Treatment FAQ

how to get insurance to pay for alcohol treatment

by Germaine Botsford II Published 2 years ago Updated 2 years ago
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If you don’t have insurance, don’t worry. There are various ways someone can pay for alcohol rehab services without insurance, including grants, self-pay, sliding-scale fees, government funding, and more. You may also be able to apply for insurance through the Health Insurance Marketplace.

Full Answer

Does insurance pay for alcoholism treatment?

While many insurance plans cover a healthy portion of alcoholism treatment expenses, there are still costs for which the policyholder is responsible. These include: Lifetime limitations: Some insurance plans only pay for coverage up to a certain point; the policyholder is responsible for all costs beyond that.

Can I find alcohol addiction treatment without health insurance?

It’s important to know how to find alcohol addiction treatment without health insurance, in case you’re uninsured or you have a health plan that doesn’t cover the services you need. Here are some ideas to help you get started.

Does Medicaid pay for alcohol addiction treatment?

It covers the basics of alcohol dependency recovery—such as inpatient care, outpatient visits, and more. In most states, Medicaid recipients don’t pay a co-pay for addiction treatment services. However, not all facilities accept Medicaid as a form of payment. What Does Health Insurance Cover for Alcohol Treatment?

Does insurance cover outpatient alcohol rehab?

As a result, outpatient and inpatient rehab coverage differ by individual health plan and treatment provider. Generally, alcoholism treatment coverage includes medically necessary therapies, medications, and services, which may include: Additional services deemed not medically necessary are less likely to be covered.

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Does insurance cover alcohol intoxication?

Most health insurance policies will cover injuries or illnesses related to the acute effects of alcohol abuse, including the admission to a hospital for detoxification. Residential recovery programs and long-term treatment programs are covered by some health insurance policies, but coverage is widely variable.

What treatment options are available for an individual who has a drinking problem?

Treatment can include one-on-one, family, or group sessions. Medications. A primary care clinician or a board-certified addiction doctor can prescribe non-addicting medications. These can help people stop drinking and avoid relapse.

Is addiction considered a pre existing condition?

Under the ACA, addiction is no longer considered a pre-existing condition for insurance purposes.

How much does recovery Centers of America cost?

At a company that promotes itself as the new frontier of addiction treatment and charges an average of $24,000 a month, some patients were not getting basic counseling. They were often unsupervised. The staff has complained repeatedly to management and the state that they weren't able to keep the patients safe.

What is the criteria for alcohol use disorder?

Alcohol is often taken in larger amounts or over a longer period than was intended. There is a persistent desire or unsuccessful efforts to cut down or control alcohol use. A great deal of time is spent in activities necessary to obtain alcohol, use alcohol, or recover from its effects.

How long does it take for brain chemistry to return to normal after alcohol?

The new research shows that it takes at least two weeks for the brain to start returning to normal, so this is the point at which the alcohol recovery timeline begins. Until the brain has recovered, it is less able so suppress the urge to drink. This is because the alcohol has impaired the brains cognitive ability.

Is therapy covered by insurance?

Services such as therapist visits, group therapy, and emergency mental healthcare are typically covered by health insurance plans. Rehabilitative services for addiction are also included. Therapy can be expensive, with or without insurance.

Can you get health insurance for pre-existing conditions?

Yes, you can get health insurance even if you have a pre-existing medical condition. But most policies restrict when they can pay out to treat pre-existing conditions.

Does insurance have to cover mental health?

Is mental health covered under health insurance as standard? Most health insurance providers will not cover mental health or psychiatric care in their standard policies, though some do. This means you'll have to ask your provider for a specific mental health add-on, which will cost extra.

Where do celebrities go to rehab?

Crossroads, Antigua. Courtesy of Crossroads. ... Passages, Malibu, Calif. ... Promises, Malibu, Calif. ... Betty Ford Clinic, Rancho Mirage, Calif. ... Silver Hill Hospital, New Canaan, Conn. ... The Dunes, East Hampton, N.Y. ... The Meadows, Wickenburg, Ariz. ... Wonderland, Los Angeles, Calif.More items...•

Does Recovery Centers of America pay well?

Recovery Centers Of America pays an average salary of $77,968 and salaries range from a low of $68,053 to a high of $89,540. Individual salaries will, of course, vary depending on the job, department, location, as well as the individual skills and education of each employee.

Does Recovery Centers of America drug test?

Our nursing staff will complete a urine drug screen and bloodwork, and the physician will perform a history and physical, which includes a TB and Serology test. Once you've been assessed by the physician, he or she will determine your dosage and you will be assigned a counselor.

Does Health Insurance Cover Alcohol Rehab Treatment?

Health insurance typically covers alcohol rehab—either fully or partially—for individuals. That's because addiction is a disease and requires medic...

Can I Go to Rehab Without Insurance?

If you don’t have insurance, various state-funded health programs can help with the cost of rehab. These programs include Medicare and Medicaid. In...

What Does Health Insurance Cover for Alcohol Treatment?

Heath insurance coverage varies by policy. As a result, outpatient and inpatient rehab coverage differ by individual health plan and treatment prov...

What happens if your health insurance company denies you a service?

If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.

What services does a behavioral health plan cover?

Plans must provide coverage for: Inpatient behavioral health services. Behavioral health care, including counseling and psychotherapy. Addiction treatment. Depending on your state and the health plan you choose, specific behavioral health benefits may vary. Some insurance companies cover part or all of the costs of rehabilitation ...

Does insurance cover alcoholism?

Typically, health insurance for addiction treatment may cover the below at approved facilities: Inpatient care. Outpatient care. Medical detox, including medications.

Does health insurance pay for services?

Your health insurance company will only pay for services that it determines to be “reasonable and necessary.”.

Does insurance cover addiction treatment?

Although insurance companies cover varying levels of treatment services, they may not fully cover treatment for relapses. American Addiction Centers is in-network and negotiates coverage with most providers. We may accept insurance from providers not listed.

Does Insurance Cover Rehab for Alcohol?

In 2010, when the Affordable Care Act passed, substance use disorder (SUD) treatments were classified as an essential health benefit. This meant that all marketplace plans were required to offer coverage for SUDs treatment and could no longer discriminate against pre-existing drug and/or alcohol addiction. 3

Ways to Pay for Drug and Alcoholism Treatment

Those using private insurance can call their member services representative to see what types of treatments are covered within their specific policy. The most common healthcare plans are HMOs and PPOs—both offer a variety of options.

Out-of-Pocket Costs for Rehab

Whether you use private or government-funded insurance, there are still certain things you’ll have to pay for out-of-pocket. Typically, policyholders are responsible for the following:

How to Use Insurance for Treatment

Once you’ve established which insurance provider you’ll be using and verify your coverage, consider the following:

Contact AAC Admissions Navigators

If you’re unsure of what coverage you have or how to best utilize the services under your plan, our Admissions Navigators are available 24/7 to chat about your treatment options. Or you can contact one of our facilities directly to speak with an insurance specialist who can help you navigate the specifics of your policy.

How does alcohol rehab work?

In most cases, alcoholism rehab treatment billing will be relatively straightforward. The person who needs care will get that care, and the family and/or the insurance company will get bills that reflect the costs associated with that care. Families will need to read those bills and pay attention to the details, so they can avoid additional charges.

How do insurance companies keep costs down?

Some insurance providers keep costs down by pulling together lists of approved providers. These approved providers accept a smaller payment in return for the promise of clients. That way, the insurance company pays less overall, but the provider tends to make money.

How many Americans don't have enough money to pay for medical bills?

But a study cited by CNBC suggests that more than 60 percent of Americans do not have enough money to handle common emergencies, including medical expenses. These are families that are living from one paycheck to the next, and they do not have the buffer of cash in savings that could allow them to cover rehab costs.

What do treatment teams believe in?

Treatment teams believe in recovery, and they want to see it happen. They will help families navigate how to pay for care, so the person with alcoholism has the best chance at achieving a healthy and lasting recovery. What families need to do is to ask for that help and get the process started.

Is alcoholism treatment free?

Depending on your insurance provider and policy your addiction treatment could be free. Families that decide to accept the help that an alcoholism treatment plan can offer are investing in the future health, wellbeing, and success of their families, both now and in the years to come. But alcoholism rehab is an investment, ...

Do you have to have insurance for alcoholism?

All of those services must be covered, and the Act requires all people to have insurance coverage or pay a penalty. As a result of these two factors, many people who enter alcoholism treatment programs have insurance coverage, and the plans they have provide benefits for addiction care.

Can medical bills impede alcoholism recovery?

