Not too soon after addiction recovery is considered, the focus and the conversation turns to money. “How are we going to pay for this?” “Can we afford treatment?”
These are valid questions, as addiction treatment can be expensive. At California Highlands Addiction Treatment Vistas, we understand how cost and health insurance can bring concern and some stress, so we aim to help our clients understand what their insurance covers.
We can help you or your loved one explore the best treatment options for your situation, so please call us at 844-208-4761 and speak to one of our addiction specialists.
Any and all information you provide remains confidential. Our specialists are more than happy to review your insurance benefits and set up a financial plan that works best for your situation.
Addiction, a chronic and progressively destructive brain disease, can be dangerous and even fatal if left untreated. We advise that you or your loved one receive proper treatment, which is the best and most effective way to combat addiction. Cost should never be the reason to abandon the option of getting addiction treatment help if that’s what’s needed.
It is a good idea to look at your financial options before committing to a treatment center. There are nearly 15,000 drug and alcohol abuse treatment facilities in the United States, per the National Institute on Drug Abuse, which means there are literally thousands of options to choose from. They all offer different courses of treatment in a variety of settings, so it’s important to choose the right one.
First, it’s important to know that the law recognizes that addiction is a treatable medical condition under the Affordable Care Act (ACA). Insurance providers generally know this. Since 2014, the ACA requires that insurance plans cover 10 health services known as Essential Health Benefits, and this is true regardless of what kind of insurance a person has.
People receiving Essential Health Benefits can get help with mental health disorders, drug or alcohol abuse, as well as counseling and therapy. However, the services provided vary depending on the center, and you (or another payment source) must pay for any services that aren’t covered by your insurer. It’s also important to note that insurance companies that cover addiction treatment may not cover every type of therapy or even the therapy you need. They also may not cover every kind of addiction treatment facility, so keep that in mind as you look for a center.
It may be easier to find treatment at centers with an established relationship with your health insurance provider; that doesn’t mean that you shouldn’t consider out-of-network facilities.
You or your loved one may be able to receive coverage for another treatment center if that center works for your situation. However, it’s realistic to expect your provider to review the facility first to see if it meets its coverage criteria.
When looking at a potential center, health insurance providers typically review:
Depending on the specific terms of your health insurance plan, you may be eligible for coverage for:
A common concern people have is whether their insurance plan will cover a specific substance dependency. If your plan offers addiction treatment as a covered benefit, then care will be provided. Some health providers cover addiction treatment for all substances, including alcohol, while others offer treatment for specific ones. Some may treat specific or less-common therapies and modalities. Still, that doesn’t mean insurers will cover all treatment or therapies, or certain medicines.
If you’re in doubt about what’s covered under your insurance plan, the best thing to do is call your insurance provider or the benefits department at your place of employment for guidance. When you call, be sure to ask the insurance representative if your primary care physician is required to give you a referral before expenses for certain treatment services will be covered. You also should ask if you are required to have any copayments ready and if substance abuse treatment expenses will apply to a deductible.
There are a few factors that determine how long your insurance coverage will last during treatment. One main factor is how long your program is. Depending on your benefits, your health provider may cover the costs for the entire time or it may limit coverage to a certain number of days. Whether you are in a private or public treatment facility can also influence how long your coverage lasts. Generally, private facilities can cost more. There’s also the possibility that you or your loved one can reach the maximum treatment limits faster than you would at a public treatment center.
Still, when choosing a drug or alcohol rehab, you should look for quality, credentials, and treatment plans that have a successful record of treating clients. Again, if your insurance company does not provide full coverage for the recovery treatment services that you need for a full recovery, California Highlands Addiction Treatment Vistas can help.
Yes. Give us a call at 888-721-5606 to discuss your options. It may take some time to figure out the best plan, but you definitely should not give up on treatment. You or your loved one may be eligible to receive scholarships or grants that can cover your treatment costs. Some facilities offer their clients a sliding scale, which means they will adjust treatment costs in proportion to one’s income and ability to pay or afford the treatment if he or she doesn’t have health insurance. This can substantially reduce the amount one pays and make the cost a fraction of the full price.
We are in-network for Anthem Blue Cross Blue Shield of California.
California Highlands Addiction Treatment Vistas works with insurance professionals and advocates to help our clients finance their drug rehab with the benefits available to them. If you don’t have insurance, we explore other payment arrangements that can make covering addiction treatment costs easier.
Our specialists are standing by 24/7 to answer your call and provide with the information you need. Call (888) 721-5606 now or contact us online to connect with one of our addiction professionals.
Substance Abuse and Mental Health Services Administration, (July, 2017). National Directory of Drug and Alcohol Abuse Treatment Facilities 2017 from https://www.samhsa.gov/data/sites/default/files/2017%20SA%20Directory.pdf
eHealth, (n,d). What is the difference between in-network and out-of-network providers? eHealth. from https://www.ehealthinsurance.com/ehi/help/newhelpcenter?entry=faqId=HI1%3BcategoryId=HI1-11%3BentryId=1
Investopedia, (n,d). Preferred Provider Organization – PPO. Investopedia. from https://www.investopedia.com/terms/p/preferred-provider-organization.asp