Having good insurance coverage is a major predictor of success in overcoming addiction, especially when such coverage will cover both behavioral and medication-assisted intervention (Meinhofer, A., & Witman, 2018). Fortunately, most forms of insurance will cover some degree of substance abuse treatment, which is a notable improvement compared to 20 years ago, due to major changes arising from the Mental Health Parity Act (2008) and the Affordable Care Act (2010). Yet, the procedures and options covered by an insurance plan will vary widely. For example, medication-assisted treatments such as suboxone is not covered by some insurance plans, despite strong calls from the medical community for commercial health plans to cover these treatments (Polsky, Arsenaut, & Azocar, 2020).
Some research suggests that if consumers don’t understand their insurance, they are less likely to utilize it (McLeod & Adepoju, 2018). Given the complexities of health insurance, this is a good reason to contact a reliable treatment center to see what levels of care are covered by insurance. While it’s true that prospective patients can learn much from their insurance company about what level of care would be covered, let’s face it, insurance companies don’t typically have stellar customer service. Furthermore, the job of the treatment center is to advocate on your behalf and ensure that you get as much treatment covered as possible. Whereas your insurance company’s job is biased toward trying to save themselves money, not you.
The best way to understand what your insurance will cover is to consult a reputable treatment center directly
Therefore, the best way to understand what your insurance will cover is to consult a reputable treatment center directly. The BeWell Network offers confidential, no-cost, no-obligation insurance verification and review. The job of the treatment center is to make your coverage easy and clear, that way you can make the most informed and best decision for your care. Furthermore, in consulting the treatment center, you’ll get additional details that your insurance provider can’t provide. For example, your insurance company cannot quote you the cost of treatment at a specific treatment center.
One important consideration is whether the treatment program is in your insurance’s network and whether there are certain out-of-pocket costs. Depending on the type of insurance you have, some addictions treatment programs may be part of your insurance plan’s in-network coverage, but if the treatment facility you choose is not covered, you could face a substantially larger bill. It’s also helpful for potential patients to know if they will be paying any specific co-pays or will require a referral from a primary care provider. Fortunately, due to changes arising from the passage of the No Surprises Act in 2020, in following years medical billing should become very transparent and help you make informed choices.
Another factor to consider with your insurance is whether your plan covers treatment of mental health concerns beyond addiction. This is because mental health and addiction are often enmeshed together, and a major step in treating addiction could be addressing underlying depression, anxiety, or trauma experiences (Wang & Xie, 2019). Some insurance plans may have differential benefits for addictions treatments versus psychological or psychiatric treatments, and a facility approved by your plan for treating one condition may not necessarily be approved for another condition. Therefore, readers are highly recommended to communicate frequently with their insurance providers and treatment facility if they have any concerns about the coverage of their plans.
