Is Alcohol Rehab Covered by Insurance?

Edited by Paul Alexander

Last updated July 1, 2020

The team at Northbound Treatment is dedicated to providing comprehensive care and support at all levels. We understand that the expense of a rehabilitation center can be a factor when choosing which treatment program to attend for alcoholism, drug addiction, or substance abuse disorder. To help alleviate the stress of our clients and their loved ones during this pressing time, we’re here to assist with navigating your health insurance coverage.

If you’re wondering whether alcohol rehab is covered by insurance, you’re not alone. The language used in health insurance policies is notoriously difficult to understand. This can make figuring out your options extremely challenging, but that’s where Northbound comes in. Here, we’ll cover the basics of alcohol rehab insurance and provide answers to some of the most frequently asked questions about coverage for addiction treatment.

What to Know About Alcohol Rehab Insurance

For many individuals struggling with early signs of alcoholism, the cost of rehab can be a barrier to seeking treatment. Although detox or residential rehab might seem out of reach financially, what many don’t realize is that their current policy likely includes some form of alcohol rehab insurance — especially if this is your first time seeking treatment for alcoholism. The remaining costs not covered by insurance can be sorted out with a payment plan that works for your unique situation.

Substance Abuse Treatment and the Affordable Care Act

With the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 and expansions on the ruling under the Affordable Care Act, insurance companies are now legally required to cover treatment for mental health and substance abuse. Not only that, but treatment for these conditions has to be billed as essential healthcare, meaning benefits must be equal to a plan’s coverage for standard medical care. With essential healthcare services, policyholders don’t have to meet their deductibles before coverage goes into effect.

Bear in mind that insurance companies still have some leeway as to which types of treatment they cover for substance abuse. In other words, individual policies vary when it comes to detox programs, inpatient rehab, and outpatient treatment.

Insurance Coverage for Alcohol Detox

Technically, insurance companies aren’t required to cover alcohol detox. Yet for many suffering from drug and alcohol addiction, it’s a vital first step to long-term sobriety. We strongly recommend that those who need to undergo detox do so in a safe setting, under the medical supervision of an accredited treatment facility. 

While health insurance policies don’t have to include detox, many do as part of their coverage for inpatient treatment. However, some may require policyholders to meet their deductible first. If you’re not sure whether your plan includes coverage for a detox program, Northbound Treatment can help. Our specialists can review the details of your policy and tell you what your options are for detoxification. We can also help you find out if you’ve already met your deductible for the year or how close you are to meeting it.

Residential and Outpatient Alcohol Rehab

There’s a good chance your policy includes alcohol rehab insurance for programs at a treatment center, including both residential (inpatient) and outpatient facilities. One thing to consider is that many health insurance plans require what’s called pre-certification before approving residential rehab coverage. What this means is that a physician would need to evaluate your condition and recommend inpatient rehab, almost like a prescription for treatment. If your plan requires pre-certification, Northbound can help you complete the process.

Outpatient treatment for substance abuse is typically billed similarly to regular therapy or mental health counseling appointments. Most policies cover a certain number of outpatient sessions each year. You can find out your level of coverage for both outpatient treatment and inpatient programs by calling your insurance company directly, reviewing your policy online, or reaching out to us at Northbound. We’d be more than happy to help you figure out what your options are for treatment centers.

In-Network Alcohol Rehab Insurance

Many people wonder about in-network versus out-of-network alcohol rehab insurance coverage. As far as what your benefits include, another key factor is whether your plan is an HMO (health maintenance organization) or a PPO (preferred provider organization). If your insurance is through an HMO, your healthcare options are limited to providers and facilities that are contracted within the network. With a PPO, you can see both in-network (preferred) and out-of-network providers, but you’ll typically get a better rate if you stick to those within the network.

When you log into your account online or reach out to your insurance company directly, you can find out whether you have an HMO or a PPO plan. (Some insurance companies offer both.) If you’re having trouble determining which type you have, don’t hesitate to call us at Northbound. We’re an in-network provider for most major insurance companies, and if your benefits don’t cover treatment with us, we’ll recommend another facility that exceeds our standards of care.

