During the first three months of 2022, the Center for Disease Control and Prevention (CDC) estimated over 26,000 deaths by drug overdose. That’s over 100,000 overdoses annually. Substance abuse rehabilitation is an important and influential step in overcoming addiction and can save lives, but the high cost of treatment is a barrier for many.
Fortunately, finding the right private health insurance drug rehab doesn’t need to be a hassle. Pathfinders Recovery Center is connected to major insurance providers in America to make rehabilitation care accessible for everyone.
Get Treatment with Private Health Insurance Drug Rehab Coverage
The cost of medical and mental health care, especially drug and alcohol addiction treatment, can be pretty expensive. Securing a health insurance plan helps to offset the cost of care, making it more affordable and accessible. However, not all health insurance plans are the same, and coverage can vary depending on your provider.
That’s where we come in. At Pathfinders Recovery Center, we’re committed to helping you find the best possible drug addiction treatment for your needs. We are in-network with many of the leading insurance providers in the United States, which means we can offer our clients high-quality yet affordable care.
We understand that the cost of treatment can hinder alcohol and drug addiction treatment, so we will work with you to find the best possible solution for your unique situation.
Does Health Insurance Cover Drug or Alcohol Addiction Rehab?
The good news is that most insurance plans, including private insurance plans, provide comprehensive drug or alcohol addiction rehab coverage.
The Affordable Care Act (ACA) requires all insurance plans to provide coverage for substance abuse treatment. This means that if you have health insurance, you should be able to get help for your addiction treatment without having to pay the full out-of-pocket costs.
The level of coverage you can expect from your health insurance plan will depend on the type of plan you have. Most health insurance plans will generally offer some coverage for alcohol and drug addiction treatment, though the specifics will vary.
Understanding the Affordable Care Act
The Patient Protection and Affordable Care Act, more commonly known as the Affordable Care Act (ACA) or Obamacare, is a law that the federal government passed in 2010 to make health insurance more affordable and accessible for everyone.
The Affordable Care Act requires all health insurance plans to provide coverage for essential health benefits. These are a set of 10 services that all plans must cover, and they include things like emergency services, hospitalization, and prescription drugs.
One of the key provisions of the ACA is that it requires all health insurance plans to provide coverage for substance abuse treatment, recognizing that mental health services are also essential health benefits.
This means that health insurance companies are required to treat drug and alcohol addiction as a pre-existing condition and cannot refuse to provide health insurance coverage to someone with substance abuse issues.
The ACA also created the health insurance marketplace, which is a place where people can shop for health insurance plans. The health insurance marketplace offers a variety of different plans, from private insurance plans to public insurance plans like Medicaid.
All plans offered on the health insurance marketplace must provide coverage for essential health benefits like substance abuse treatment.
The Structure of Private Health Insurance Policies
Private companies offer a multitude of private health insurance plans and policies, and can be either for-profit or non-profit. These plans are typically more expensive than public health insurance plans like Medicaid, but they also usually offer more coverage.
Most private health insurance plans are structured as follows:
Health Maintenance Organization (HMO) Plans
With a Health Maintenance Organization (HMO) plan, you can only choose from the list of primary care physicians your insurance company provides. This allows you to have a physician who knows your entire medical history. If you need to consult with a specialist not affiliated with your HMO network, you will need a referral from your primary care physician.
HMO plans typically have low to no deductibles and lower monthly premiums than other private health insurance plans. They cover costs for in-network doctors, hospitals, and other providers. If you seek a provider out of network, you will usually have to pay the total out-of-pocket cost.
Preferred Provider Organization (PPO) Plans
With a Preferred Provider Organization (PPO) plan, you have the flexibility to see any doctor or specialist that you want without needing a referral from a primary care physician.
This plan encourages you to use the in-network providers in contract with your insurance company for less cost, but you can still see an out-of-network provider if you are willing to pay more for their services.
PPO plans typically have higher monthly premiums and deductibles than HMO plans. However, they also offer more comprehensive coverage for out-of-network providers.
Point of Service (POS) Plans
A Point of Service (POS) plan is a managed care plan similar to an HMO plan. With a POS plan, you can only choose a primary care physician from the list of in-network providers. However, you also have the option to go out-of-network for services in special cases, although it will usually cost more.
Insurance companies have different rules for POS plans, so it’s important to check with your insurance company to verify your plan coverage.
Whatever your treatment plan is, there’s a good chance that your private health insurance will cover at least a portion of the costs. To find out what your insurance provider covers, you will need to contact them and ask about their benefits for drug abuse treatment.
Private Health Insurance Coverage for Alcohol and Drug Rehab
If you have a private health insurance plan, there is a good chance that they will provide coverage for mental health treatment. However, the amount of coverage that your program offers can vary greatly. Some plans may only cover a few days of treatment, while others may cover the entire cost of your stay.
Here are a few private health insurance companies that provide substance abuse treatment coverage:
Blue Cross Blue Shield
Blue Cross Blue Shield (BCBS) is one of the largest health insurance companies in the country, providing coverage to all 50 states, the District of Columbia, and Puerto Rico. The BCBS offers various insurance plans, most of which give some drug and alcohol rehab coverage.
The amount of coverage that Blue Cross Blue Shield provides can vary depending on the state that you live in and the type of plan that you have. However, most plans will cover at least a portion of the cost of treatment.
With the many locations that Blue Cross Blue Shield has, it is easy to find a drug and alcohol rehab center that accepts their insurance. The company may also provide out-of-state coverage if you go to a treatment center outside your home state.
