Does Insurance Cover Addiction Treatment?

When you or a loved one are ready for recovery, you need a seamless process to get started. Any delays could mean doubts, and any doubts could mean a failure to enroll. That’s why it’s important to understand how insurance for addiction treatment and other payment options work before you look to get started.

At BlueCrest Recovery, we work with most major insurance companies, so your treatment could come at little to no out-of-pocket cost. Our dedicated insurance specialists will work with you to ensure all the necessary details are in order before you start treatment. They can answer any questions about your particular plan or insurance verification and help make sure there are no surprises when it comes time for payment. Learn more about insurance for addiction treatment and how it can help you access the care you need by calling 888.292.9652 today.

How Do I Pay for Addiction Treatment?

You shouldn’t let financial concerns derail your plans for addiction treatment. Most treatment providers accept insurance coverage as well as private out-of-pocket pay. You may also be able to ask family members and friends to contribute financially to cover any expenses not covered by insurance. Some treatment providers also offer sliding scale or installment payment plans to help ease the burden. Make sure you ask your preferred provider directly about their payment options.

If a reputable treatment provider feels that you’re not financially qualified for their program, they should refer you to a program that you may be able to afford.

Will My Insurance Coverage Cover Addiction Treatment?

The federal government requires private insurers, including those who provide both individual and group policies, to offer equal coverage for mental health and addiction treatment as they do for other medical conditions if they offer such benefits. This means that insurers who provide mental health and addiction treatment coverage must ensure those benefits are equivalent to other medical coverage.

Insurers who provide coverage for substance use and mental health treatment must make sure that their coverage:

  • Has the same level of payment required and amount of coverage as the medical benefits that they offer
  • Must be governed by the same rules and regulations as other medical benefits (in other words, no special burdens can be placed on substance use and mental health treatment)
  • Provide out-of-network benefits for mental health and substance use care if the plan offers out-of-network benefits for other medical care

Insurance plans sold on the Affordable Care Act Marketplace are required to provide mental health and substance use coverage and can’t put a financial limit on the amount of coverage provided in a given year.

Can I Confirm My Coverage Before I Enroll in Treatment?

Yes, and you should. Not every insurance plan covers every treatment program, so it’s wise to confirm that your insurance will cover your preferred provider before enrolling. Luckily, this process is quick and easy. Just ask your provider of choice to verify your insurance benefits. During this process, they may ask for some details from you, including:

  • Your name and address
  • Your insurance provider
  • Details of your insurance policy

It’s important to provide accurate details during this process. If you’re not sure about the details of your policy, contact your employer or your insurance company directly. Once benefits are verified, you can be more confident that insurance will cover the provider of your choice.

How Do I Know My Insurance Is Covering My Treatment?

One of the easiest ways to verify what your insurance coverage is paying for during addiction treatment is to review the documentation your insurance provider must send you. Some providers will call these documents a statement of benefits, while others may use different terminology.

After your insurance provider has covered a particular aspect of your treatment, they should send you a breakdown in writing of what they have paid and how much is still left for you to cover. This amount will vary depending on factors like the size of your deductible and the type of insurance plan you have.

When you receive your statement, review it carefully for a few critical details. These include:

  • What aspects of your treatment the insurance provider covered
  • What aspects of your treatment the insurance provider did not cover
  • How much you owe after your insurance payment
  • Whether you have met your deductible or still owe an additional amount

It’s also wise to look for any unexpected charges or lapses in coverage. This commonly happens in two ways. Your insurer could mistakenly miss a payment that you are owed, or your provider could mistakenly charge for a service. It’s important to be educated and make sure your benefits are being applied where they should.

Does Government-Run Health Insurance Cover Addiction Treatment?

Yes. The government-run health insurance program Medicare provides addiction treatment benefits for certain needs. These include:

  • Psychotherapy
  • Medication-assisted treatment for opioid addiction
  • Substance use therapy and counseling
  • Drug testing
  • Screening and intervention for addiction in a hospital setting
  • Inpatient addiction treatment
  • Outpatient addiction treatment

However, it’s important to note that not every addiction treatment provider accepts Medicare and other government-run insurance programs. If you are relying on this coverage for your treatment, make sure to ask upfront about whether or not your chosen provider has such coverage. It’s important that you work with a Medicare-certified provider if you want to be covered under the insurance program.

Who Can Answer My Questions About Insurance for Addiction Treatment?

Both addiction treatment and insurance coverage can be confusing and daunting. But don’t let that intimidate you. Ask your treatment provider and insurer questions to better understand your options. This list of suggested questions below can help you get started:

Treatment Provider Questions

  • Which insurances do you accept?
  • Are your services in or out of network for most insurers?
  • Can you verify my insurance benefits?
  • What are my payment options for any amounts not covered by insurance?
  • Do you have any other payment-related policies I should understand?

Insurer Questions

  • Do you offer mental health and substance use treatment benefits?
  • Are there any limitations on those benefits?
  • How does coverage typically work with addiction treatment providers?
  • How much is my deductible for mental health and substance use treatment?
  • Do you have a point of contact for further questions, particularly about benefits?

Verify Your Insurance at BlueCrest Recovery

Don’t let financial concerns prevent you from getting the addiction treatment help you need. Insurance, private out-of-pocket pay, and other financing options are available to make sure your recovery journey is smooth and seamless.

At BlueCrest Recovery, our dedicated specialists will work with you every step of the way to verify your insurance and help you find an affordable payment plan. Reach out for assistance today by calling 888.292.9652 or contacting us online.

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