Does Insurance Cover Drug Addiction Treatment?

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The Affordable Care Act (ACA) requires insurance companies to cover drug addiction treatment. Outpatient and inpatient services are included, depending on what state you live in and what health care plan you choose. Generally, though, insurers cannot completely deny coverage for substance abuse disorders. There are, however, some states that require insurers to cover treatment for drug addiction.

While most insurance companies cover drug addiction treatment, the specific services covered vary by policy. Depending on the policy, some may only cover detox services, while others may cover a broader range of addiction treatment services. A list of approved or “in-network” drug addiction treatment providers may also be provided by insurance companies. As a result, treatment can be more affordable.

The Affordable Care Act Improved Rehab Admission Rates

Before the Affordable Care Act, many people could not afford rehab due to payment issues and lack of insurance. Even though insurance coverage has increased significantly, coverage concerns remain a barrier to addiction treatment.

Some people are concerned that their insurance will not cover the full cost of treatment or that they cannot afford the deductibles and co-pays. Some people worry that their employers will discover their addiction and fire them. Others are concerned that their family members will find out and they will be ostracized. There are many barriers to addiction treatment, and sufficient insurance coverage is only one of them.

How the ACA Reduced Stigmatization of Drug & Alcohol Addiction

On March 23, 2010, the Affordable Care Act was passed. Mental and behavioral health services must be covered by all insurance plans under the act. In addition to treating depression, anxiety, and substance abuse, these services also include mental health services. Additionally, the ACA prohibits insurance companies from discriminating against people with pre-existing conditions, such as mental illness and addiction.

Mental illness and addiction are less stigmatized as a result of the ACA. Some insurance companies, however, still prevent those suffering from addiction from getting the help they need. Some insurers require prior authorization for addiction treatment. As a result, a patient may have to go through a lot of hoops to gain coverage. Other insurers cap mental health benefits over a lifetime. It may limit the amount of money someone can spend on treatment. You should therefore be aware of your rights under the ACA. There are resources available to help those struggling with addiction.

Insurance for Rehab Difficult Before the ACA

Before the passage of the Affordable Care Act, rehab insurance was difficult to obtain. Historically, many insurance companies denied coverage for addiction treatment to members with substance use disorders or other co-occurring mental health conditions. As part of the Affordable Care Act (ACA), also known as Obamacare, all insurance plans must cover substance abuse and mental health services. Also under the Affordable Care Act, Medicaid expanded access to free or low-cost health insurance for low-income adults, children, pregnant women, and people with disabilities.

These changes have made it easier for people to receive treatment. Despite this, there are still some gaps in coverage, and insurance companies can still limit what they cover. Detox and Residential Treatment Programs (RTPs) are not covered by many plans. To find out if your insurance covers substance abuse treatment, check with your provider.

Medicaid Now Covers Rehab

The Affordable Care Act makes it easier for people with substance abuse disorders to receive treatment. Nearly 12% of adults with substance use disorders are covered by Medicaid, a federal health insurance program. You may be eligible for Medicaid coverage if you have a substance abuse problem and are struggling to afford treatment.

People with substance abuse disorders should also be covered by mental health insurance. Mental health conditions are often diagnosed in people with substance abuse disorders. The treatment of both mental health conditions and substance abuse disorders can help people recover and lead healthy, productive lives.

Insurance can be confusing, especially when it comes to rehab coverage. You or a loved one should understand your insurance coverage and what options are available to you if you’re considering treatment. Contact our counselors at 833.970.2054 for help navigating the maze of insurance options.

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Reviewed By:

Clearhaven Recovery Clinical Staff

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Your Insurance Can Pay for Rehab