In many cases, the reason someone does not get help for an addiction or substance abuse problem is because of the barriers they have placed in their mind. Whether it is an expense or the ability to take time away from their daily obligations, none of that matters if their readiness to change is not met. There are other factors as well that include the stigma around addiction treatment, but there are ways around each and every obstacle. Making the decision, even when one is ready to step away and admit to the problem, is difficult, but cost should never be the reason not to seek treatment.
It’s true that modern medicine in the United States is expensive, but health care and addiction treatment in this country is the most advanced in the world. Addiction is a chronic disease that for many will last a lifetime. Addiction can spread throughout your life like any other disease. It will eventually affect finances, careers, relationships, and ultimately, your health. Addiction can also lead to adverse consequences such as problems with the law or infectious diseases. Your life is worth the cost of treatment if you are suffering a substance use disorder.
Understanding how insurance works for this type of matter is challenging, but there are a few simple steps to be aware of that can make paying for addiction treatment easier.
The two basic categories of insurance providers are private and federal, and the quality of care can differ vastly between the two. A federal insurance provider, for example, would be Medicare and Medicaid. Government-funded insurance providers are much easier to qualify for, but the quality of care is less than what you’d receive from private insurance. Federal insurance plans are accepted only in select treatment programs and government treatment providers.
Private insurance is the complete opposite. It is independently funded and offers coverage that is more expensive. The problem is that private insurance is more challenging to qualify for than federal options. Private insurance is more comprehensive and allows for more options, and most high-quality addiction treatment centers accept the majority of private insurers.
If you have private insurance, there is a greater chance of being covered for at least a portion of addiction treatment. Throughout the United States, there are several thousand options for treatment centers. Private insurances tend to have better coverage for treatment centers than the options offered in federal packages. It is in the insurance companies’ best interest to choose the most effective treatment method so you will not require multiple visits.
Treatment is not a one-size-fits-all solution. When a medical team examines the unique requirements of the potential client, it may determine a specific set of treatment and therapies that will be the most beneficial to the person being treated. This does not translate into everything being covered. For this reason alone, it is necessary to speak with an insurance representative when deciding which treatment programs to pursue. You also are advised to speak with medical professionals and addiction specialists to get their opinion as well. They will guide you in the right direction whereas insurance companies will drive you into the most cost-effective direction.
Those who do not have private insurance may apply for federal assistance. Federal assistance is a good alternative if you’re ready to take the next step to a better life. However, the best quality treatment you will find is through a private insurance carrier, but getting the help you need must be the top priority to getting back to a healthy life.
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When you are looking into what is explicitly covered by your health insurance company, it is necessary to note that it will differ from one policy to another. Health insurance companies thoroughly check treatment centers to review how effective they are. They do this by looking into the track record of a facility’s results, and their methodologies are backed by science. Some of the factors they will consider when approving a treatment center are:
There are many addictions throughout society that don’t relate to chemical substances like drugs or alcohol. There are addictions to the internet and food, which are caused by behavioral issues. The research, however, has focused strictly on substance use disorders that involve psychoactive drugs. Insurance companies tend to approve more inquiries that relate to drugs because there is more proof of need. This is not to denigrate any other addiction. All addictions can lead to serious consequences and destroy someone’s life, but insurance companies follow science.
Some substances have traits that make them more addictive than others. This is especially true for meth, heroin, and alcohol. There are also prescription drugs that make their case statistically speaking. Other drugs like marijuana and psychedelic drugs with lower thresholds for addiction may be more difficult to have covered by insurance.
While these still do hold the potential for addiction, they are not categorized as highly like the more illicit substances mentioned above. While it is not impossible to get help for marijuana, it is just harder to prove the case.
Drug withdrawal, infectious diseases, and medical conditions related to addiction are typically covered by insurance companies at least partially if not entirely. Having a specific medical need will require that a more intensive approach is taken. A medical detoxification or inpatient service is necessary for treatment, and those medical needs will be fulfilled by these levels of treatment. When going to treatment for a substance use disorder that involves barbiturates, benzodiazepines, or alcohol will likely be covered because of the risk of deadly withdrawal.
Evidence-based treatment is a series of therapies and methodologies proven credible and effective by science. These therapies can be used in a variety of settings. This is useful if an individual can participate in outpatient treatment rather than the traditional residential. While alternative options have helped many people, evidence-based treatments are backed by science and boast the highest percentages of successful results. Insurance companies want to see that a treatment center uses cognitive behavioral therapy.
As mentioned earlier in this article, treatment is not a one size fits all solution. Each individual has unique requirements that will factor into the length of their stay as well as the various therapies they receive. Time spent in substance abuse treatment is an important question when it relates to effective addiction therapy.
Clients who spend a minimum of 90 days in treatment will reap the benefits of higher success rates, according to the National Institute on Drug Abuse (NIDA).
The length of substance abuse treatment that is covered will depend on your needs, but addiction treatment centers should work with the health insurance company to ensure you get the help you need and for as long as you need it.
If you or someone you care about is struggling with an addiction to alcohol or drugs, there is no cost too high for saving your life or the life of a loved one.
Seeking out treatment before it’s too late should be the main priority because when it comes to payment, but options are always available.
At Family Recovery Specialists, we offer in-depth care and provide a seamless transition from medical detox to ongoing addiction therapy. Our compassionate, professional team of doctors, clinicians, and staff will work to provide the resources, support, guidance to help you or your loved one take back your life from addiction.
National Institute on Drug Abuse. (n.d.). Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine) from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral
National Institute on Drug Abuse. (n.d.). Drug Addiction Treatment in the United States from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/drug-addiction-treatment-in-united-states