Why Some Health Insurance Won’t Cover Drug Rehab

The United States has the highest rates of drug addiction in the world. This is because, despite the fact that over two million Americans are addicted to substances like opioids, cocaine, amphetamines, cannabis, hallucinogens, inhalants and prescription drugs (NIDA), it can be very difficult for addicts to get into drug rehabilitation treatment at all. Although there are many reasons for this, one reason is that some health insurance companies refuse to cover drug rehab or charge significantly more than others do for their coverage.

Why won’t some Health Insurance cover Drug Rehab?

As far as it is known, there are three main reasons why some health insurance companies refuse to cover drug rehab or charge significantly more than others do for their coverage. The first reason is because, generally speaking, addiction to illicit drugs like heroin and cocaine is considered less of a medical necessity than addiction to legal substances like alcohol. Second, because the majority of patients who suffer from substance abuse problems will relapse at least once before they can beat their disease, health insurance companies view the drug rehabilitation process as a chance to save money. The final reason why some health insurance companies refuse to cover drug rehab or charge significantly more than others do for their coverage is that, although it can be very effective, addiction treatment is not considered a medical necessity by insurers because there are no guidelines from the National Institute on Drug Abuse (NIDA) which outline who should receive treatment and how it should be administered.

How can you know if your Health Insurance can cover drug rehab?

If you want to know if your health insurance can cover drug rehab with no problems, the best way to find out is to contact them directly and ask. If you are part of a group or family plan, it may be worth asking everyone in your household if they have had to pay for drug rehab in the past because, although the issue is an individual one, many companies will apply their pricing policy based on how much each member has paid in total. Also, when speaking with the company about your health insurance and drug rehab, it is a good idea to ask what the criteria for addiction treatment is and how many times you can go through the process before you have to pay for it yourself.

How much does health insurance cover for Drug Rehab?

In general, most health insurance companies will not pay for more than one trip to drug rehab. As a result, if you have been hospitalized because of your addiction the odds are that you will have to pay for any future treatment yourself. In some cases, however, it may be possible for addicts who relapse more than once to re-enter rehab at little or no cost as long as they do not go over their coverage limit.

What alternatives are there?

If you are an addict looking to get into drug rehab, it may be possible for you to decrease your out-of-pocket costs by signing up for a high deductible health insurance plan. However, before doing so, it is important to understand that this will increase the amount of money you have to spend on medical care in general so if your addiction is serious, it may be better to pay for addiction treatment out of your own pocket. This said, if your addiction is not very strong and you are more likely to be hospitalized with a cold than an overdose, high deductible health insurance may help you avoid thousands in medical expenses each year without increasing the risk that you will relapse and require drug treatment.

How can you find a Health Insurance that covers Drug Rehab?

There are several ways to find a health insurance that covers drug rehab. The first step is to speak with your employer and find out if they offer group health coverage; most do, especially if it is for full-time staff members. If you want to go through the private sector you can use resources like the Health Insurance Marketplace to find a comprehensive high quality plan which will have lower out-of-pocket costs and a better chance of covering drug rehab. Ultimately, the decision to refuse coverage for drug rehab or charge a lot more than others do is up to each health insurance company. Before signing up with a company that refuses to pay for your drug treatment, you should consider how severe your addiction is and whether it would be cheaper in the long run to pay for addiction treatment out of your own pocket or go with a company that doesn’t mind paying. For more information, call us today at 833-364-0736!