Does Insurance Cover Rehab for Addiction?

If you are wondering, “Does insurance cover rehab for addiction treatment?” the good news is that most health plans do. The degree to which they cover these services does vary between plans and providers, though, so do check the details.

In the past, there were not many insurance providers that covered costs related to substance abuse or mental health. But in recent years, major changes in federal law pushed insurers to treat addiction as they do other diseases. They were no longer allowed to discriminate in their coverage.

The financial cost of obtaining treatment is among the most powerful barriers that prevent people from getting the help needed. It’s true that rehab is pricey, but there are some options available to help pay for it. Insurance coverage is one of those options.

 Do You Need Rehab?

Substance use disorder is an umbrella term that includes a range of symptoms. Based on the number of symptoms a person displays, the condition is considered mild, moderate, or severe.

Someone who has been binge drinking, for instance, may be engaging in substance abuse and high-risk behavior. If this is a fairly recent practice, they would be diagnosed with mild alcohol use disorder. They would benefit from rehab but may be able to shift their course through a local A.A. program and therapy.

Those with moderate or severe substance use disorders are best served by enrolling in a treatment program. Without the structured setting and systematic approach to therapy, they would be less likely to be able to remain sober. Symptoms of a substance use disorder include:

• Wants to quit using the substance but cannot quit on his or her own.
• Becomes hyper-focused on getting, engaging in, and recovering from substance use.
• The decline in work or school performance.
• Dishonest with themselves and others about how much they are using or drinking.
• May steal alcohol or prescription meds, doctor shop for more refills, or purchase drugs on the street.
• Neglects appearance.
• Neglects responsibilities.
• Cravings
• Tolerance increases to the effects of the substance.
• Engages in high-risk behaviors.
• Withdrawal symptoms emerge when the substance wears off.

5 Steps to Prepare for Rehab

If you believe that you or someone you love is showing signs of addiction, there are some steps to take. These can help someone prepare for rehab:

1. Research rehabs. If you planning for rehab, research the features and services that distinguish the various programs to find the best fit. Call the top choices and get all your questions answered, including if they have a bed available.
2. Learn about the disease. The more that you learn about the disease of addiction, the more you will be of help to the person. Do some research prior to rehab so you know what to expect and how to be better able to support them.
3. Gather support. Ask your loved ones to be available to provide emotional support and encouragement over the months to come. If it is a loved one going to rehab, be prepared to offer your support.
4. Plan logistics. When you or a loved one goes into treatment there may be a need to set up childcare arrangements. You may need to arrange for the kids to be transported to school and back. You will also need to consider plans for bills to be paid during the time in rehab.
5. Talk to the boss. One of the most difficult pre-planning steps is meeting with the boss to inform him or her of your plans to get treatment. If you plan to enter an outpatient program, you can work out a reduced work schedule with the boss. If you plan to go to inpatient rehab, you or the loved one will need a leave of absence.

Does Insurance Cover Rehab For Addiction Treatment?

One of your first questions will be “Does insurance cover rehab for addiction treatment?” That is the starting point of the quest to obtain this important information. When you inquire about your benefits you will be guided through the insurance company’s coverage limitations and qualifying criteria.

The extent to which you are covered varies from plan to plan. For instance, a PPO plan may cover more of the costs, and allow you to use any rehab you select. An HMO will be stricter about the provider options and how much will be paid. Regardless, all major insurers, including Tricare for members of the military and their families, offer some level of coverage.

Covered services may range from weekly outpatient therapy sessions to intensive outpatient programs, partial hospitalization programs, or inpatient treatment. They may cover the full amount or a percentage of the costs. You will be encouraged to choose an in-network provider to ensure the lowest out-of-pocket costs.

Will You Need Detox?

By the time someone reaches out for help, they have likely developed a substance use disorder. Most of them will need to start the recovery process with detox and withdrawal. This is the phase after you stop taking the substance and your body goes through a period of withdrawal symptoms.

As withdrawal symptoms emerge, they will be managed by a skilled medical detox team. These experts monitor vital signs and symptoms closely so they can provide medical support as needed.

Withdrawal symptoms vary depending on the substance and the duration and severity of the substance use disorder.

Rehab Treatment Options for Addiction

Addiction treatment should never be one size fits all. There are different levels of care available for treating a substance use disorder. These fall into two main groups: outpatient and inpatient:

Outpatient. An outpatient program is a good option for someone with a milder substance use disorder. These programs allow the person to keep working while they are enrolled in treatment.  Also, the costs of outpatient treatment are much lower than inpatient rehabs.

Inpatient. The inpatient or residential rehab offers the highest standard of addiction treatment and care. The highly structured setting creates a safe, supportive space for treatment and healing. The risk of relapse is reduced, as there is no exposure to drugs and alcohol during the program.

LifeSync Malibu Can Help You Overcome Addiction

LifeSync Malibu is a leading addiction recovery program that offers detox and residential treatment. Please contact our team to begin the recovery process, starting with finding out if insurance covers rehab for addiction treatment. Call us today at (866) 491-4426.