If you are in need of addiction treatment, you may be asking yourself a ton of questions. One of them focuses on affordability. You also might have medical insurance.
You might be wondering if your insurance will pay for your addiction recovery treatment. The short answer is yes. We’ll explain how this happens in a moment. If you need help for your addiction, know that you are not alone.
A New Jersey drug rehab facility will be able to accommodate your treatment plans based on your critical needs. You should also consider if the facility accepts your insurance or a different payment method.
Let’s take a look now at the following in-depth details about medical insurance and addiction recovery treatment.
Yes, medical insurance pays for addiction treatment
In compliance with the Affordable Care Act (ACA), all insurance policies will cover treatment for addiction and mental health. Because of this law, you already have an insurance plan that will be able to take care of your own treatment.
You will need to review the insurance policy to see what is actually covered. Keep in mind that the insurance policy will not pay for the balance in its entirety. This means that you may need to consider other payment methods in conjunction with your insurance.
What are the other payment methods for addiction treatment?
Aside from your insurance, there are different payment methods that can be accepted for your addiction treatment. Keep in mind that there may be limitations with some of these alternatives.
Here is what’s available to you:
- Medicare: Medicare is a government-funded insurance program that also complies with federal laws for covering addiction and mental health treatment. Those who qualify for Medicare are persons who are 65 years of age or older. Persons who have a disability can also receive Medicare if they are below the minimum age.
- Medicaid: This is also a government-funded program. Recipients of Medicaid will need to meet certain requirements in accordance with their income. This will vary from one state to the next. Those who are eligible for Medicaid will need to meet requirements such as persons who have income below 138 percent of the poverty line (including those with children through age 18). Some parents or caretakers who have a low income can also qualify. Seniors or those with disabilities receiving SSI can also qualify.
- Direct payments: Direct payments using cash, check, or credit will be the best option. Most of the time, this will be useful for those who intend to pay the balance in installments. This is often the best choice if the insurance covers a majority of it. You can save up money in a separate account. This money can be through a means of income. If you have no employment, you may have other funding sources. This can be loans through a friend or family member. Crowdfunding can also be a useful method as well.
What to know if you are covered by Medicare/Medicaid
In the case of Medicare and Medicaid, it’s important to consider what’s included and what’s not. Let’s break down how it works:
If covered by Medicare
If you are covered by Medicare, it’s important to be aware of the following information:
- Under Part A, there is a lifetime limit of 190 days coverage for treatment. This includes treatment at inpatient rehab centers and mental health facilities.
- Medicare Part B will handle outpatient treatments. This includes mental health counseling, screenings for alcohol misuse, and intensive treatments and services (outpatient). Also covered are certain medications, therapy sessions (individual and group), and partial hospitalization programs.
- Part D will cover medications or medication assisted treatments (MATs). This part may not cover all prescriptions. However, they can cover mental health medications such as antidepressants, antipsychotics, and anticonvulsants. If you have received a dual diagnosis, this needs to be noted with your family and therapists.
If covered by Medicaid
If you receive Medicaid, you need to know the specific details of how the program covers your treatment. Here’s what you need to know:
- State-funded detox and rehab programs will cost lower than private facilities. Because of their source of funding, they will most likely accept Medicaid.
- Medicaid covers both inpatient and outpatient rehab for drug addiction.
- Medicaid provides mental health services, albeit a limited number.
- MATs are covered by Medicaid.
- Rules for eligibility for Medicaid will vary from state to state. The same applies for treatment coverage for inpatient rehab.
Keep in mind that Medicaid may be a ‘payer of last resort’ for any services you need for addiction recovery treatment. It’s important to make sure you have other sources of payment available to you before considering Medicaid is able to provide any coverage. This includes your insurance policy that you may have.
When should I ask for payment methods?
As part of the facility selection process, you can ask what the payment methods are. You may eliminate one from your list if it doesn’t fit your critical needs and preferences. Some facilities may be part of a certain insurance network, which can mean paying less.
If the facility is outside of your insurance network, it may mean paying more. Choosing a facility based on your insurance policy’s ability to pay will be crucial. The more coverage your insurance is able to provide, the better (including the less you pay out of pocket).
Final Thoughts
Paying for addiction recovery treatment can be a challenge. However, you have plenty of coverage options available to you. Please take careful consideration of what you currently have.
If you have no insurance, you may apply for a policy that fits you best. Otherwise, see if you meet certain requirements for Medicare or Medicaid. It is also important to ensure that you have a source for funding your treatment.
Don’t let a lack of coverage slow you down. Nor should you allow it to delay your treatment. If you have any questions about payment options for addiction recovery, contact Epiphany Wellness today for more information.