Even when considering the more modest drug and alcohol addiction treatment centers, fees for service can be an obstacle to opting for help. From quality medical care to administrative costs to the constant attention that is sometimes required by individuals seeking treatment for the disease of addiction, the bills can pile up rather quickly. In light of this, and because of a growing understanding of addiction and its very real effects, a great many insurance providers have responded by providing addiction treatment coverage to participants of their insurance plans. However, simply because you have insurance does not mean that you are automatically covered.
At Cornerstone Recovery Center, we pride ourselves on being knowledgeable about addiction treatment insurance coverage, and we are willing to contact an insurance provider on your behalf to investigate the coverage provided within the scope of your policy.
Should you wish to contact your provider prior to initiating drug and alcohol addiction treatment, here are some questions you may wish to ask.
Do You Offer Drug and Alcohol Addiction Coverage?
A very basic question, yes, but it is certainly the most important. The intricacies that come with treatment coverage – and there are very many – are moot if treatment coverage isn’t offered in the first place. And the reason behind this question is simple: not all insurance companies provide addiction treatment coverage nor are they required to. Any requirement to do so is delineated by the state in which you reside, and without a requirement in place, offering such coverage is at the provider’s discretion.
Is Addiction Considered a Pre-Existing Condition?
Maybe you don’t have insurance at the time of addiction and decide to seek coverage concurrently with treatment. In such a case, this question can prove crucial. Not all insurance companies explicitly list addiction as a pre-existing condition, thus allowing you to enroll. (Please note that, as of 2014, under the Affordable Care Act, insurance companies will not be able to turn you away for any pre-existing conditions). If addiction is listed as a pre-existing condition, under current regulations, coverage may be denied.
How Will My Premiums Be Affected by Addiction Treatment?
Under our current system, despite existing coverage, the usage of the treatment afforded you may cause your premiums to rise. This is certainly dependent on the policies instituted by your insurance provider. (Again, as of 2014, under the Affordable Care Act, insurance companies will be made to comply with insurance premium caps.)
What Kind of Treatment Can I Expect?
The specific programs that qualify under addiction treatment insurance plans vary depending not only on your coverage, but on the nature of the addiction as well. Insurance providers approach addiction in vastly different ways, particularly when considering the substance to which an individual may be addicted. Inpatient services may be covered under certain plans and for certain addictions while others may only qualify as requiring intensive outpatient treatment services. Whatever the case may be, a clear understanding of the programs offered by an insurance provider as they relate to your specific addiction is needed.
Does Addiction Treatment Insurance Cover Medications?
If addiction treatment is offered by your insurance company, the medications associated will usually be covered if a lack of them is considered life-threatening. For example, such medication may be needed toward the treatment of opiates, the withdrawal symptoms of which can prove dangerous to the well-being of an individual. It is important to note, however, that coverage in this case varies also. Ascertaining the exact coverage for medication-assisted treatment is imperative when speaking to your provider or shopping around for one that may accommodate you.
What about Addiction Treatment Aftercare?
Recovery is a lifelong commitment. No matter the quality of treatment or the thoroughness of detox, recovery will prove a tall – or a taller – task without the understanding that treatment doesn’t end upon completion of a program. The recovery process may require ongoing support inasmuch as personal counseling, relapse prevention, and group meetings – among other things – are concerned. And though some treatment facilities go the extra mile in including aftercare group meetings to alumni as part of a completed treatment program, it is important to understand your insurance company’s policy toward aftercare should the service require payment.
The Conversation about Coverage Need Not End Here
These are only a few questions related to addiction treatment insurance coverage, but the conversation isn’t as neatly encapsulated as this article may make it seem. The truth is that, when considering treatment insurance, the conversation may prove endless and questions may persist beyond the conversation, but don’t let this discourage you. In this case, perhaps more so than in others, the old cliché is firmly entrenched in truth: there are no stupid questions. Please confer with your insurance provider. And, to reiterate, regardless of which drug and alcohol addiction treatment center you are considering, please don’t hesitate to contact us about the addiction treatment insurance partners with whom we partner, or to have us contact a provider on your behalf.