Changes in the health insurance market are due to the Affordable Care Act (ACA) and relate to the War on Drugs. According to the ACA, insurance programs and companies are required to provide rehab insurance coverage. Addiction and mental health disorders are now covered in the scope of health insurance plan coverage.
Enacted during the administration of U.S. President Barack Obama, the ACA is also known as Obamacare, which leads to questions such as, Does Obamacare cover drug rehab? It does. Many Americans are receiving rehab insurance and other needed assistance because they have the coverage needed to fund such assistance. The plans vary in what they cover and how long they provide this coverage. Insurance coverage differs based on the plans that people currently have, as each plan is different.
If you are wondering more about health insurance that covers substance use disorder, learn the specifics of choosing a health coverage option and what exactly it covers. Most health insurance policies in the United States are sold to people who want assistance to meet their health care needs. Substance use disorder care plans and mental health coverage are often part of those needs.
Public Insurance Options
Every U.S. state provides drug rehab insurance. This type of insurance is provided for people who are under the poverty levels in specific areas. All public health insurance coverage options, such as Medicaid programs and children’s health insurance programs, must provide both mental health and addiction care services to people in need.
Private Insurance Options
Private insurance options are offered through employers or for premium prices to those who are willing to pay for them outside of the health insurance marketplace. Private insurance options are required to provide addiction and mental health coverage, but they often limit how much they provide. They also limit where people may find help or how long sources may give help. That is why it is important to know how to check insurance coverage to obtain the assistance that you need.
Group Insurance Options
Group insurance options provide insurance coverage options for people who are members of the same group. This group may be a workplace, a professional association, or another group. According to the ACA, substance use disorder is one of the ten essential health issues that require coverage. But while group insurance options do cover the issue, they may also limit specific factors relating to insurance coverage.
Drug Addictions Covered
What does health insurance cover? It depends. Every program is different, and because of this, it is important to study a specific plan to determine what it covers.
Insurance plans provide substance use disorder insurance to treat addictions to different drugs. Some of the drug addictions commonly seen and covered under insurance coverage options and plans include treatments for addiction to
- Methanphetamine (meth)
- Opioid drugs
- Crack cocaine
Substances that have produced addiction produce conditions that need treatment at substance use disorder treatment centers. The type of treatment depends on the substance of addiction.
Since addiction requires insurance coverage, it does not matter what caused the addiction in the first place. According to the ACA, if a person needs treatment in a facility, through a caregiver, or with specialized medications, the treatments need to be covered.
This also means that regardless of the addiction, paying for treatment may ultimately help reduce costs. People without addictions require less medical care and interventions than people who are using and abusing substances. Putting drug users in jail is also not a good solution. In addition to depriving people of their liberty, imprisonment may cost much more than providing people with the treatments that they need to become and stay sober. Proving treatment insurance is a smart financial option for insurance companies to make.
Mental Health Issues Covered
What does healthcare cover? Well, ACA regulations require insurance coverage plans to cover mental health issues as well as substance use disorder. The mental health issues that are covered are expansive, and there are too many to name here. Reaching out for help, receiving a diagnosis, and seeking treatment, whether short-term or long-term, may occur through different insurance plans. Any illness, disease, or condition that is a mental health issue has to be covered by law.
Just like the specifics of drug addiction coverage, mental care issues require insurance coverage. Health insurance is not particularly specific or choosy in terms of coverage for this condition. Conditions should be covered as long as they meet the requirements of mental illness.
Types of Treatment Facilities Covered
Assistance is readily available. According to the National Institute on Drug Abuse (NIDA), there are over 14,000 different facilities that provide some sort of substance use disorder treatment help for those that require it. For example, facilities and programs may be covered by insurance coverage for residential treatment centers, facilities that require people to stay at the centers while they receive treatment. Many facilities accept some sort of insurance plan or public insurance. Just like with doctors and other professionals, rehab treatment facilities may not accept all insurance plans.
Your type of insurance coverage may determine the facilities you are approved to attend. Some insurance plans, especially private insurance companies, allow you to choose a facility that you prefer. If the entire cost is not covered, you may be able to cover any amounts that are outstanding after you finish your stay.
The treatment facilities that take these insurance coverage options generally provide mental health, behavioral, and addiction assistance to those that need such types of help. Often, obtaining referrals from hospitals or physicians may help you find a facility that accepts your specific coverage to receive the rehab health care that you need.
Do Rehabs Accept Insurance?
Several rehabs and other types of treatment facilities accept insurance. According to the ACA, rehabs and other treatment facilities must accept insurance of some sort and provide help for people who visit them. This is especially true for facilities that offer mental health help.
Before going to a rehab facility, you can speak with its staff members to ask if they accept your specific insurance coverage. You may also speak with your insurance provider to determine which facilities they cover. Insurance provided by U.S. states may only cover state-specific facilities. Privately owned and operated facilities may not accept Medicaid, Medicare, TRICARE (military), or other government health care plans. Private facilities are often thought of as luxury rehab facilities that provide amenities those who want to stay in secluded, almost hotel-like facilities,
Maintenance and Long-Term Care Coverage
Any sort of long-term care coverage for substance use disorder or mental health issues depends on the type of insurance coverage in question. Certain insurance types, specifically those that are privately owned, offer specific types of coverage or covers specific lengths of time.
For example, the health insurer Aetna provides a program known as the Guardian Angel program to provide ongoing support in addition its coverage options. Such options may help those who are recovering from addictions receive assistance that may last for longer periods of time. Continued care may help people with their sobriety and may help prevent relapses.
Our insurance verification team works quickly to verify your insurance benefits to place you into one of our centers as soon as possible. Because of our industry expertise we will be able to verify this information in a timely manner and can advocate for more coverage or more time in treatment. We strive to do this as quick as possible while also maximizing your coverage. Our insurance verification process is of no cost to you and there are absolutely no obligations.
Useful Health Insurance Resources
Please feel free to use these useful health insurance resources to find out more regarding substance use disorder and mental health help:
- Mental Health.gov
- Health care and insurance information
- The article “Moving Beyond Parity: Mental Health and Addiction Care Under the ACA”
- The textbook chapter “Health Care Systems and Substance Use Disorders”
- U.S. Substance Use Disorder and Mental Health Services Administration (SAMHSA)
- U.S. Department of Health & Human Services
Here are some common insurance providers that may provide further information on coverage, as well as ways to sign up for their services. If you need Medicaid, Medicare, TRICARE, or children’s health insurance coverage, it is important to speak with workers at such government-affiliated medical programs. They may provide more information on how to sign up and receive the services. Such conversations may help you answer the question, Does Medicaid cover substance use disorder treatment?
You may learn how to get insurance to pay for drug rehab through these links, as well as find the best health insurance for mental health coverage:
- Medicaid / Medicare / CHIP (Children’s Health Insurance Program)
- Fedelis Care
- BlueCross BlueShield
- UnitedHealth Group
Learning how health insurance covers substance use disorder is important. The Affordable Care Act has made rehab insurance coverage mandatory. If you have insurance, you have a plan that covers mental health and substance use disorder assistance to some extent, though the coverage terms of each insurance plan vary. Finding the best health insurance for mental health coverage is recommended for people who have had substance use disorder disorders or mental health issues.
Health care plans may make health care more accessible and affordable for people who require help not only for physical health but for mental health as well. Some people are embarrassed to seek help for substance use disorder or mental health issues because they are situations that other people may still stigmatize.
It should not be this way. Do not be afraid to seek the help you need. Whether this assistance is covered through insurance companies or state-funded options, it is out there.
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.