Drug addiction can be a devastating disease, both for the addict and for their loved ones. Can you buy health insurance for someone with an addiction? The answer is yes – but it can be tricky.
Insurance companies are often reluctant to cover drug addiction treatment because of the high cost. In this blog post, we will discuss whether or not a drug or alcohol addiction is a disability for health insurance purposes, and how you can get help if you are struggling with a substance abuse problem.
What is Drug and Alcohol Addiction Rehab Insurance?
Many addicts struggle with alcoholism because they lack access to substance abuse treatment in the form of professional rehab services for their addiction. Rehab can be costly and deter some people from looking for treatment centers to help them.
Drug and alcohol addiction insurance is a type of insurance that can help cover the cost of rehab. Can you buy health insurance for someone with an addiction? Yes, you can. Health insurance plans for addiction treatment can be purchased by an addict or by a loved one.
However, it is important to remember that an insurance provider may not offer insurance coverage for addiction treatment. It is important to check with your provider to see if they offer this insurance coverage.
How much treatment will insurance cover?
Most health insurance plans offer insurance coverage for a variety of substance abuse treatment services. These can include inpatient care at a rehab facility, outpatient treatment at addiction treatment centers, medical detox programs, behavioral health services, and mental health treatment.
However, insurance companies often limit the amount of coverage they will provide for drug and alcohol addiction treatment services. It is important to check with your insurance company to see what type of coverage they offer for addiction treatment services.
The individual insurance plan will contain the details on its substance abuse treatment coverage. Often, the insurance plan restricts the amount and type of care that are covered.
For example, insurance companies can reimburse patients for the detox procedure as well as the medications needed during these stages of rehabilitation. However, they may be unable to cover all substance abuse rehabilitation services needed for the patient’s subsequent recovery.
What types of rehabilitation programs accept health insurance?
Generally, insurance covers most drug rehab programs, but certain restrictions may apply. An insurance plan that offers coverage for persons with a substance abuse problem is widely accepted by several treatment programs across the country. The Affordable Care Act enacted in 2010 plays a huge role in helping persons with a substance use disorder (SUD) to get the essential health benefits they require.
Does insurance cover rehab in private rehab centers?
Private insurance can cover the costs of medical care in drug rehab centers. In a private treatment facility, an insurance plan with drug addiction coverage is accepted. Some private insurance providers like Blue Cross Blue Shield cover addiction treatment and a variety of health services including behavioral health conditions.
For persons without private insurance, government-funded programs such as Medicaid and Medicare are also accepted by most treatment programs. These programs mostly cater to the elderly, low-income communities, and persons with disabilities. The Affordable Care Act has also made these programs more accessible to these groups.
What mental health issues are covered by insurance?
Thanks to the Affordable Care Act and the Mental Health Parity and Addiction Equity Act, patients seeking treatment are also eligible to receive behavioral health benefits. These legislations aim to provide mental health care that would normally be available only to those with mental health issues.
Private insurance plans such as Blue Cross Blue Shield, as well as government-run programs, are required to provide care to a patient with a mental health condition at the same cost as medical and surgical services. Thus, insurance plans can cover a wide range of mental health treatments at a treatment facility.
Are treatment medications covered by insurance?
Maintainance programs as part of after-treatment care can help people who can not achieve their usual function when they are not using drugs. These people need drugs to fix their imbalances and live independent lives. A drug rehab or treatment program that includes after-care is also more efficient to address long-term substance abuse issues.
The question is if these medications are covered by insurance. Medication-assisted treatment is often covered by an insurance policy. These medications are administered under the guidance of medical professionals or the patient’s primary care physician.
While medications are generally covered by an insurance policy, the coverage has restrictions. Most insurance providers will cover the cost of generic medication and not the expensive brand. If the patient has a preferred brand, they will have to seek financial assistance or pay out-of-pocket for the cost of the drug.
Insurance Providers & Rehabilitation Coverage
Can you buy health insurance for someone with an addiction? Yes, you can. Where can you find a health insurance provider with sufficient insurance coverage?
