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Addiction Recovery Blog

5 Health Insurance Myths about Addiction Treatment Coverage

A man sits on a couch holding a phone and a piece of paper.
Not sure how much of rehab your insurance covers? Your best bet is to get on the phone.

Imagine if you came down with the flu or had a nagging back pain that was affecting your day-to-day. If the symptoms didn’t subside with home remedies, your next step would be to see a doctor. So, you find a doctor in your area, work an appointment into your busy schedule and go to the appointment.

Unfortunately, your hope for relief drops when you’re told by the receptionist at your appointment that your insurance won’t be accepted. You’ll have to pay full price for the visit and any additional treatments needed.

Now imagine that same scenario if you or a loved one is struggling with addiction. The thought of being denied coverage and assuming they can’t pay for rehab causes many people not to even try. But the reality is there are many misconceptions about insurance coverage for addiction rehab. This article will debunk some of these myths and give you the information needed so that you or a loved one can get the addiction treatment needed.

Addiction Treatment Insurance Myths Debunked

Myth #1: Insurance Plans Don’t Cover Addiction Treatment

It’s important to nip this one in the bud immediately. Most insurance companies provide some level of coverage for addiction treatment. What isn’t always clear is what your specific insurance plan includes.

As you or a loved one tries to courageously take the next step to get treatment, call your insurance provider to get details about your specific insurance plan. Does it cover addiction treatment? And if so, how much coverage is provided? If insurance coverage isn’t included in your current plan, is there a way to get coverage?

Asking the insurance provider directly is the fastest way for you and your loved one to find out what sort of insurance coverage is available for addiction rehab.

Myth #2: Addiction Treatment is Too Expensive

This is another myth that often prevents people struggling with addiction from seeking help. While addiction rehabs can get pricey because of the medical care, treatment and amenities provided, the Mental Health Parity and Addiction Equity Act requires insurance companies to treat substance addiction the way they do other physical diseases.

This means insurance companies need to offer levels of coverage for addiction treatment so people like you or your loved one can more easily pay for the life-saving care they need and deserve.

However, it’s important to note that not every insurance plan is created equal. As mentioned above, you should contact your insurance provider and find out what sort of coverage you do have with you healthcare plan.

When you’re able to estimate how much insurance coverage you’ll get, you can then plan out additional ways to cover the remaining rehab costs, if necessary.

Myth #3: Insurance Providers Deny Addiction Treatment Coverage

This myth stems from the stigma around substance addiction. Fortunately, how we approach addiction and treatment throughout the nation is changing. As already mentioned, insurance providers like Aetna and BlueCross BlueShield have to treat substance abuse the same way they do other diseases.

In other words, if you or a loved one is diagnosed with substance addiction that requires medical care and treatment, your insurance provider can’t just deny treatment.

However, it’s important for you or your loved one to get a medical assessment done with a doctor who can diagnose the addiction and any other mental health issues at play. This will make it easier to prove to an insurance provider that you or a loved one need treatment.

Myth #4: Insurance is Required to Get into Addiction Treatment Programs

It’s no secret that addiction treatment is easier to pay for when you have insurance coverage. However, insurance is by no means required in order to enroll in an addiction treatment program.

In fact, there are many other ways for you or your loved one to pay for treatment. From private pay and income-based payment plans to drug rehab financing and loans, there are many resources available to help with addiction rehab costs.

Myth #5: Insurance Coverage Doesn’t Cover Rehab’s Length of Stay

While it’s true that insurance coverage varies for the types of addiction treatment available, most insurance policies will cover an assessment, detox, outpatient treatment and some degree of inpatient treatment.

The specifics regarding how long your insurance coverage will cover a rehab stay will vary based on your insurance provider and policy. Your length of stay coverage may also vary depending on what is deemed medically necessary for your unique situation. It’s best to work with you doctor and insurance provider to determine the length of treatment your policy will cover.

Determining Your Insurance Coverage for Addiction Treatment

If you’re trying to figure out what your insurance coverage is like, there are a couple different ways you can do this. Let’s say you have Aetna insurance or BlueCross BlueShield insurance. Your first step is to look at your insurance card and call the phone number listed under member services.

Once you do that, you’ll be connected to an insurance representative. Be sure to ask them a few specific questions, including:

  • Will my insurance pay for assessment, detox, rehab and aftercare
  • What would my co-pay and deductible be?
  • Will my insurance cover any prescription medications used in rehab?
  • How long will my insurance cover rehab for?
  • Can I choose any rehab facility or are there limitations?

It’s also a good idea to call the specific treatment program you’re considering and talk to someone from the admissions department. More likely than not, they’ll know what each type of insurance covers.

Given how confusing healthcare and insurance can be, it can be helpful to call both your insurance company and any treatment programs you’re considering to get a full picture of what your options are—and what might be best for you.

Recovery is Possible at The Raleigh House

At The Raleigh House, we work with many insurance providers like Aetna and BlueCross BlueShield and offer information on additional ways to pay for treatment. Our ultimate goal is to help you or your loved one heal from addiction and dual diagnosis disorders. You can’t do that if you’re worrying about how you’re going to pay for treatment, which is why we can guide you through the admissions process and can verify your insurance for you.