Individual Plans Vary

One of the main reasons why health insurance policies are so confusing is that even within a network, there are often multiple levels of coverage and types of plans. For instance, if you have health insurance through your employer, you may have gotten the option of two or three tiers of coverage with varying out-of-pocket costs toward your premium. So, your benefits might be slightly different than your co-workers’ in terms of co-pays and the extent of coverage for some types of care.

As we mentioned, your plan probably includes coverage for different stages of alcoholism treatment. Having said that, your policy might not cover the costs entirely and may limit the kind of treatment you seek. You might need to pay for some or all of rehab out-of-pocket.

Talk to an Experienced Insurance Expert at Northbound

If the cost of rehab is making you second-guess getting treatment, please contact us today. Our seasoned insurance specialists know the ins and outs of verifying coverage for treatment. We’re here to clarify any concerns you have and give you an idea of what to expect in terms of paying for rehab.

Over the last three decades, Northbound Treatment has mastered the highly complex art of navigating insurance policies and getting approval for rehab. We know how to maximize your alcohol rehab insurance coverage and minimize your out-of-pocket costs. To get started, fill out our online insurance verification form, and one of our insurance specialists will get back to you within 12 hours.

Flexible Payment Options for Alcohol Rehab

The treatment cost shouldn’t prevent you from getting help, but we realize it shouldn’t be disregarded, either. Northbound Treatment is committed to making alcohol addiction treatment affordable to individuals and their families. When you get in touch with us, our admissions coordinators will evaluate your insurance coverage and financial situation and provide a confidential assessment of your options for alcoholic treatment.

We offer flexible payment plans for alcohol rehab, which are based on a number of factors, including your clinical diagnosis, your anticipated length of stay, and whether any specialized care is required. Any portion of treatment not covered by your insurance plan can be worked into an individualized payment plan.

Our Approach to Alcoholism Treatment

The alcoholism treatment programs at Northbound are effective. Our clients are able to get sober, heal physically and mentally, repair their relationships, find happiness, and adjust to a normal life. The journey to sobriety is challenging, to say the least, and there’s no one-size-fits-all approach to treatment. That’s why we offer personalized plans that take into account all aspects of your addiction, lifestyle, medical history, and goals. Additionally, a treatment plan can be adjusted at any time if an alternative approach better suits a client’s needs.

We offer a complete continuum of care for alcohol rehab, including an accredited detox treatment program, integrated residential rehab, outpatient treatment, and aftercare services for individuals and their families. In mild cases, patients may only need outpatient treatment, but many benefit most from attending an inpatient program first. 

Whether residential treatment calls for a short-term program or a long-term recovery plan, we want our clients to succeed not just in achieving sobriety but with all aspects of their lives. The trademarked Careerbound® and Collegebound® programs from Northbound Treatment help clients get back on the path to professional success. We also offer a music-focused rehab program, as well as programs catered specifically to trauma survivors.

Are you ready to take the first step to sobriety? Call Northbound Treatment now at (844) 919-0403.

Sources:

  1. “Mental Health Parity and Addiction Equity Act (MHPAEA) | CMS.” Cms.gov. N.p., n.d., https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/MHPAEA
  2. “Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans.” Hhs.gov. N.p., 7 Apr. 2015. , https://aspe.hhs.gov/report/affordable-care-act-expands-mental-health-and-substance-use-disorder-benefits-and-federal-parity-protections-62-million-americans

Article Reviewed by Paul Alexander

Paul AlexanderPaul Alexander is the founder and CEO of Northbound Treatment. He received his Certified Addiction Treatment Specialist training at Saddleback College in Mission Viejo, CA, and was awarded Outstanding Alumni Service Award in 2002. Paul holds a Bachelor of Arts degree in Criminology, Law and Society, Summa Cum Laude, from University of California, Irvine, and a Juris Doctorate degree from Loyola Law School of Los Angeles. He believes wholeheartedly in transformational leadership, organizational health and effective, fully integrated substance use disorder treatment.

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