Learn how to navigate your insurance policy and find an addiction treatment center that is covered by your provider.
Many people are able to offset the cost of drug and alcohol treatment by using their health insurance for drug rehab. However, there can be many differences in coverage and benefits between insurance providers and each individual policy. Because of this, it’s important to understand your policy, what it covers and where it can be accepted.
Insurance typically covers some or all of the costs of rehab treatment and it is typically the best option for those with a policy. If you do not have insurance, there are still ways you can find treatment that is both affordable and effective.
Does Insurance Cover Rehab?
The Affordable Care Act required both private and public health insurance providers to cover treatment for drug and alcohol abuse. Many treatment centers accept most types of private insurance. Some will also accept government-funded policies like Medicare and Medicaid.
Before attending treatment, it’s important to contact your insurance provider and chosen facility to verify your specific insurance coverage.
Verify Your Substance Abuse Insurance Coverage
The Recovery Village Cherry Hill at Cooper makes it easy to find out whether your policy will cover your stay in rehab. Use our confidential insurance verification form to quickly find out about deductibles, out-of-pocket costs and more. After you complete the form, one of our representatives will contact you to discuss your insurance benefits. You can also contact your insurance provider to verify what your specific policy covers.
See if you or loved one is covered, instantly!
What Questions Should I Ask About My Insurance Coverage?
There are a few things you’ll want to ask your insurance provider to help you choose a rehab facility and treatment plan, including:
- Does this plan have substance misuse and mental health treatment benefits? If it doesn’t, you’ll likely have to pay for rehab yourself.
- Can this policy be used at a freestanding facility? A freestanding facility is one that isn’t attached to a hospital. If your plan can’t be used at one of these facilities, you may need to privately pay for rehab or attend a facility that is attached to a hospital if you want to use your insurance benefits.
- Does this policy require attendance at an accredited rehab center? If it does, you must find an accredited rehab center or privately pay to enroll at a facility that is not accredited. However, choosing an accredited center is recommended to help ensure that you receive the best possible care.
- Does this policy cover detox care? Detox is often the first step of rehab care and is usually the most intensive. This can make it one of the most expensive levels of care, so it’s a good idea to choose an insurance plan that covers detox and/or confirm that yours does.
- Does this policy cover residential treatment? If the plan provides coverage for inpatient treatment, you’re covered for residential treatment that offers intensive medical care. It can also be helpful to understand the length of stay your specific plan covers.
- Does the policy cover outpatient and other aftercare programming? After higher levels of care, such as detox and inpatient, outpatient care or other aftercare plans can help you to transition from a rehab environment back to day-to-day life. Understanding what and how much your insurance plan covers can help you create your aftercare plan.
- Is my facility of choice in-network with my policy? While many plans usually help cover rehab costs, how much they cover is usually related to whether the facility is in-network or out-of-network.
- Can this policy be used in other states? If your plan doesn’t cover out-of-state treatment, you’ll need to find an in-state rehab facility or choose to pay privately for out-of-state treatment.
In-Network vs. Out-of-Network Insurance Coverage
If cost is a consideration for you, it is often a good idea to choose treatment at an in-network location when choosing a facility. When a facility is in-network with your insurance provider, your insurance provider receives discounted rates from the facilities. This means your costs will be lower and insurance will cover more of your expenses. Out-of-network providers usually do not offer the same savings and you may have to pay higher copays and deductibles, depending on your plan.
Keep in mind that even in-network policies may have restrictions regarding length of stay, type of treatment covered and more. Contact your insurance provider directly or The Recovery Village Cherry Hill at Cooper to learn more about what is specifically covered by your policy.
No Health Insurance Coverage?
Attending rehab with no insurance is also possible. We work with our clients to create private pay plans that fit both their budget and treatment needs. If we aren’t able to help you, we’ll help you find someone who can.
Understanding Insurance Verification Terms
There are a few terms you’re bound to come across when reviewing your health insurance policy. Here’s some help with the most common insurance terminology:
- Deductible: Your health insurance deductible is the amount you must pay before insurance begins to cover your expenses. For example, if your deductible is $5,000, you must pay $5,000 toward health-related costs before insurance will pay for the rest.
- Copayment: Your insurance copayment, or copay, is the amount you pay for a covered health care service. This is usually a specific amount. For example, the copay to visit a doctor may be $50.
- Coinsurance: Coinsurance often kicks in after meeting your deductible and it involves paying a percentage of your health-related costs. For example, if your coinsurance is 20% and you have a $1,000 bill, you will pay $200. You will only pay this until meeting your out-of-pocket maximum.
- Out-of-pocket maximum: Your out-of-pocket maximum is the maximum amount you will pay toward health-related costs in a year. Your deductible, coinsurance and copayments all count towards your out-of-pocket maximum.
- Policy effective date: This is the date when your health care coverage begins. This can begin weeks or months after you initially enroll with an insurance provider.
Navigating insurance coverage can be confusing and sometimes overwhelming, but The Recovery Village Cherry Hill at Cooper is here to help. Contact us today to discuss your insurance coverage, payment planning and treatment programs that can work well for your situation.