Congratulations on choosing rehab. It is not easy, but you are on the path to a brighter and healthier future.
When seeking treatment, here are 5 things to consider to get coverage from your health insurance company:
1. Every Insurance Plan is Different
Keep in mind that each plan offered by each insurance company is going to have variations in what is covered. Check your Explanation of Benefits that came with your policy when you signed up, or call your carrier to find out what your specific plan covers.
Questions to ask: Are you eligible for detoxification and inpatient treatment? How many days, weeks, or months? Outpatient services?
2. Copay or Deductible
With most insurance plans, you are responsible for an upfront amount of the costs. When you visit a doctor, for example, you pay an office visit copay. The same can be true for rehab. You may also have a deductible in place, which is an annual dollar amount you pay before the insurance company pays anything.
When you find out about your specific insurance plan, you will also find out about your part of the costs.
3. Your Insurance Plan May Not Cover All the Costs
If your carrier does not pay the full cost of your rehab services, are you able to pay for the rest? What amount of money are you able to pay out of pocket for rehab?
Although the answers are important, do not let money stand in the way of accessing the treatment you need.
4. Affordable Health Care Act Changes
Now that ObamaCare is rolling out, substance abuse and mental health treatment are to be equal to all other treatment. This means that, starting January 1, 2014, changes will be made to how rehab services are accessed and covered under all insurance plans.
If you are seeking services now, find out if changes have already been made in treatment centers and with your insurance company.
5. If Coverage is Denied
Your insurance company will let you know if and when services have been denied, but that does not mean you cannot still get reimbursed for rehab. You can appeal the decision, and with the backing of your primary care physician or another medical or mental health care professional showing that you medically need rehab services, you may be able to overturn the insurance company’s decision.
Through the process of getting your insurance company to pay for rehab, it is most important to remember that you are trying to get better, and treatment is the primary way to do that. If addicts and alcoholics could heal on their own, they all would.
The reality of it though is that we all need help when substance abuse has reached a dangerous level, and when loss of control over use, an obsession with using, denial of a problem, and continued use despite negative life consequences, has taken over your life.
Seek the services you need, based on what your insurance company will cover, and then make the choice each day to do the work necessary to stay clean and sober!
Cindy Nichols is an intervention specialist and treatment advisor, learn more about her work helping people in recovery by watching Recovery Now TV.