Private pay health insurance will cover some or all of your addiction treatment. Both alcohol use disorder and substance use disorder are currently recognized as chronic mental health issues. Under the Affordable Care Act, private pay health insurance companies can no longer penalize applicants for having either of these illnesses as pre-existing conditions. Moreover, private pay health insurance companies are also legally required to pay a portion of rehab costs. If you’re currently shopping your options in coverage ahead of entering addiction treatment, it’s important to know exactly which plans to look for. No matter which company you work with or what plan you bind, there are several treatment-related costs that you’ll have to cover on your own. These include:
- Certain prescription fees
- Co-payments
- Plan deductibles
Plan deductibles are monies that policyholders must spend before their coverage actually kicks in. Plans with higher deductibles often have lower premiums. Thus, you’ll pay less each month for this coverage, but you’ll have to spend more before you can benefit from it. When you know that you’ll be using your health insurance right away for rehab, it’s best to look for a reasonable balance between affordable deductibles and affordable premiums. This way, both your short and long-term spending on healthcare will be manageable. You also have the ability to limit your spending on prescriptions and co-payments by paying a bit more in monthly premiums.
Ways to Save When Purchasing Health Insurance for Rehab
Most health insurance companies offer several different levels of coverage. Although most consumers shop for policies based solely upon affordability, the lowest-priced options usually provide the least amount of coverage. At each tier, policyholders can enjoy more covered benefits, lower costs for prescriptions and co-payments, and access to a greater range of services. For addiction treatment, shopping for top-tier plans whenever possible is a good idea. For instance, if a health insurance company offers bronze, silver, gold, and platinum plans, you’ll pay less for prescriptions and co-payments when you purchase a gold plan or higher. Your premiums will be costly, but given that you’ll be actively relying on this coverage for one to three months during in rehab, you’ll likely save considerable sums on medication. Upgrading to a higher plan is always a good idea when you know that you’ll need lots of medical support during detox. If your detox plan includes the use of alternative, non-habit forming medications, or if your detox program will slowly wean you off of a substance, prescription fees can add up fast. This is especially true if you’ve got a low-cost, low-benefits plan in place. This is also the case for substances that are known to cause severe withdrawal symptoms and for which detox is best-managed with medical interventions. Prescription costs during detox are a special concern for anyone in rehab for:
- Alcohol addiction
- Benzodiazepine addiction
- Opioid or opiate addiction
Even if a goodly portion of your other treatment costs are handled by your insurer, you could wind up paying a considerable amount out of pocket if the prescription benefits for your chosen plan are nominal.
Going to Drug Rehab Out of State
Another important factor to consider is whether you want to go to rehab in the state where you’ve bound your policy or in another location. There are both HMO and PPO plans to choose from. Health Maintenance Organization or HMO plans require policyholders to receive care from a limited network of providers. More often than not, these networks include only in-state facilities and professionals. If you choose to travel out of state for treatment with an HMO plan, your coverage might not honor your chosen rehab. Conversely, Preferred Provider Organization or PPO plans will allow to work with both in-network doctors and facilities and doctors and facilities of your own choosing. Thus, a PPO plan will likely work best if you intend to travel out of state for care.
Which do Health Insurances Do Rehab Facilities accept?
Every addiction treatment center has its own list of accepted health insurance. To find out which health insurance companies a facility is able to accept, you’ll have to call in and speak with an admissions counselor. Admission counselors can verify your health insurance, determine how much you’ll need to pay out of your own pocket and clarify your plan details. When necessary, they can also help you get a feasible payment plan in place for managing any costs that are uncovered. If you’re currently shopping your options in health insurance or rehab centers, we can help. Call us today at 833-846-5669. Our counselors are always standing by.