Health Insurance Enactments
A standard health insurance policy carries a list of medical benefits that are considered covered services, like tests, drugs, treatment services, labs, mental health and substance abuse services (counseling, rehabilitation, mental therapy, hospitalization, and more). Drug and alcohol addiction in 2018 is termed a medical condition and it does not carry the forbidden stigma that its history once denotes.
Years ago, it was nearly impossible for families or individuals to get health care through insurance policies. Nearly all states now require group health plans to cover addiction treatment. Finding the right facility, like the services provided by the Harris House, is the first step. For the right health insurance, don’t forget that the Mental Health Parity and Addiction Equality Act of 2008 has made it illegal for insurance companies to discriminate against patients because of an addiction.
Does Your Policy Use This Language?
Granted, the Act does not mandate that insurance companies carry specific treatments for addictions. However, insurance companies are required to provide coverage for mental and substance abuse disorders which are a part of any addiction, thus it is identified as a regular medical condition. Insurance policy language should involve wording like:
*medical detoxification treatments with or without the words “hospitalization”
*rehabilitation – inpatient care
*intensive outpatient treatment for family
*intervention
*individual outpatient treatment
Why People Wait For Help
Unfortunately, many people with substance abuse disorders don’t immediately seek help. When they are admitted to intensive treatment programs, it is generally due to a serious health issue. At this point in their life, they need intensive inpatient residential care, medical assistance, and counseling. Addicts may be suffering from heart disease, depression, a life-threatening illness, or recovering from an overdose. For those who enter accredited rehabilitation facilities at an early stage of their addiction, they respond well to short-term counseling sessions under primary care specialists.
Obama Care and Looking Inside Insurance Policies
The Affordable Care Act (“ACA”) or (“Obama Care”) has required that people must carry health insurance. One of the benefits of Obama Care is that the program includes more comprehensive coverage for addictions and mental illness. The ACA provides more coverage for families to receive the addiction treatment benefits that they need. In addition to the ACA, all state-wide Medicaid programs also offer mental health care coverage and substance abuse coverage.
Other ACA benefits include health and alcohol screening, the elimination of co-payments or cost sharing for certain screenings and referrals. Another benefit in receiving addiction and rehabilitation treatments through either a private insurance policy or a public/government insurance policy is again centered around language. Insurance policies don’t separate certain treatments like identifying specific drugs or specific addictions. No matter what addiction a person has, insurance language just states that a policyholder’s treatment should be covered.
Common Insurance Sense
Many in-network addiction treatment centers take most health insurance providers that cover detox programs, outpatient program, and 28-day inpatient program. Other covered health insurance services help with transitional housing levels, dual diagnosis treatment, partial hospitalization programs, and supportive counseling programs.
Modern-day insurance companies understand that covering the cost of addiction treatment is a lot less costly than providing coverage for the adverse medical symptoms that substance abuse and drug addiction carries. Today insurance providers understand that addiction treatment facilities are a cost-saving preemptive medical service.
In-Network Benefits
Helping to treat individuals through drug and/or alcohol addiction services, facilities provide treatment services for men and women who are caught up in the addiction to substance abuse. Check with your health insurance provider to find out if your treatment facility is an in-network facility or an out-of-network facility. Insurance policies cover rehabilitation facilities that are in-network centers because out-of-network facilities will have a higher co-payment fee.
Other benefits in health insurance to cover addiction treatment include no annual dollar limitations. This is good for covering long-term care. There are no limits applied to treatments because addiction care legally cannot be any more prohibitive than the treatments provided under general medical services. The right health insurance policy saves individuals and family members a ton of money for the help that they desperately need.
Check your health insurance policy to determine what your coverage entails for substance abuse disorder treatment facilities. A majority of health insurance policies cover facilities that are designated detox facilities, outpatient facilities or hospitals. Policies also cover limited rehabilitation periods from 30 days to 4 months.
