Yes, insurance policies now include coverage for substance addiction such as heroin. This used to be not the case before the implementation of the Affordable Healthcare Act of 2010. Most insurance policies used to consider addiction and mental health illness as pre-existing conditions, excusing them to cover the cost of the treatment.
But this is already against the law at present. All insurance policies are required to cover the cost of addiction and mental health treatment among patients. Substance addiction is now considered a chronic illness just like diabetes and hypertension. It requires medical care which health insurance policies need to enlist in their coverage.
What Are The Benefits of Insurance Coverage For Heroin Rehab?
Insurance coverage is a huge benefit among patients who struggle with drug addiction, especially those who have co-occurring disorders. This condition is also known as comorbidities. Most patients who use this drug rely on the drug as a means of self-medication for their underlying mental health problems.
Some patients also use the drug to magnify the high from other substances such as alcohol or other opioids. This makes them develop two kinds of substance use disorders. One for this drug, and another one for the other substance.
Comorbidities require specialized treatment which can be expensive since it needs a crucial process. Health insurance coverage is highly beneficial for this cause. Insurance can provide financial assistance to patients who enroll in a dual diagnosis treatment, which ensures that all health disorders are medically attended to.
Apart from that, the government also benefits from the financial aid provided by health insurance programs to those who suffer from drug addiction. The economic burden which roots in paying for the consequences brought by addiction can be decreased. These consequences include the cost of hospital admissions and criminal justice costs.
How Do Health Insurance Programs Work For Heroin Rehab?
Health insurance programs are great partners in accessing quality healthcare. There is no need to worry about the cost of medical care as long as you own a health insurance policy. Some policies are personally bought while others are provided by company owners as benefits to their employees. State-funded health insurance is also available.
The cost of the screening and diagnosis of the condition can be covered by insurance. In addition, medications and services during detox and one-on-one therapy are also included. Food, accommodation, and other amenities can also be covered depending on your policy.
There are two types of health insurance programs that every person can avail of in the country. First is the federal and state-funded health insurance which is Medicaid and second is the private health insurance programs.
Medicaid Health Insurance
The main requirement to enjoy the benefits of Medicaid include citizenship or residency of the state where you want to avail of the health program. Also, you need to belong to the poverty threshold which the state determines. Top beneficiaries include the elderly, teens, the pregnant, and those who are parents.
Medicaid can provide financial assistance for the full cost of the rehab treatment among qualified members. In some cases where the partial cost can only be provided, patients may need to pay out-of-pocket the remaining balance which includes a huge discount already.
To apply for Medicaid insurance, you need to visit the nearest health home in your state and turn in the requirements. First, they will let you sign a form, and then they will verify the details you provided for qualification. It is important to note that state policies for this system vary.
Private Health Insurance
Private health insurance policies work in three ways for their financial coverage. Here are the details of these three types of policies.
Health Maintenance Organization (HMO)
HMO policies will finance treatment which includes a specific network of medical providers. This is considered to be the most affordable treatment plan. It costs you low monthly deductibles and you are likely to pay less out-of-pocket.
If you are particular about choosing the desired physician for your care, HMO may not work for you. They do not cover the cost of services outside the network they hold.
Exclusive Provider Organization (EPO)
EPO is a little less expensive than HMO. They are typically the same in terms of financing the treatment only to a specific network. However, this network is expected to be bigger than the HMO. For this, you will have higher deductibles than HMO and still pay less out-of-pocket unless you choose a healthcare provider outside the given network.
Preferred Provider Organization (PPO)
Lastly, the PPO is the most flexible when it comes to the choice of healthcare provider. There are no networks to limit your choice. You can seek help from any specialist without needing a referral. However, this flexibility also comes with high deductibles every month.
How To Choose The Right Rehab
Choosing the right rehab is necessary for you to receive valuable medical care for your condition. Treatment can be extremely uncomfortable, and you must receive quality services as you begin the process.
First, you need to determine a clear diagnosis of your condition. Your doctor will recommend you to either inpatient or outpatient treatment depending on the level of your diagnosis. If your case is severe, then you go for inpatient care. Otherwise, you can go outpatient.
Second, you can start exploring the nearest rehab centers in your area. You have to find out which facilities can cater best to your needs. You can also ask them for an estimated cost of the treatment of your condition and inquire whether they accept the insurance policy that you have or not.
Third, you can filter your choices based on online reviews and testimonials about these rehab facilities. This is a highly reliable means to determine the quality of care they provide to their clients.
Finally, you can check the actual facilities yourself and then decide how well they could implement the treatment plan that you have evaluated with your chosen specialist.