

The Affordable Health Care Act (ACA, also known as Obamacare)

The ACA made it possible that someone who applied for insurance coverage for an addiction treatment program was now no longer made to pay fees for their pre-existing addiction conditions.

If someone had either a drug or alcohol dependence, they were covered for health benefits under the ACA, which meant they could seek professional treatment of their addictions and mental health issues, just as anyone who needed treatment for cancer.

Most ACA-sponsored insurance policies cover between 60% to 90% of the cost for rehabilitation treatment programs depending on the plan you selected.

Health Insurance and The Affordable Care Act

Before the ACA or The Affordable Healthcare Act was created in 2010, most insurance companies refused to cover any rehabilitation and recovery programs of drugs and alcohol. The ACA made it so that insurance companies were forced to rehab treatment programs with the support of the American Medical Association.  

This change in how drug or alcohol treatment programs were classified made it so that anyone with addiction problems was recognized as having a legitimate disease that required treatment. Before this change, someone had drug or alcohol dependence; this was seen as a personal choice and not a medical problem requiring treatment.

Does Insurance Cover Alcohol Rehab?

Even though alcohol is sold and consumed legally, it can still be addictive, causing a person to become dependent on it. 

The process of withdrawal from alcohol can become a life-threatening stage as a person is recovering. As many as 25% of people recovering from alcohol lose their lives from the effects of alcohol withdrawal.

The answer is often “YES” if you wonder if the ACA covers you for alcohol rehabilitation programs.

Does Insurance Cover Drug Rehab and Mental Illness Treatment?

Most rehabilitation facilities are equipped to handle patients who need help with drug or alcohol dependence and may have a history of mental illness. Recovery experts understand that if mental illnesses are left untreated, they can stop the patient from reaching a successful recovery.

If someone is working towards recovery from drug or alcohol dependence, they will also need help with their emotional and mental health. Coverage for addiction treatment programs usually offers plans that offer to pay for medical attention for mental health.

Aspen can Help

Taking the first step into treatment for drugs or alcohol dependence can be scary if done alone. Let our team of medical professionals and recovery experts guide you as you begin to learn how to handle the stressors of a sober life.Our team is ready to help you every step of your road to recovery and to help change your life for the better. Contact Aspen Behavioral Health to learn how we can help.


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