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Does Insurance Pay for Addiction Treatment?

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Does Insurance Pay for Addiction Treatment?

Many types of coverage can help you get the treatment you need

If you’re thinking about starting an addiction treatment program for yourself or encouraging a loved one to get the help they need, there’s a good chance you’re wondering how that treatment is going to be paid for. You may wonder if your health insurance will pay for your treatment. It medical symbol caring handsturns out, there’s a good chance it will, or at least it will pay for part of it. This wasn’t always the case. In 1965, the American Psychiatric Association made a push for health insurers to cover treatment for alcoholism, and during the ten years that followed many insurance companies did just that. But it was only a suggestion, and it didn’t carry any real authority. From 1989 -1994 there was a big drop in the coverage of inpatient services for drug and alcohol treatment as well as mental and behavioral health services in general.

Mental Health and Addiction Parity

That began to change again when The Mental Health Equity and Addiction Act of 2008 was passed into law and finalized in 2010. The law stated that coverage for mental health services and addiction services needed to be “on par” with the coverage of comparable services for other health ailments. This applied to group health plans that insurer more than 50 people. The new law was an improvement over the Mental Health Parity Act of 1996, which put dollar limits on lifetime and annual coverage. In the end of 2013, Mental Health Parity was revisited again as a consideration in line with the Affordable Care Act, and parity of mental health and addiction coverage became a requirement of health insurance plans within the Health Insurance Marketplace — including smaller groups with under 50 participants. Mental Health and Substance Use Disorder Services was listened among the 10 essential services where coverage was required.

Coverage Still Varies

There is still a lot of differences between health insurance plans available, and the coverage they provide. Less expensive plans may have a higher deductible, or pay a lower percentage of an overall bill or overall hospital coverage for all types of medical ailments. Any limits in coverage should be similar to what you’d experience if you sought medical treatment for another procedure like having your gall bladder removed. The better your coverage, the more your insurance will pay. Insurance companies will also specify which treatment facilities they provide in patient coverage for. One example is California’s Medi-Cal program for Californians who earn less than $16,000 per year. Medi-Cal participants need to seek treatment in one of 1400 approved treatment centers across the state.

Health Savings Accounts

One option that is available to some people is to use money from their Health Savings Account to cover part of the price of treatment. These accounts are interest earning accounts that people can set up when their health insurance has a high deductible. The money deposited into the HSA is tax deferred, and much be less than the annual contribution limit. In 2015, that amount was $3350 for an individual plan and $6650 for a family insurance plan. Any money not used in one year is carried over into the next year, and when the money is needed for a qualifying health expense, including addiction treatment, it is available. Those who withdraw for unapproved expenses face stiff tax penalties.

Ask the Treatment Facility

When you are signing up for addiction treatment, the actual facility may have a handful of insurance providers that they work with as well. Before beginning the program, it is important to explain what type of insurance you have to make sure it is one that they accept. At the Brentwood House, there are several insurance providers that we work with to help make our program more affordable. We also do our best to see that those seeking treatment get their money’s worth. We provide a highly individualized comprehensive addiction treatment program with a nutritional program, continued outpatient support and family integration included. Research suggests that programs that treat the whole person and continue with follow up care see fewer instances of relapse than facilities that merely help a person physically detox from drugs.

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