Does insurance cover drug rehab?

 Many people deter from seeking help and going into drug rehab due to the high cost of the treatment. Most medical insurance will cover part of the cost of your drug rehab treatment. As part the 10 “elements of essential health benefits” of The Affordable Care Act, insurance companies are bound to cover part of your drug rehab treatment for all the policies sold on the open exchange. The health insurance companies will cover part of your treatment and you will be responsible for part of the payment in form of co-pay and deductibles.

 What are Co-pay, Deductibles, and Providers? 

  • Co-Pay: Co-pay are small fixed dollar amounts you pay directly to your doctors or the rehab treatment facility. The rest of the cost which is the bigger chunk of the treatment is paid by the insurance company.
  • Deductible: Deductible is a minimum deductible amount which is fixed yearly, after which your insurance policy kicks in. You will have to pay your deductible amount before your insurance company starts paying. This amount varies from policy to policy.
  • Providers: In some cases even though your policy covers drug rehab, your insurance policy might only cover the treatment if you go to the specific drug rehab provider mentioned in your policy.

 What part of drug rehab treatment is covered by Insurance?

Even though drug rehab treatment are supposed to be covered by your insurance policy, it will depend on your insurance company on what it considers “medically necessary”. What your insurance will pay for varies from policy to policy, as some policies cover drug rehab treatment while other policies will only pay for medical detox or medications. It is wise to call your insurance agent and ask them what part of drug rehab is covered under your policy.

In some cases, if insurance companies deny you coverage for drug rehab, you can appeal the decision. Although the appeals process needs to be carefully filed and has to be followed closely.