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Does Health Insurance Cover Drug Rehab?

by | Dec 21, 2024

Page Tags: 2024 | coverage

​If I need Help for Alcohol or Drug Abuse

Will My Health Insurance Cover Me?

If you’re considering treatment for substance abuse, we have some wonderful news. Thanks to the Affordable Care Act (ACA) passed in 2010, substance abuse now falls under the same category as mental health, meaning it’s covered by insurance. Starting with the Mental Health Parity and Addiction Equality Act (MHPAEA) of 2008 and then continuing with the ACA, all health insurance providers are required to provide some degree of substance abuse treatment to their members.

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Does Health Insurance Cover Drug Rehab?Pin

So, whether you have private insurance, marketplace insurance (Obamacare), Medicare, Medicaid, or TRICARE for veterans, rest assured, you can get the treatment you need. Also, under the ACA, substance abuse is no longer considered a pre-qualifying condition, so treatment for it cannot be denied. It must be treated equally the same as any other conditions or diseases like diabetes, cancer, or heart disease. That said, your specific coverage and how much you pay out of pocket all depend on your particular health plan.​

 

Health Insurance Does Not Cover All Rehab Services

While health insurance is required to cover many things, it still doesn’t cover everything, and it’s important to understand what your insurance does and does not cover. Generally, if it’s something medically necessary, your insurance will cover it. For example, if you needed medication for withdrawal, that would be deemed medically necessary.

On the other hand, things like music and art lessons (although perhaps relaxing to a person) will probably not be considered medically necessary.

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​What Rehab Services Will Health Insurance Cover?

Many who struggle with substance abuse, also struggle with mental health disorders like depression, anxiety, and bipolar disorder. Often, treatment will include medication, therapy, and rehab for both provided it’s medically necessary.

Detox

Often the first step in getting help is Detoxification, which is enduring withdrawal symptoms as the addictive substances exit the body. This can be both an unpleasant and medically dangerous time. To aid in this, many hospitals and addiction treatment centers offer non-addictive medicine to make the person comfortable.

Inpatient Rehab

Sometimes, those looking to recover from substance abuse problems need an inpatient setting to do so. This inpatient setting will usually include detox, medications, counseling, and the person residing at the treatment center for anywhere from 28-90 days.

Outpatient Treatment

Outpatient treatment allows the person to still reside at home, work their normal job, and maintain their regular life while still getting help for their disease. Oftentimes, this therapy includes group and individual therapy along with medication as it’s needed.​

 

Healthcare Coverage for Rehab Services with Nevada Insurance Enrollment

Different health insurance plans have different coverage options. So, if you need substance abuse rehab services, we’ll find the perfect plan for you. At Nevada Insurance Enrollment, our health insurance agents are here to plan for your needs and find the best coverage options available.

 

 

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What is a Summary of Benefits and Why Should I Read It?

A summary of benefits (SBC) is a 4-page document explaining a health insurance plan’s coverage, costs, and examples. It helps compare plans, understand costs like premiums and deductibles, and assess coverage for services like doctor visits or preventive care. Available through Nevada Health Link, the SBC is standardized for easy comparison but does not include provider networks or full exclusions. Learn how to use the SBC to choose a plan that fits your needs.

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What is a Summary of Benefits and Why Should I Read It?

A summary of benefits (SBC) is a 4-page document explaining a health insurance plan’s coverage, costs, and examples. It helps compare plans, understand costs like premiums and deductibles, and assess coverage for services like doctor visits or preventive care. Available through Nevada Health Link, the SBC is standardized for easy comparison but does not include provider networks or full exclusions. Learn how to use the SBC to choose a plan that fits your needs.

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What Is a Health Insurance Carrier?

A health insurance carrier provides plans to cover medical expenses, like doctor visits and prescription medications. Understanding your insurer’s network, plan types (HMO, PPO), and costs (premiums, deductibles) is key to choosing coverage. In Nevada, carriers collaborate with Nevada Health Link to offer ACA-compliant plans, ensuring access to preventive care and essential benefits. Learn how to select a dependable health insurance company and manage costs effectively.

What is a Prescription Drug Deductible?

In the world of health insurance, “deductible” is a common word. It refers to an amount of money that you pay out of your pocket before the insurance company begins to pay. A prescription deductible is the portion you’d pay first, then after you’ve paid the deductible, you may only have to pay a co-pay when you pick up your medication.

If you are single, you would only have to meet your prescription deductible. If you have two or more people in your family, each member may have to meet their own prescription deductible which could be up to 2 deductibles in the family. A prescription deductible is different and separate from the medical deductible, unless otherwise stated. One deductible is for medical, ie: hospitalization, doctors, etc., and the other deductible is for filling your prescriptions.

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