Does Health Insurance Cover Inpatient Alcohol Rehab?

When an addiction sufferer avoids getting help because of financial concerns, that’s a tragedy. The reality is paying for rehab might not be as burdensome as some people believe it to be. Why? Most people aren’t aware that healthcare insurance providers are required by law to cover rehab costs in the same manner they would cover the costs related to other medical conditions.

The law to which we refer is none other than the Affordable Care Act of 2009. When that bill was signed by then-President Barack Obama, the bill did two things to benefit addiction sufferers.

First, it established that insurance companies would need to offer coverage for rehab costs. These costs are expected to be covered by insurance companies in the same manner they would cover an enrollee going to the hospital for a broken arm of bad flu.

Second, it eliminated the possibility of insurance companies could deny coverage based on a preexisting condition clause. That matters for addiction sufferers because addiction is almost always considered a preexisting condition.

While the Affordable Care Act does dictate that insurance companies must cover rehab costs, it also gives them some leeway in terms of the types of costs they aren’t required to cover. For clarification purposes, here is a list of what insurance companies are required to cover in regard to rehab:

  • Costs related to the detox process
  • Any prescription medications needed during treatment
  • Basic inpatient treatment costs
  • Outpatient treatment costs

If there are any limits to the financial extent of coverage, those limits must also apply to any other medical treatments. That’s the letter of the law, and that is why you might be able to pay for treatment if you have healthcare insurance as an individual or through your employer.

Does health insurance cover inpatient alcohol rehab

Assuming you have a significant alcohol addiction problem, you would most likely need to go through a residential or inpatient treatment program. If that would be the case, you would benefit by understanding how your healthcare insurance provider will agree to cover your rehab costs.

As we stated above, your insurance carrier is required to cover basic inpatient treatment costs. Surely, you would like a better understanding of exactly what that means.

First, that would certainly include inpatient detox services. It is widely understood that you would need the opportunity to work through your withdrawal issues before you would be reasonably ready to go through therapy. Better yet, it would be reasonable for you to stay safe as you tackle what could be significant withdrawal symptoms.

After that, basic inpatient costs refer to what the addiction community would consider being basic therapy options. What might not be included are some holistic treatment and some evidence-based therapy options. What does that leave? That leaves basic individual, family, and group therapy programs.

Of course, insurance companies could place other restrictions on inpatient therapy options. For instance, you would most likely not get approval to receive treatment from what would be considered a luxury rehab facility. In other words, insurance companies do have the ability to restrict the value of your coverage.

Given how complicated it is to determine your extent of rehab coverage, you have to do what’s necessary to find out about your coverage before heading into rehab. There are several ways to can check on your rehab coverage, including:<ul>
<li>Read the rider attached to your healthcare insurance policy

  • Contact your insurance company’s customer service department for clarification
  • Have a prospective rehab facility like ours contact the insurance company on your behalf and get preapproval for your treatment

In regard to letting the rehab facility’s staff help you confirm coverage, most rehabs have administrative staffers who know quite well how to deal with insurance companies. They doing the upfront work on your behalf could end up saving you a lot of time and effort.

While we understand why you might be concerned about paying for treatment, we suggest you focus more on actually getting treatment. This is something you need to do before your addiction destroys the fabric of your life. When you are ready to seek treatment, we will be here to help you in any way possible. Yes, that includes verifying your insurance company if necessary. If you would like more information about our treatment facility and the services we can offer you, we ask you to give us a call at 833-846-5669.