Alcoholism or alcohol use disorder (AUD) is currently classified as a chronic mental health condition. Alcohol addiction is a complex disease that affects a person’s brain functioning and brain chemistry. Under the Affordable Care Act, insurance companies are required to pay for a portion of policyholders’ addiction treatment. In fact, some insurance companies and plans may even pay for all of it.
Thus, if you plan on going to rehab for alcoholism, your out-of-pocket costs may be far lower than you think. It’s also important to note that insurance companies are not legally allowed to penalize you for having alcoholism or AUD as a known, preexisting condition.
As such, you may be able to get help with your rehab costs even if you don’t have insurance right now. By shopping for a plan that will provide maximum coverage for the rehab of your choosing, you can effectively hurdle one of the biggest barriers to addiction treatment. Notwithstanding these things, there are still several out-of-pocket expenses that you should be prepared for, and several things that you should know in order to maximize the benefits that any health insurance plan provides.
What You Need to Know About Using Health Insurance or Alcohol Rehab
Although all rehab centers accept health insurance, not every rehab center is guaranteed to accept the type of coverage you have. As you shop your options in facilities, you can:
- Visit the websites of rehab centers to see lists of accepted insurance
- Contact your insurer directly to find in-network providers
- Call rehab center to ask about accepted insurance in-person
Getting a list of in-network rehab facilities from your insurance company is an easy way to target locations that accept your plan. Your insurer can also tell you which treatments and services they will cover, and which treatments and services they will not. No matter which type of coverage you have, you’re guaranteed to pay several charges out of your own pocket. These are:
- Your plan deductible
- Your co-payments
- Any agreed-upon prescription fees
The only way around these charges is by using a secondary health insurance plan to cover them or by paying with money that you’ve stashed away in a healthcare savings account. If you’re shopping for a health insurance policy to go to rehab, you should start by deciding whether you want a health maintenance organization (HMO) plan or a preferred provider organization (PPO) plan.
There are many affordable HMO plans available. However, with an HMO plan, you’ll have to receive your addiction treatment from the defined network of rehab centers that your plan includes. PPO plans may cost a bit more upfront, but they also provide greater flexibility. PPO providers have defined provider networks too. However, they additionally allow policyholders to choose their own out-of-network doctors and facilities. If you have very specific ideas about where you want to receive your addiction treatment, a PPO plan may be best for you.
This is especially true if you are considering out-of-state rehabs. There are also several tiers of coverage available. Plans with the lowest premiums often have high deductibles. A deductible is the amount of cash that you have to pay out-of-pocket before your coverage benefits actually kick in. Bottom-tier plans with low premiums and high deductibles are only suitable for people who need minimal healthcare. They work well for young adults who are in excellent health and who lack preexisting conditions.
Higher tier plans have higher premiums and more modest deductibles, and they pay for a far greater range of services. While you’ll pay more for a top-tier plan right now, you’ll be glad you did so when going to rehab. More coverage will mean having less to pay on your own. Keep in mind that you don’t have to pay for rehab with health insurance alone. Many rehab centers are willing to accept reasonable payment plans for any uncovered costs. They also take full or partial payments by:
- Credit card or debit card
- Personal checks
Some rehab facilities additionally have scholarship opportunities available. These are relatively modest sums of money that are offered by charitable organizations. If necessary, you can also crowdsource or fundraise in other ways to take care of any remaining rehab costs. Don’t let cost keep you from getting the AUD treatment you need. Your insurance company will pay for a portion of your care. There are also multiple ways to cover any costs that your health insurance plan won’t. If you need help finding a rehab center that accepts your insurance, we’ve got you covered. Contact us today by calling 302-842-2390 to speak with one of our counselors.