There are a variety of barriers to addiction treatment that can prevent you from getting the help you need. For many, it’s their own readiness to change that needs to develop before they seek treatment. Other factors may include social issues like the stigma surrounding seeking rehab, responsibilities that seem to prevent you from taking a break from everyday life to seek recovery, and simply not knowing where to start. However, one of the most common concerns that cause people to avoid treatment is the cost.
Any treatment in modern medicine can be expensive, and addiction treatment often involves long-term solutions. However, addiction is a chronic disease that is not going to go away unless you address it. The disease also spreads from one part of your life to another, until it affects your career, finances, relationships, and health. Addiction can also lead you to lasting consequences like legal issues and infectious diseases. If you have a substance use disorder, the cost of treatment shouldn’t be a deterrent to getting the help you need. Your life is worth it.
That being said, there are ways to get the guidance you need with financial help. As modern medicine has come to understand addiction as a disease that is both chronic and treatable, insurance companies have followed suit. Most insurance providers offer coverage for drug and alcohol addiction treatment, and many addiction treatment centers accept coverage from private insurers.
Still, navigating your insurance policy can be a challenge. There are a few things you should know that can help make the process of financing your addiction treatment simpler.
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There are two basic categories of insurance provider: private and federal insurance. Federal insurance providers include programs like Medicare and Medicaid. Government-funded insurance providers are easier to afford and qualify for, but they are notoriously less comprehensive. Federal insurance plans are accepted in select treatment programs and government treatment providers.
Private insurance providers are independently funded companies that offer insurance that is typically more expensive and difficult to qualify for than federal options.
However, they usually cover more and allow for more options. Most high-quality addiction treatment centers accept most private insurers.
If you already have a private insurance policy, you will more than likely be covered for at least a portion of addiction treatment. There are thousands of specialized treatment centers in the United States, and dozens of treatment modalities to consider. Though private insurers offer relatively robust coverage for addiction treatment, they may not cover every center and therapy options. Typically, it’s in their best interests to cover the most effective treatment. If you successfully go through treatment, they are less likely to have to pay for treatment again.
However, addiction treatment is highly individualized and focused on your specific needs. Insurance companies don’t necessarily have expertise or experience in helping people find individual treatment. For that reason, it can be valuable to speak to an insurance representative when looking for treatment, but you should seek other professional opinions as well, like from your doctor or an addiction specialist.
If you don’t have private insurance or if you can’t qualify for a private policy, federal assistance may be a good alternative. However, it’s worth noting that the best quality treatment will be under private addiction treatment.
Determining what your insurance provider will cover when it comes to your addiction treatment will depend on your specific policy. However, insurance companies do look for a number of things when they are considering your coverage. They generally look for effective treatment, a proven track record, and methodologies that are backed up by science. Here are some factors they would consider:
There are a variety of addictions that many people struggle with that aren’t powerfully addictive chemical substances. The more we learn about addiction, the more we discover that even things like the internet and cell phones can cause addictive behavioral issues. However, research has focused primarily on substance use disorders involving psychoactive drugs. Insurance companies gravitate toward these issues because they have shown to be clear and proven needs.
However, some substances are more addictive than others. Meth, heroin, alcohol, and certain prescriptions pose the greatest threat when it comes to addiction, at least from a statistical standpoint. Though not impossible, it may be more difficult for people to find treatment for substance use disorders that involve marijuana, many psychedelics, and other drugs with low addiction potentials. Still, it’s possible to get treatment covered if those substances are used with other addictive drugs or if a person has co-occurring psychological or medical disorders.
Medical needs like drug withdrawal, infectious diseases, and other medical conditions that can come with addiction are often covered, at least partially, by your insurance. Medical needs also require more intensive care, including medical detoxification or inpatient services. Substance use disorders involving alcohol, benzodiazepines, and barbiturates are more likely to be covered for medical services and high levels of care because they come with the risk of deadly withdrawal.
Evidence-based treatment refers to therapy methodologies that have been proven to be effective in scientific studies. Evidence-based therapies can also be recreated in a variety of settings. Insurance companies prefer treatment centers that offer a foundation of evidence-based services because they have shown to be more effective than alternative options. There are a variety of alternative therapies like yoga, equine therapy, and art therapy that have reportedly helped many people, but their effectiveness has not been proven in studies. While it’s OK for a treatment program to use alternative therapies, insurance companies want to see that a company primarily uses evidence-based options like cognitive-behavioral therapy.
The length of time you spend in treatment is a significant question when it comes to getting effective addiction therapy. So significant, in fact, that the National Institute on Drug Abuse has said, “research has shown unequivocally that good outcomes are contingent on adequate treatment length.” According to research, clients achieve the best treatment outcomes after 90 days of treatment from inpatient to outpatient services. However, it may be difficult to get your insurance company to cover you for that long.
The length of treatment your insurance company covers will depend on your specific needs. However, your treatment center should work with your insurance company to get you the time you need for effective treatment.
We are in network for Anthem Blue Cross Blue Shield of California.
To learn more about addiction treatment and the therapy options available to you, speak to an addiction specialist at (888) 969-8755.
Finding addiction treatment coverage and navigating your insurance policy can be challenging and confusing, but you don’t have to go through it alone. Our addiction treatment specialists can help determine your eligibility for treatment under your insurance provider, work with your insurance company to determine coverage, and calculate any out-of-pocket expenses. If you enter a treatment program at California Highlands Addiction Treatment, we will also handle billing through your insurance company while you focus on recovery.
To learn more about addiction treatment and the therapy options available to you, speak to an addiction specialist at (888) 969-8755. Start your road to recovery today
Centers for Medicare & Medicaid Services. (2018, June 11). Centers for Medicare & Medicaid Services. from https://www.cms.gov/
National Institute on Drug Abuse. (2018, January). Drug Addiction Treatment in the United States from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states
National Institute on Drug Abuse. (2018, January). Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine). from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral
National Institute on Drug Abuse. (2018, January). How long does drug addiction treatment usually last? from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment