Wondering whether addiction treatment is covered by insurance? It can be complex. Health insurance is key in providing access to necessary treatment. And it’s not just a financial matter but is a lifeline for those seeking to overcome addiction. While many insurance plans do provide coverage for addiction treatment, the extent and nature of the coverage can vary widely.
Read this overview about this key aspect in deciding where and what treatment centers can help you.
Does Insurance Cover Addiction Treatment?
Fortunately, with the Affordable Care Act (ACA), all eligible marketplace plans cover mental health services, as well as many group health insurance and private health insurance plans.
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 was a pivotal breakthrough in eliminating the stigma associated with addiction and mental health conditions. It increased access to help for millions of Americans.
It requires insurance plans that offer coverage for mental health and substance use disorders to provide those benefits at parity with medical and surgical benefits. So insurers can’t impose less favorable benefit limitations on mental health and addiction treatment than on medical/surgical services.
This includes financial restrictions, such as deductibles and copayments, and treatment limitations, such as the number of covered visits or days of coverage. While challenges and disparities still exist, the MHPAEA has laid the groundwork for a more equitable and accessible approach to addiction treatment
How Long Does Insurance Cover Rehab?
There is no one answer. Carefully review your coverage benefits. The specifics of coverage can vary widely between insurance providers and policies, including:
- Type of addiction covered
- Duration of coverage
- Extent of financial coverage
Nonetheless the trend is toward greater support for individuals seeking treatment for addiction.
Insurance Coverage and Different Levels of Care
Most insurers may ask their members to select from a small set of approved or “in-network” providers to ensure the treatment comes at a lower cost. They may also expect you to pick up certain additional costs such as premiums, “co-pay” costs and deductibles.
The variety of types of plans can be confusing, so read your plan carefully and consult your insurer to clarify any aspects of your policy. In general there are several levels of care [A]:
Fee for Service (FFS) plans are of two types: non-PPO (Preferred Provider Organization) and with a PPO.
Health Maintenance Organization (HMO) plans provide care through a network of physicians and hospitals in particular geographic or service areas. HMOs limit your out-of-pocket costs to the relatively low amounts shown in your benefit brochures. In an HMO, a Point of Service Product (POS) lets you use providers who are not part of the HMO network. However, you pay more for using these non-network providers.
Most health insurance plans now recognize the necessity of covering addiction treatment services, including:
| Type of Care | Description |
| Detoxification (Detox) | A medically supervised process to manage withdrawal symptoms |
| Inpatient rehabilitation | Hospital care |
| Partial Hospitalization Programs (/PHP) | Intensive program. A step-down from inpatient hospitalization. A higher level of support than traditional outpatient therapy |
| Outpatient programs | Therapy and counseling while living at home |
| Residential (Rehab) | Intensive treatment in a residential treatment center |
| Medication-assisted Treatment (MAT) | Use of medications in combination with behavioral therapies |
| Aftercare | Post-treatment services to prevent relapse |
Services covered under the ACA include:
| Addiction Assessment | Brief intervention | Addiction treatment medication |
| Clinic visits | Alcohol & drug testing | Home health visits |
| Family counseling | Anti-craving medication |
Affordable Addiction Treatment in Los Angeles
Choosing treatment is a brave thing to do. Effective treatment programs typically incorporate many components, with each targeted to a different aspect of the illness and its consequences. There are a variety of evidence-based approaches to treating addiction. The specific treatment or combinations depend on the person’s needs and on a medical and therapeutic assessment.
At The Encino Recovery & Detox Center we offer our relational model of care in a safe space. It was designed to re-introduce men and women to themselves, in a more loving way. Free from the negative effects of addiction and addictive behaviors that have led to unwanted consequences and loss.
The therapeutic relationships at The Encino Recovery & Detox Center promote ideas, creativity, connection, and long-term sobriety. These valuable relationships will help you or your loved ones find freedom from the long-term isolating effects of addiction. The mental health component consists of a team of licensed clinicians who run special therapeutic groups to meet the individual needs of each client.
We offer trauma recovery and the following evidenced based therapies:
- Trauma Focused Cognitive Behavioral Therapy (TF-CBT)
- Aggression Replacement Training (ART)
- Acceptance and Commitment Therapy (ACT)
- Dialectical Behavioral Therapy (DBT)
- Somatic Experiencing and Body Work
- 12-Step Program
- Mindfulness Meditation
- Exposure therapy
- Group experiences
Safe Recovery in Los Angeles
If you or a loved one is seeking a way out of substance abuse, private, confidential help is just a call away. Reach out to our Admissions team at The Encino now.
At the Encino Recovery & Detox Center in Los Angeles we don’t just treat addiction. We nurture the spirit, heal the mind and help you to regain your life. All in a safe space.
We provide medically supervised detox. After detoxing, you may enter our residential treatment center. Trained staff are equipped to offer clinical care. They will provide the support, guidance and interventions necessary for you to reach your treatment goals. Participating in residential care greatly enhances your success rate at avoiding relapses.
Sources
[A] US Office of Personnel Management (OPM). Plan Types.
