Does My Insurance Cover Rehab Programs

As of the year 2014, the Obama Administration passed the Mental Health Parity and Addiction Equity Act (MHPAEA). This section of the Affordable Care Act, regularly referred to as Obama Care or the ACA was legislated by Congress in the year 2008 and necessitated insurance firms to cover substance abuse and mental health treatment programs to the same degree that they cover other healthcare services like heart disease.

This means that insurance firms are required to cover at least part of an individual’s substance abuse treatment. For now, insurance firms are not allowed to withhold coverage to pre-existing conditions, including substance abuse disorders.

H2: Private Insurance for Addiction Treatment

For individuals who are covered by private insurance firms or those who are covered by their employers, the Affordable Care Act mandates at least partial coverage of these services. Although, it’s important to know that insurance will not cover 100% of the treatment.

It is also essential to know that your insurance most likely will not cover every single treatment facility or option, you will likely be required to ensure that the rehab program is in-network (this means accepted by your provider) with your insurance.

From that point, you will be required to firstly cover a co-pay, deductible. And/or out-of-pocket maximum, after that your insurance will cover the remainder. Understand that your insurance firm may still cover a portion of certain treatments.

H2: COBRA in the Event of Job Loss

In an unfortunate occasion where you lose your job but still want to hold on to your health insurance, the Consolidates Omnibus Budget Reconciliation Act (COBRA) has you covered. Your previous employer will notify you if you are eligible for the program. If you sign up, you are responsible for paying for your entire health insurance plan including the percentage your company used to cover.

Unless your ex-employer modifies the healthcare plan at the company, you will be able to continue receiving the same benefits. Meaning that you should still be able to access substance abuse and mental health treatment under your insurance.

Although the ACA has made substance abuse and mental health treatment essential benefits of health insurance, ensure that you precisely understand what your insurance covers. You can learn more about COBRA on their website, and also you can check what exactly your insurance plan covers on your provider’s website, or just dial the number on your health insurance card.

Using Public Insurance Like Medicaid

For individuals eligible for Medicaid coverage, it is possible that substance abuse treatment is covered by the state-level program.

Although, federal Medicaid coverage lists fundamental medical services, while the state run programs will provide more detailed information regarding services that are covered.