Cigna
Cigna is another staple name in terms of providing comprehensive insurance policy coverage. They are known to be one of the more generous companies in substance abuse treatment, with most plans providing coverage for inpatient rehabilitation and mental health treatment.
Cigna has an extensive network of providers that they work with, making it easy to find an alcohol and drug rehab center that will accept their insurance. One example of Cigna’s comprehensive rehab coverage is the Cigna Connect 6500 EPO plan.
Aetna
Established in 1853, Aetna is another large health insurance company providing alcohol and drug rehab coverage. The amount of coverage that Aetna provides can vary depending on your state, the type of plan you have, and the treatment facility you choose.
Aetna is active in all 50 states, and they have an extensive network of providers that they work with. You can easily find an alcohol and drug rehab center that accepts Aetna insurance.
Beacon Health Options
Beacon Health Options is one of the most dedicated private insurance providers regarding behavioral health. They offer a wide variety of policies that provide coverage for drug and alcohol rehab and other mental health and behavioral services.
If you have private insurance with Beacon Health Options, there is a good chance that your policy will provide coverage for drug and alcohol rehab. However, the amount of coverage can vary depending on the type of plan you have, but it is likely to be comprehensive.
Optima Health
Optima Health is one of the well-known and leading comprehensive health insurance providers in the nation. They offer manifold health insurance policies covering primary care, critical care, and behavioral health.
When it comes to behavioral and mental health, Optima Health offers policy coverage for inpatient rehabilitation, prescription coverage, and other mental health services. The amount of coverage that Optima Health provides can vary depending on your policy type, but they are likely to cover a significant portion of the cost.
Federal Insurance Coverage for Drug and Alcohol Rehab
The federal government also provides financial assistance for mental and behavioral health services. Alcohol and drug rehab coverage can also be given to those who qualify. Many rehab facilities accept this type of insurance, and the coverage can be very comprehensive.
The Substance Abuse and Mental Health Services Administration (SAMHSA) is a federal agency that offers grants to states and organizations to help them provide mental and behavioral health services, including substance abuse treatment.
Medicare and Medicaid are two federal health insurance programs that provide drug and alcohol rehab coverage. Medicare is a health insurance program for those who are 65 years of age or older, while Medicaid is a health insurance program for low-income individuals and families.
Both Medicare and Medicaid have different requirements for eligibility, but most treatment centers accept these forms of insurance. The coverage that these programs provide can be very comprehensive, and it can cover the majority of the cost of treatment.
Pathfinders location in Aurora, Colorado accepts certain regions of Colorado Medicaid coverage, so be sure to ask our Admissions team if your policy is accepted!
What Will Private Health Insurance Cover?
Most private health insurance companies will cover at least a portion of alcohol and drug rehab costs. The amount of coverage that your plan provides can vary greatly. Some plans may offer to cover the entire cost of treatment, while others may only cover a portion.
There are many different types of treatment programs available, including:
Medically Supervised Detox
Drug detoxification is the first step in treatment and helps to rid the body of toxins. This is often the most challenging part of drug or alcohol rehab and can be very uncomfortable. Medically managed detoxification can help to make this process more comfortable and safe.
Residential or Inpatient Rehabilitation
After detox, you will begin treatment. Treatment can be done in an inpatient or outpatient setting. Inpatient treatment is typically more intensive and allows you to live at the facility while you receive care. Outpatient treatment requires that you live at home and come to the rehab facility for appointments and treatments.
The type of treatment that you receive will be based on your individual needs. Treatment typically includes some combination of behavioral therapy, medication-assisted treatment, and support groups.
Aftercare Planning and Relapse Prevention
After you have completed treatment, you will enter the recovery phase. Recovery is the ongoing process of living your life without using drugs or alcohol, and this can be a lifelong process.
Aftercare is the support and resources that you receive after completing treatment. This includes support groups, sober living homes, and therapy.
Recovery and aftercare are essential parts of treatment to ensure that you stay sober.
How To Find Reputable Drug Rehab Centers Covered by Your Private Health Insurance
When looking at drug rehab facilities, it is important to ensure that the drug rehab center is accredited and licensed. This ensures that the facility and healthcare providers meet high standards of care.
It is also essential to ensure that the treatment facility accepts your insurance. Many treatment centers accept private health insurance. You can check with your insurance company to see if they have a list of approved treatment providers.
If you are unsure whether a treatment facility accepts your insurance coverage, you can always call the treatment center and ask. The staff should be able to verify your insurance coverage and tell you what your benefits are.
At Pathfinders Recovery Center, all calls are confidential, and we can let you know your private health insurance drug rehab coverage within minutes. And you can rest easy, knowing that looking up your policy details never impacts your cost or plan, in any way.
Compassion and Expertise Sets Us Apart
Seeking help for a drug or alcohol problem can be difficult, but it is the first step to a better and healthier life. When looking for the best treatment options and medical services, it is crucial to find a treatment facility that you feel comfortable with and that has your best interests at heart.
Pathfinders Recovery Center is committed to helping people get the health care services they need to overcome addiction. At our facility, you will receive individualized care from our team of compassionate and expert treatment providers.
We understand that addiction is a complex disease, and we will work with you to create a treatment plan that meets your unique needs. We also know that the cost of treatment can be an issue for many people, and that’s why we work with most major insurance providers to ensure our clients get the treatment they need when they need it.
Find a New and Drug-Free Life with Pathfinders Recovery
The cost of treatment should not stop you from getting the help you need. If you or a loved one is struggling with addiction, Pathfinders Recovery Center can help. We are here to answer any questions about our facility, treatment options, and insurance coverage.
Contact us today for a confidential consultation. We look forward to helping you take the first step on the road to recovery!
