Information About Insurance for Alcoholism Rehab
Insurance coverage for alcohol rehab varies depending on several factors, including the insurance provider, the specific policy, the country or region’s health regulations, and the type of treatment required. In the U.S., due to the Affordable Care Act (ACA), many insurance plans are required to cover mental health and substance use disorder services, including behavioral health treatment, counseling, and psychotherapy. Learn about companies that cover alcohol rehab, how much it costs, and much more.
What Insurance Companies Cover Alcoholism Rehab?
- Coverage: As an association of independent companies, coverage specifics can vary based on the local BCBS affiliate. However, most BCBS companies offer some coverage for substance abuse treatment, which can include detoxification, inpatient rehab, outpatient services, and counseling.
- Notes: Since BCBS operates as a federation of affiliated companies, coverage can vary greatly by state or region. It’s always essential to check with the local BCBS company for specifics.
- Coverage: UnitedHealthcare often covers substance abuse treatments, both inpatient and outpatient. This can include therapy, counseling, and medication-assisted treatment.
- Notes: Their online portal offers a “Find a Provider” tool to help policyholders find in-network substance abuse treatment providers.
- Coverage: Aetna’s coverage can include detoxification, residential treatment, partial hospitalization, intensive outpatient, and outpatient services.
- Notes: Aetna’s online tools can help policyholders understand their benefits and find in-network providers specializing in addiction treatment.
- Coverage: Cigna’s policies might offer full or partial coverage for detox, inpatient rehab, outpatient treatment, and counseling.
- Notes: Cigna has an emphasis on integrated care, potentially offering holistic treatment options and support for coexisting mental health conditions.
- Coverage: Depending on the plan specifics, Humana may cover detox services, inpatient rehab, outpatient services, and therapy.
- Notes: Humana offers a Behavioral Health division that focuses on mental health and substance abuse service
- Coverage: Kaiser Permanente often provides integrated services, which means that substance abuse treatment can be coordinated with other medical and mental health services.
- Notes: As both an insurance provider and a healthcare provider, Kaiser operates its facilities, which can streamline the process of seeking treatment.
- Coverage: Being affiliated with BCBS, Anthem’s coverage for alcoholism and substance abuse is quite comprehensive in many of its plans, ranging from detox to outpatient counseling.
- Notes: As with BCBS, the specifics of Anthem’s coverage can vary based on the region or state.
- Coverage: Health Net plans typically include substance abuse treatment options, though specifics can vary based on the plan and region.
- Notes: They often emphasize holistic health, meaning there could be support for complementary therapies.
- Coverage: As a significant provider of state-sponsored health programs, Centene often has comprehensive coverage for substance abuse treatment.
- Notes: Since Centene focuses on government programs, specifics might vary based on state requirements.
- Coverage: Molina specializes in Medicaid and Medicare, so its coverage for substance abuse often aligns with the requirements of these programs.
- Notes: Coverage might vary significantly based on state regulations, given the nature of Medicaid.
What Type of Alcohol Rehab Does Insurance Cover?
- Description: The initial phase of recovery, during which the body is cleansed of alcohol. Medical supervision ensures the patient’s safety and can help manage withdrawal symptoms.
- Coverage: Many insurance plans will cover medically supervised detox, recognizing the potential health risks of unsupervised withdrawal.
- Description: Patients reside at a facility, receiving intensive treatment, usually for 30, 60, or 90 days (though it can be longer). Treatment often includes group therapy, individual counseling, and other therapeutic activities.
- Coverage: Many insurance policies cover inpatient treatment, but the duration of coverage can vary. Some might cover the entire stay, while others may only cover a portion.
- Description: A step down from inpatient treatment, PHPs provide intensive treatment for several hours a day, but patients can return home in the evenings.
- Coverage: PHPs are often covered, especially if deemed medically necessary as a transition from inpatient care or as an alternative when full inpatient care isn’t necessary.
- Description: Similar to PHP but requires fewer hours per week. Patients participate in regular therapy sessions but don’t need to stay at the facility.
- Coverage: Many insurance providers cover IOPs, especially when seen as a continuation of a treatment plan after more intensive care.
- Description: Patients attend regular counseling or therapy sessions, usually once a week, while living at home and possibly even working or attending school.
- Coverage: Outpatient treatment is commonly covered by insurance due to its cost-effectiveness and the ability to integrate treatment into daily life.
- Description: Use of medications, in combination with counseling and behavioral therapies, to treat substance use disorders.
- Coverage: Medications used in MAT, such as disulfiram (Antabuse), naltrexone (Vivitrol), and acamprosate (Campral) for alcoholism, may be covered by insurance, especially if deemed medically necessary.
- Description: Both individual and group therapy sessions to address the underlying causes of addiction and develop coping strategies. This includes popular therapies for alcoholism like DBT, CBT, and MI.
- Coverage: Many insurance plans will cover both individual and group counseling, recognizing their importance in maintaining long-term sobriety.
Important Laws and Guidelines to Know
Under the ACA, most individual and small employer health insurance plans, including all plans offered through the Health Insurance Marketplace, are required to cover mental health and substance use disorder services. This includes behavioral health treatment, counseling, and psychotherapy. Also, Medicaid plans offered in states that have expanded Medicaid coverage must provide these services.
In the U.S., federal parity laws require insurance companies and group health plans to provide the same level of benefits for mental and/or substance use treatment and services as they do for medical/surgical care. This means if your insurance offers coverage for medical services, it should offer at least equal coverage for substance abuse treatment.
Even if alcohol rehab is covered, the patient might still be responsible for certain out-of-pocket costs like deductibles, co-pays, or co-insurance amounts. The exact amount varies by plan.
Some insurance plans may have limitations on the duration or type of treatment. For example, they might cover inpatient rehab but only for a certain number of days or might have a preference for outpatient treatment.
Some insurance plans require pre-authorization for substance abuse treatment, which means the treatment facility or the patient must get approval from the insurance company before beginning treatment.
While many private insurance plans offer some level of coverage, public insurance options like Medicaid might have different requirements and coverages.