Does My Insurance Cover Addiction Treatment?

When asking yourself “Does my insurance cover addiction treatment?” it is important to understand that each insurance plan is different. Most of the private health insurance policies through a job, or through the affordable care act, will cover addiction treatment. The Affordable Care Act (ACA) stated that behavioral health treatment needs to be covered as an essential benefit of health insurance. This means therapy and addiction treatment. Now most insurance plans have limits on the coverage of things such as grief, which don’t necessarily add up to being a disorder. Checking with your insurance representative is the best way to gain a full scope of knowledge surrounding your specific health care plan.

Affordable Care Act and Health Insurance

The ACA was signed into law in 2010 with a goal of expanding the Medicare program and making private health insurance plans more easily accessible to all Americans.it also makes it so that, regardless of any pre-existing conditions, healthcare coverage should be available to all who seek it. The ACA made it so that insurances have to include both substance abuse and mental health treatment are essential and must be covered. So under the Affordable Care Act, it makes it so your insurance covers addiction treatment. Understand though, there could be some limitations. Every plan and insurance is different.

Does My Insurance Cover Addiction treatment?

Addiction treatment under your health insurance is as simple as a phone call. If you are struggling with addiction to substances of any kind, and wondering “does my insurance cover addiction treatment?” all you’d need to do is call. We can do what is called a verification of benefits, this tells us what is covered. It will provide a detailed explanation of what the insurance provider will cover, as well as what will be classified as an out of pocket expense. This helps to take the confusion and chaos out of seeking help, and the financials of it. Then we can begin the process of getting you better, both physically and mentally. 

Will People Know You Got Help?

No! Your medical information is confidential, and without consent, no information can be shared with friends, family, or employers. Private information like your status or location when seeking help will only be shared when you provide written consent to those providing the care. Much like when you go to the hospital or your primary care physician. You get to choose what is shared and with who.

Common Insurance Types

If you ask yourself “does my insurance cover addiction treatment?” then you should understand the different types of insurances available, and know what kind of coverage you do have. There are three main types of insurances available, and all have different benefits and coverage. Knowing what your insurance covers is the best way to know if your insurance covers addiction treatment. 

HMO: This means “Health Maintenance Organization” and allows you to choose a primary care physician of your choice within a network of providers. Most out of network providers may not be covered, however anything within the network usually comes at a lower cost. There may be low, to no deductible required. These plans benefit those who are not in need of out of network specialist care, as those expenses are generally the patient’s responsibility to pay for out of pocket. 

PPO: This is a “Preferred Provider Organization”. These plans allow you to see a provider, either in or out of the network, and usually without a referral. PPO plans allow a little more flexibility when it comes to choosing a provider. They may have higher deductibles, and lower copays than an HMO plan, but they also allow you the freedom to see a doctor or specialist of your choosing.

POS: Point of Service plans are similar to HMO. The only real difference is that sometimes these plans allow you to see a doctor outside of your plan’s network. The POS plans will vary from company to company. Just as with coverage.

What if I Don’t Have Insurance?

If you do not have insurance, that does not mean there is no help available to you. There are many free and low cost treatment options available to you. It may take a little research, but most states offer assistance for those who do not have private health insurance and are in need of addiction help. Google will be your friend in finding options in your area. 

Help and Treatment for Addiction in South Florida

Seeking treatment for addiction can be extremely hard to do. It can seem overwhelming, and scary. However, it is the best gift that you can give to yourself. If you or a loved one struggle with drug or alcohol addiction, or even both, there is help available. At Ambrosia Treatment Center, our team of professionals can help to guide you through the beginning stages of receiving help, and make the process smoother as you begin your journey to recovery. We are one phone call away. Contact us now, and begin the next chapter of your life!

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