Understanding Insurance for Rehab: A Quick Guide | The Ranch

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Understanding Insurance for Rehab: A Quick Guide

February 6, 2018
insurance agent talking to couple

It’s difficult enough to come to terms with addiction and admit you need help. Unfortunately, worrying about how to pay for treatment often gets in the way of going through with it. At Promises, we believe the expense of addiction treatment should not prohibit you or your loved one from accessing the very best rehab program available. It’s helpful to know what to expect from a financial standpoint in case you need assistance with co-pays or deductibles. Every insurance plan is slightly different in terms of general mental health and addiction treatment coverage.

How Much Does Rehab Cost?

The cost of drug rehab varies widely, depending on the type of program, e.g. outpatient versus inpatient, location, amenities and length of treatment.

  • When you call us for a free assessment, we’ll provide additional information helpful for determining your coverage, such as specific treatment program recommendations and 30-, 60- or 90-day residential treatment options.
  • Residential treatment for substance use covered by insurance is typically deemed an intermediate level of care. Individual insurance plans classify residential treatment (e.g. inpatient or outpatient benefits) based on how similar services for medical or surgical conditions are categorized.1

What Does Insurance Cover?

The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 requires health insurers and group health plans to provide the same level of benefits for mental and/or substance use treatment and services as for medical/surgical care.2 The Affordable Care Act mandates that all plans cover essential mental health benefits, although the extent of coverage is determined by your state of residence and the health plan you select. The MHPAEA ensures that marketplace plans provide “parity” protections between medical and surgical benefits on the one hand, and the following mental health and substance abuse benefits on the other.3

  • Behavioral health treatment, such as psychotherapy and counseling
  • Mental and behavioral health inpatient services
  • Substance use disorder (commonly known as substance abuse) treatment

Substance use insurance coverage and benefits can be complex. Perhaps you’ve already called your insurance company to verify general mental health coverage. They likely will not be able to tell you exact coverage until you verify the facility, length of treatment and obtain other details. To help facilitate this process, we need the following information when you call us:

  • Name of insurance carrier
  • Insurance company contact info
  • ID number
  • Group number
  • Calendar-year deductible
  • Applicable co-pays (if you know)

Our admissions advisors will work directly with your insurance company to ensure you obtain the greatest coverage possible under your plan. All steps in the process are confidential, from your initial call, to communications with your insurance company, as well as the entire treatment process. Don’t let the cost of rehab or insurance uncertainties get in the way of your recovery. We’ll help you choose the right program and take care of all the logistics so you can focus on a healthier you.

  1. The uncertain present and future of addiction treatment and insurance coverage under mental health parity and addiction equity act (MHPAEA) and Affordable Care Act (ACA). Baldwin Research website. http://www.baldwinresearch.com/addiction-treatment-insurance-coverage.cfm Accessed October 7, 2017.
  2. Implementation of the Mental Health Parity and Addiction Equity Act (MHPAEA). Substance Abuse and Mental Health Services Administration website https://www.samhsa.gov/health-financing/implementation-mental-health-parity-addiction-equity-act Updated January 24, 2017. Accessed October 7, 2017.
  3. Mental health & substance abuse coverage. HealthCare.gov website https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/ Accessed October 7, 2017.

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