Will a Treatment Center Contact My Insurance Provider if It’s Not Me?

The most amazing thing people quickly learn when getting treatment in an addiction treatment center is about the level of support that is given. Without support throughout the entire treatment process, it would be nearly impossible for a client to get through treatment with a meaningful recovery in hand.

Given that reality, most of the drug and alcohol rehab centers in the country, especially Florida, strive to make sure they have plenty of support resources in place. They do so in large part to help guide clients along. Beyond the support resources made available during rehab, there are usually support mechanisms in place to help make every aspect of treatment as easy as possible. That even applies to the assessment process where determinations about the mode of payment are made. As the client, you have an obligation to decide how you want to pay for the services you will receive.

If you have healthcare insurance, that would certainly be the best payment option you’ll have at your disposal. Working on the assumption you do intend to use your healthcare insurance as your primary and hopefully the only mode of payment, we offer this reminder.

According to the Affordable Care Act of 2009, your healthcare insurance provider is required by law to cover at least some of the costs related to addiction treatment. The percentage of coverage may vary, but the law does require they cover some costs. Here’s the good news. If you want help figuring out exactly what your insurance will cover but feel uneasy about contacting them, many addiction treatment centers have an administrative staff member that will help you with the process.

Will the Insurance Company Give Details if It’s Not You?

The short answer to this question is yes. Insurance companies do have a process whereby representatives from a hospital, doctor’s office or addiction treatment center can call about the client’s coverage. You may have to sign an authorization for the rehab facility to contact the insurance company on your behalf, but once that’s in place, they can advocate for you. Here’s the thing about the ACA. While is does dictate your insurance carrier cover certain expenses, it does not dictate to what extent. That information should be available in your policy summary. To help you get an idea of what you can expect, here are some of the basic costs your policy must cover:

  • Addiction treatment-related medications
  • Basic inpatient and outpatient programs
  • Family Counseling
  • Aftercare programs

Addiction Treatment-Related Medication

When someone enters rehab with a significant addiction, they will likely need to spend time in a medication-assisted detox program. In such programs, medications are often prescribed to help mediate withdrawal symptoms and cravings. If the individual is coming off a long-term addiction to opiates, they may need medications like suboxone or methadone in order to ease off the drugs in a much more controlled manner. The insurance company would also be required to cover any medications related to dual diagnosis treatment or co-existing conditions (addiction and psychological).

Basic Inpatient and Outpatient Programs

With insurance coverage, most of the inpatient treatment options are restricted to what the insurance company would classify as basic treatment methods. That usually means traditional individual and group therapy programs. With outpatient care, insurance companies offer a lot more flexibility simply because they want to promote outpatient care, which is substantially lower in cost. Only the Cadillac insurance plans will usually cover evidence-based and holistic treatment methods.

Family Counseling

Given the importance of the family as a support mechanism, many insurance companies will cover additional family members who want to participate in family counseling. That could include therapy given to family even when the client isn’t present in the treatment session.

Aftercare Programs

The last thing an insurance company wants to endure is having to pay additional costs for clients who relapse. To help avoid these costs, many insurance companies will pay for additional outpatient therapy as well as perhaps covering a portion of the costs related to the client living in a sober living home. Before your addiction destroys your life, you need to get yourself into treatment regardless of the potential costs. If you have healthcare insurance, you’ll likely find solace in knowing at least a portion of rehab will be covered. If you are not sure, we would be happy to provide you with treatment and also help you figure out information about your coverage. When you are ready for treatment, contact us at 888-534-1951.