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Does Health Insurance Cover Drug Rehab?

by | Oct 3, 2024 | Health Insurance

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Page Tags: 2023 | coverage

​If I need Help for Alcohol or Drug Abuse

Will My Health Insurance Cover Me?

If you’re considering treatment for substance abuse, we have some wonderful news. Thanks to the Affordable Care Act (ACA) passed in 2010, substance abuse now falls under the same category as mental health, meaning it’s covered by insurance. Starting with the Mental Health Parity and Addiction Equality Act (MHPAEA) of 2008 and then continuing with the ACA, all health insurance providers are required to provide some degree of substance abuse treatment to their members.

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Does Health Insurance Cover Drug Rehab?

So, whether you have private insurance, marketplace insurance (Obamacare), Medicare, Medicaid, or TRICARE for veterans, rest assured, you can get the treatment you need. Also, under the ACA, substance abuse is no longer considered a pre-qualifying condition, so treatment for it cannot be denied. It must be treated equally the same as any other conditions or diseases like diabetes, cancer, or heart disease. That said, your specific coverage and how much you pay out of pocket all depend on your particular health plan.​

 

Health Insurance Does Not Cover All Rehab Services

While health insurance is required to cover many things, it still doesn’t cover everything, and it’s important to understand what your insurance does and does not cover. Generally, if it’s something medically necessary, your insurance will cover it. For example, if you needed medication for withdrawal, that would be deemed medically necessary.

On the other hand, things like music and art lessons (although perhaps relaxing to a person) will probably not be considered medically necessary.

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​What Rehab Services Will Health Insurance Cover?

Many who struggle with substance abuse, also struggle with mental health disorders like depression, anxiety, and bipolar disorder. Often, treatment will include medication, therapy, and rehab for both provided it’s medically necessary.

Detox

Often the first step in getting help is Detoxification, which is enduring withdrawal symptoms as the addictive substances exit the body. This can be both an unpleasant and medically dangerous time. To aid in this, many hospitals and addiction treatment centers offer non-addictive medicine to make the person comfortable.

Inpatient Rehab

Sometimes, those looking to recover from substance abuse problems need an inpatient setting to do so. This inpatient setting will usually include detox, medications, counseling, and the person residing at the treatment center for anywhere from 28-90 days.

Outpatient Treatment

Outpatient treatment allows the person to still reside at home, work their normal job, and maintain their regular life while still getting help for their disease. Oftentimes, this therapy includes group and individual therapy along with medication as it’s needed.​

 

Healthcare Coverage for Rehab Services with Nevada Insurance Enrollment

Different health insurance plans have different coverage options. So, if you need substance abuse rehab services, we’ll find the perfect plan for you. At Nevada Insurance Enrollment, our health insurance agents are here to plan for your needs and find the best coverage options available.

 

 

Medical Loss Ratio

Medical Loss Ratio

This Medical Loss Ratio states that when a family or individual buys a medical plan, 80% of every dollar collected and paid to an insurance company MUST pay medical claims/research. So that leaves the insurance company to pay ALL of their expenses with the remaining 20%. .20 cents on the dollar for their employees, buildings, broker costs, etc.

Why You Should Always Use an Insurance Agent

Why You Should Always Use an Insurance Agent

Insurance agents are licensed professionals who specialize in connecting people with the insurance policies that are right for them. They help the customers understand their coverage by studying all the insurance company’s policies and procedures.

 

By page visits (this month)

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog

#5) Request a Quote

By page visits (this month)

 

#1) Health Insurance Subsidy Chart

#2) Health Insurance

#3) Health Insurance WITH a Subsidy

#4) Insurance Blog Posts

#5) Request a Quote

Filing An Appeal To A Health Insurance Company

If your health insurance company refuses to cover a claim, you have the right to appeal the decision and have it reviewed by a third party. Your policy should outline how to appeal a denial.

What Does Guaranteed Issue Health Insurance Mean?

Guaranteed issue means that the health insurance coverage is guaranteed to be issued to applicants, regardless of their medical history, their age, their gender, or any other factors that might increase their likelihood of using health services.

Health Insurance Deductible

A deductible is an amount you pay before the Insurance Company starts paying. Health insurance plans will have different deductibles. You’ll be expected to pay the whole medical bill out of your own pocket until you’ve paid your deductible.

Comparing Medicare Advantage To Medicare Supplement

During the Medicare Annual Election Period (AEP), which is from October 15th through December 7th each year, many people may ask the question, “Do I want a Medicare Advantage Plan or a Medicare Supplement Plan (Medigap)?”

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