During alcoholism recovery, every single person in the family has an opportunity for growth and healing. Medical bills should not impede those changes. Families worried, lost, or just confused can reach out to the treatment provider for more assistance.

What does ACA cover?

The Affordable Care Act (ACA) lists drug or alcohol addiction services as 1 of 10 categories of essential health benefits, which means that any insurance sold on the Health Insurance Marketplace must cover treatment. 1 Insurance companies are required to cover certain basic health services, which include the treatment of mental and behavioral health conditions as well as substance use disorders (SUDs). Additionally, the Mental Health Parity and Addiction Equity Act (MHPAEA) ensures that all private insurance plans cover substance abuse treatment to the same degree that they cover other medical issues, so you can expect equal levels of coverage for both. 2

What is the phone number for rehabs.com?

To find out if you have coverage, give us a call (888) 341-7785. Helpline Information. ✕. How Our Helpline Works.

Can insurance companies deny SUDs?

In addition, insurance companies cannot deny coverage for any pre-existing conditions, including SUDs. 3 This means that you can apply for insurance coverage regardless of what stage of recovery you are in. Insurance can help dramatically reduce what you might otherwise have to pay for detox and substance abuse treatment.

Does insurance cover substance abuse?

Additionally, the Mental Health Parity and Addiction Equity Act (MHPAEA) ensures that all private insurance plans cover substance abuse treatment to the same degree that they cover other medical issues, so you can expect equal levels of coverage for both. 2. Spanish Version. In addition, insurance companies cannot deny coverage for any pre-existing ...

How much does insurance cover after out of pocket?

Generally, there is also an annual out-of-pocket maximum amount, and after that amount is reached, insurance policies will usually cover remaining services at 100 percent . In some cases, individuals will need to pay for treatment up front and then ask for reimbursement from the insurance company for covered services.

What is transitional care?

Transitional services. Follow-up care and recovery services. In order to be eligible to use health insurance coverage to pay for rehab, individuals will need to be in good standing with their insurance company, meaning that they are current on their payment of monthly premiums.

Do PPO plans pay less than HMO?

When using an in-network provider , people with PPO plans will pay less than if they use a provider that is out of network. HMO (health maintenance organization) plans, on the other hand, typically require members to remain in network for treatment services in order for coverage to kick in.

Is alcohol rehab public or private?

Alcohol treatment programs are generally either publicly or privately funded. Public alcohol rehab programs accept everyone even if they don’t have health insurance or can’t afford it; however, these programs are often full with waiting lists. They also may not be as comprehensive or offer quite as many options, specialty services, ...

Is alcohol rehab covered by insurance?

Alcohol rehabilitation services may need to be deemed “medically necessary” in order for them to be covered by insurance, and only certain services may be covered. Individuals may also have a health savings account (HSA) that they (and potentially their employer) put money into to use for healthcare expenses.

Is alcohol rehab as comprehensive as private rehab?

They also may not be as comprehensive or offer quite as many options, specialty services, or amenities as private alcohol treatment programs. Cost may seem like a barrier to treatment; however, the long-term benefits of rehabilitation outweigh the initial financial burden.

Does insurance cover rehabilitation?

Not all insurance policies will cover all necessary treatment services, and some rehabilitation programs may be self-pay, meaning that they may not accept insurance as a form of payment. There are several other ways to finance treatment programs other than insurance, such as private loans and payment plans.

Employee Assistance Programs

If you or a loved one is employed, you might have access to employee assistance programs (EAPs) that can connect you with wellness services.

Scholarships

Addiction treatment centers sometimes provide scholarships for those in need.

Nonprofit and Charity Organizations

Alcoholics Anonymous may be the most well-known support group for recovery from alcohol use disorder, but there are others. You can search the web, or get in touch with WebMD Connect to Care Advisors to find the right local support group for you.

Government Programs

Your state might provide addiction treatment services. This could be through a state program or through Medicare or Medicaid. Employment agencies or community health centers could also assist you with addiction treatment.

Third Party Loans

Third party loans may be tougher tos secure since interest rates can depend on credit history and income. But Wind says it might be worth it, considering the alternative.

Get Help Now

Untreated alcohol use disorder can ruin lives, so seeking help as soon as possible is the best way to avoid long-term effects. WebMD Connect to Care advisors are standing by to help you take the first step towards recovery.

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