If you or your loved one is ready to overcome addiction and regain a life of sobriety, fill out our form or contact us today to learn more about our treatment programs.

Imagine if you came down with the flu or had a nagging back pain that was affecting your day-to-day. If the symptoms didn’t subside with home remedies, your next step would be to see a doctor. So, you find a doctor in your area, work an appointment into your busy schedule and go to the appointment.

Unfortunately, your hope for relief drops when you’re told by the receptionist at your appointment that your insurance won’t be accepted. You’ll have to pay full price for the visit and any additional treatments needed.

Now imagine that same scenario if you or a loved one is struggling with addiction. The thought of being denied coverage and assuming they can’t pay for rehab causes many people not to even try. But the reality is there are many misconceptions about insurance coverage for addiction rehab. This article will debunk some of these myths and give you the information needed so that you or a loved one can get the addiction treatment needed.

Addiction Treatment Insurance Myths Debunked

Myth #1: Insurance Plans Don’t Cover Addiction Treatment

It’s important to nip this one in the bud immediately. Most insurance companies provide some level of coverage for addiction treatment. What isn’t always clear is what your specific insurance plan includes.

As you or a loved one tries to courageously take the next step to get treatment, call your insurance provider to get details about your specific insurance plan. Does it cover addiction treatment? And if so, how much coverage is provided? If insurance coverage isn’t included in your current plan, is there a way to get coverage?

Asking the insurance provider directly is the fastest way for you and your loved one to find out what sort of insurance coverage is available for addiction rehab.

Myth #2: Addiction Treatment is Too Expensive

This is another myth that often prevents people struggling with addiction from seeking help. While addiction rehabs can get pricey because of the medical care, treatment and amenities provided, the Mental Health Parity and Addiction Equity Act requires insurance companies to treat substance addiction the way they do other physical diseases.

This means insurance companies need to offer levels of coverage for addiction treatment so people like you or your loved one can more easily pay for the life-saving care they need and deserve.

However, it’s important to note that not every insurance plan is created equal. As mentioned above, you should contact your insurance provider and find out what sort of coverage you do have with you healthcare plan.

When you’re able to estimate how much insurance coverage you’ll get, you can then plan out additional ways to cover the remaining rehab costs, if necessary.

Myth #3: Insurance Providers Deny Addiction Treatment Coverage

This myth stems from the stigma around substance addiction. Fortunately, how we approach addiction and treatment throughout the nation is changing. As already mentioned, insurance providers like Aetna and BlueCross BlueShield have to treat substance abuse the same way they do other diseases.

In other words, if you or a loved one is diagnosed with substance addiction that requires medical care and treatment, your insurance provider can’t just deny treatment.

However, it’s important for you or your loved one to get a medical assessment done with a doctor who can diagnose the addiction and any other mental health issues at play. This will make it easier to prove to an insurance provider that you or a loved one need treatment.

Myth #4: Insurance is Required to Get into Addiction Treatment Programs

It’s no secret that addiction treatment is easier to pay for when you have insurance coverage. However, insurance is by no means required in order to enroll in an addiction treatment program.

In fact, there are many other ways for you or your loved one to pay for treatment. From private pay and income-based payment plans to drug rehab financing and loans, there are many resources available to help with addiction rehab costs.

Myth #5: Insurance Coverage Doesn’t Cover Rehab’s Length of Stay

While it’s true that insurance coverage varies for the types of addiction treatment available, most insurance policies will cover an assessment, detox, outpatient treatment and some degree of inpatient treatment.

The specifics regarding how long your insurance coverage will cover a rehab stay will vary based on your insurance provider and policy. Your length of stay coverage may also vary depending on what is deemed medically necessary for your unique situation. It’s best to work with you doctor and insurance provider to determine the length of treatment your policy will cover.

Determining Your Insurance Coverage for Addiction Treatment

If you’re trying to figure out what your insurance coverage is like, there are a couple different ways you can do this. Let’s say you have Aetna insurance or BlueCross BlueShield insurance. Your first step is to look at your insurance card and call the phone number listed under member services.

Once you do that, you’ll be connected to an insurance representative. Be sure to ask them a few specific questions, including:

  • Will my insurance pay for assessment, detox, rehab and aftercare
  • What would my co-pay and deductible be?
  • Will my insurance cover any prescription medications used in rehab?
  • How long will my insurance cover rehab for?
  • Can I choose any rehab facility or are there limitations?

It’s also a good idea to call the specific treatment program you’re considering and talk to someone from the admissions department. More likely than not, they’ll know what each type of insurance covers.

Given how confusing healthcare and insurance can be, it can be helpful to call both your insurance company and any treatment programs you’re considering to get a full picture of what your options are—and what might be best for you.

Recovery is Possible at The Raleigh House

At The Raleigh House, we work with many insurance providers like Aetna and BlueCross BlueShield and offer information on additional ways to pay for treatment. Our ultimate goal is to help you or your loved one heal from addiction and dual diagnosis disorders. You can’t do that if you’re worrying about how you’re going to pay for treatment, which is why we can guide you through the admissions process and can verify your insurance for you.

If you or your loved one is ready to overcome addiction and regain a life of sobriety, fill out our form or contact us today to learn more about our treatment programs.