Health insurance is designed to make medical services affordable and accessible, without the stigma associated with seeking help. Persons who need to undergo drug rehab can use their insurance in American Addiction Centers as well as in a private treatment facility.
A good insurance plan that will cover drug rehab and alcohol abuse treatment can often be found in a health insurance marketplace. Some patients prefer to use private health insurance like Blue Cross Blue Shield for their substance abuse treatment. Private insurance policies can be purchased directly from private insurance healthcare providers.
Blue Cross Blue Shield Coverage for Addiction Treatment
Blue Cross Blue Shield is a private insurance company that provides drug rehabilitation coverage based on several variables. This factor includes your state of residence, the type of Blue Cross Blue Shield insurance policy, and your individual substance abuse treatment needs.
When detox services are needed for a substance including alcohol, benzodiazepine, and/or opiates, part or the entire costs are considered medically necessary and are thus covered by a Blue Cross Blue Shield insurance plan. Often, Blue Cross Blue Shield insurance plans include group counseling in conjunction with drug rehabilitation programs in order to treat co-occurring mental health problems.
Laws for Persons Seeking Addiction Treatment
Affordable Care Act (ACA)
In October 2010, the Affordable Care Act was enacted to make insurance available to a larger number of citizens. This legislation also addressed the expansion of Medicaid programs and supported new delivery methods to patients.
The ACA lists substance abuse disorders as an essential benefit that every insurance company must cover. All healthcare providers must also offer coverage for mental health services.
Is addiction considered a pre-existing condition under the ACA?
Is drug addiction a disability for health insurance? Can you buy health insurance for someone with an addiction? The ACA does not consider addiction as a pre-existing condition. This means that a person’s addiction will not affect their ability to get health insurance.
Americans with Disabilities Act (ADA)
Now, you may be wondering – can I lose my job if I use health insurance for drug addiction? The answer is no. Several laws are already in place to help you get the treatment you need. The Americans with Disabilities Act will protect you from discrimination from your employer.
The ADA is a federal law that protects employees from discrimination. This act applies to employers with 15 or more employees. The ADA prohibits employers from discriminating against workers with disabilities and requires them to make reasonable accommodations for those workers.
Addiction is considered a disability under the ADA, which means that employers must provide reasonable accommodations for employees who need addiction treatment. Reasonable accommodations can include time off from work to attend rehab, flexible work schedules, and access to employee assistance programs.
Mental Health Parity and Addiction Equity Act (MHPAEA)
The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (MHPAEA) is a federal law that prevents health insurance providers from charging a higher amount for addiction and mental health treatment services.
Under the MHPAEA, insurance policies must cover mental health conditions at the same cost as other medical conditions. For example, if the coverage for an ankle sprain is at a maximum of $100 for three treatment visits, insurance providers must also cover a mental health illness such as depression for the same amount and number of visits to the healthcare provider.
Family and Medical Leave Act (FMLA)
The Family and Medical Leave Act is a federal law that allows employees to take up to 12 weeks of unpaid but protected leave for certain medical and family reasons. This includes time off for the employee’s own serious health condition, or to care for a close relative with a serious health condition.
The FMLA can be used to take time off from work to enter into drug rehabilitation programs, or to care for a family member who is struggling with addiction. This leave can be taken all at once or can be taken intermittently as needed.
Can you buy health insurance for someone with an addiction? Yes, you can. Now that several laws are in place to protect persons with an addiction problem, getting the appropriate insurance for people seeking treatment is a huge step towards their recovery. Before selecting an insurance plan, make sure that you are aware of the state laws where the plan will be used.
If you or someone you know is struggling with addiction, don’t hesitate to reach out for help. Seeking help for substance use disorders is highly encouraged. Although some employers still frown at the stigma that addiction may bring, substance abuse treatment is the first step in getting your life back together. As this type of treatment is now being recognized by most insurance providers, there is no reason to avoid getting help.