Should I Call My Insurance Company Before I Go To an Addiction Treatment Center?

Your health insurance is a valuable resource that helps make addiction treatment more affordable. While it is always best to call your insurance company before you go to an addiction treatment center, you should first understand that there are times when you may need to seek professional help immediately. For example, someone who is at risk of having major withdrawal symptoms needs to go to a treatment center immediately if they stop using drugs or alcohol so that they can get stabilized. Once you receive the necessary treatment, you can then work out the information regarding what your insurance covers.

In some cases, however, you do have time to reach out to your insurance company. Doing so allows you to make the best choices regarding your care, and it helps to alleviate any financial concerns that you have about going to rehab. While you can always review your insurance policy, it is often easier to speak to a representative from the company who can explain complicated language that describes your coverage. When you do call your insurance company, you can use this guide to get the information that you need to plan your stay at an addiction treatment center.

Addiction Treatment Services Covered by Insurance

The Affordable Care Act requires all health insurance companies to provide some form of coverage for addiction treatment, which means that you should expect for at least a portion of your stay to be covered. You should also know that health insurance companies can no longer treat addiction as a preexisting condition, which allows you to receive coverage if you have been to a rehab in the past.

While your insurance will cover some of your stay, the amount of coverage varies among companies as well as the type of policy that you have. Typically, you can expect for your insurance to cover detox services since they are often deemed medically necessary since certain withdrawal symptoms are dangerous if they are not controlled by a professional. In addition to detox care, you can find out if your insurance company covers these services that are commonly provided by addiction treatment centers.

  • accommodations for a residential stay such as a semi-private room
  • nutritional support
  • medications
  • professional counseling
  • group therapy

Ask the Right Questions

Making sure that the services you need are covered is the first step toward understanding your insurance policy. However, there is still more information that you need to gather regarding the coverage. For instance, you will need to ask what percentage of the cost of your stay is covered since you may need to pay the rest out of pocket. You also need to find out if your insurance policy only covers a certain amount of days of rehab. Often, an insurance company will only cover a specific number of days of residential care, but you can then continue to use your insurance for therapy over a longer period of time in an outpatient program. Knowing this beforehand allows you to stay in the treatment center for the maximum amount of time that you need before switching to outpatient care.

Your policy may also have a list of providers that they consider to be in-network. Usually, care that you receive from a provider that is in your network receives a higher level of coverage. Most insurance companies will still cover care that is out of your network, but you may have higher copayments. If you do find a treatment center that is out-of-network, but that you prefer, it is often worth making the extra payments to receive the care that you know works. As a final note, be sure to inquire about what other parts of your care are covered. For instance, being aware that your insurance company will continue to cover counseling after you finish your primary residential treatment helps you make the best plans for the prevention of relapse.

Plan for Your Recovery

At this point, you know that you need help dealing with your addiction. However, it is hard to know exactly what level of care that you will need and how long you will need to stay in a treatment center. For this reason, your next step after talking to your insurance company is to arrange for an assessment with your preferred drug addiction treatment center. During your initial assessment, you can find out things such as whether or not you professional detox care to get through the first days of your recovery. You can also ask about the average length of stay that a person has in a residential program. While your experience may change once you begin the program, knowing an average of what to expect helps you figure out what your insurance company can cover.

This information also helps you to make arrangements for covering the part of the payments that are your responsibility. For example, you may be able to work out a payment schedule for your copays. You will also need to make sure to provide the rehab center with your insurance information. Make sure that you do not forget your policy number and other important info as you pack to go to the treatment center. You can also call your addiction treatment center ahead of time to provide them with the information that they need to start getting your care covered. While you have many things to do to prepare for rehab, handling this task eliminates many of your worries about the financial part of your treatment.

Keep in mind, however, that you can still get your insurance to cover your stay if you must enter the treatment program on an emergency basis. As soon as you are able to gather the appropriate information, your treatment center team can help you make sure that the necessary paperwork is sent to the insurance company to start the coverage. Do you still have questions about how to pay for your addiction treatment? We can help! Give our counselors a call today at 877-027-9048.