Have you ever wondered whether insurance companies can cover rehab admission? The short answer is Yes. Health insurance plans generally cover the cost of treatment for substance use disorders and mental health conditions. However, the particular health insurance plan you have will determine the level of treatment that will be covered by the insurance company as well as how much you need to pay by yourself.
According to the Mental Health Parity and Addiction Equity Act, it is illegal for insurance companies to discriminate against and deny coverage to individuals suffering from substance abuse disorder. Statistics show that a high number of people suffer from substance abuse across all 50 states. Are you suffering from substance use disorder? Here are some things you should know about insurance for rehab admission.
What Is Covered?
Under the Addiction Equity Act, it is said that the coverage for the treatment of substance use disorders must be as complete as it would be for any other procedure. Therefore, it is within the rights of every health insurance policyholder to have part or all of their treatment cost covered by the insurance company.
Treatment plans covered by insurance companies include; addiction evaluation, family counseling, alcohol and drug testing, medication, in-patient treatment, and detox. Although the insurance company covers the cost of treatment, you should also check the extent to which the services are covered based on the plan you have with the insurance company to know the coverage breakdown.
Eligibility
According to federal law, insurance companies cannot discriminate against anyone with substance use disorder. They are obligated to cover the cost of treatment for addiction disorders and cannot legally refuse to grant you coverage for substance use treatment. However, there are limits on eligibility for ACA coverage.
For a person to qualify for ACA coverage, they must earn an income between the federal poverty level and four times the federal poverty level. Also, based on family size, there can be coverage changes relative to your maximum income earned annually. It is crucial to know the limits to the coverage offered to you under your policy.
How To Find Out About Your Policy
To find out about the coverage offered under your policy, you can call your insurance company or insurance agent to find out about the total breakdown for your plan. It is important to have your insurance card with you so that the company can look up your policy and attend to you appropriately.
All insurance companies are required by the law to provide coverage for substance use disorder and mental health treatment. Still, the level of coverage depends on the type of plan you have with the insurance company. Hence, it is important to find out about the coverage offered for the policy you are under.
Things To Find Out
When finding out about the coverage offered by your policy, here are some of the things you need to ask the provider.
- Find out if your insurance covers in-patient, out-patient, detox, and aftercare treatment.
- Find out the percentage covered by the insurance company for these services.
- Find out how much you need to pay alongside the insurance company.
- What your monthly premiums will be.
- The limits to the coverage offered by the company
- Find out whether prescriptions will be covered by the insurance company and the extent to which it is covered.
In some cases, individuals might need specialized care or procedures during treatment. Individuals like these also need to know about the coverage offered for these procedures and care.
What You’re Expected To Pay
Every individual is required to pay for a part of their treatment regardless of the type of insurance they have or how good it is. The amount you are required to pay, however, is dependent on the plan you have with the insurance company. In most situations, individuals must pay a co-payment, a fixed amount paid to receive treatment, and a deductible, which is the amount you’re required to pay before the insurance company takes over the rest.
Individuals are also required to pay a fixed percentage of the total treatment cost before receiving treatment, and their monthly premium, which is the service fee required to keep your insurance package active all through the year.
Conclusion
Legally, no insurance company can discriminate against any person suffering from substance use disorder and mental health issues and must offer treatment coverage to them anytime it is needed. The insurance plan or package of an individual determines the level of coverage offered by the insurance company.
Individuals must also pay a part of their total treatment cost before the insurance company covers the rest. Are you in need of treatment for substance use or mental health disorder? Find out the coverage your insurance plan offers to you today.