Does Insurance Cover Rehab in Austin, TX?

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Call 1-866-461-1759 to speak with BRC Recovery Admissions Specialist today.

The Cost of Rehab

If you’ve made it past the intervention stage of addiction recovery, then seeking treatment will be the next mark. The cost of rehab is revolved around:

  • The Type of Center – The cost of housing and intensive care are typically higher.
  • Treatments offered – Those who require more care tend to pay for more.
  • Amenities – Such as tennis courts, gourmet meals, and massages add to the cost. Luxury or well-established facilities can charge thousands by the month.

The cost of drug rehab can vary by facility and the type of program. Insurance will be the main resource to pay for rehab. Financing options without insurance is possible for patients. The cost of rehab is one of the reasons why some individuals might not receive treatment. Some treatment options are free while others require up to $1,000 per day. Rehab insurance can be provided through Medicaid, Medicare, private insurance, and state-sponsored insurance. The Affordable Care Act has included measures that prioritize addiction treatment. 

The cost of each treatment can be seen in the following:

  • Detox – On average, $1,000-1,500 in total for outpatient detox. Inpatient rehabs will typically include the cost of detox within the fee.
  • Inpatient Rehab – Costs can rise up to $6,000 for a 30-day program, with more established rehab programs costing up to $20,000 for a 30-day program. 60-90 day programs can range from $12,000 to $60,000.
  • Outpatient Rehab – The fees vary but you can expect to pay up to $5,000 for a 3-month program, even $10,000 at certain facilities. The total cost will be determined by how long you stay and how often you visit per week.
  • Medications – Since each case may not require medication, costs can raise several thousand dollars per year. These medications are commonly administered to opiate and alcohol withdrawals.

What Else Should I Know About Rehab Insurance?

It’s important to research the facility you are going to receive treatment from, such as the accreditation. If your financial needs aren’t promising, it would be best to check for free or low-cost drug rehab, however, these facilities often have limited funds and long waitlists. Contact your insurance provider or doctor to uncover any alternative treatment options. 

Non-profit organizations are available to provide treatment for those cases that require additional support. Programs such as these are targeted at anyone who needs care. The Salvation Army is a notable example. There are state-funded low-income addiction programs available as well.

Addiction treatment should be recognized as an investment because the cost of not receiving treatment can become more drastic. Imagine losing your possessions or entering a critical accident from substance use-related circumstances. It’s crucial to be honest about the true cost of your substance use disorder, as your long-term health can raise everyday costs.

Does Insurance Cover Rehab And If So, What Does it Cover?

Substance use disorders are a growing concern in the United States. Insurance coverages for addiction treatment were adjusted through the Affordable Care Act which declassified addiction as a pre-existing condition. Through the Health Insurance Marketplace, a patient can expect to compare plans similar to private insurance companies. Addiction is a treatable disease through a series of therapies, counseling, and determination. 

Under the ACA, plans in this marketplace must provide care in 10 essential categories which include addiction. Mental and behavioral health services are considered essential. This marketplace may not deny your coverage or raise the price due to pre-existing conditions. 

Luckily, the coverage for your pre-existing conditions will begin on the start date of coverage. There are no yearly or lifetime limits to the coverage of any essential health benefit.  The limits applied to mental/behavioral health services can’t be more restrictive than the limits of medical/surgical services.

What Does ACA-sponsored Insurance Cover?

Under the Affordable Care Act, these insurance plans may cover:

  • Brief interventions
  • Home health visits
  • Clinic visits
  • Addiction evaluation
  • Addiction treatment medication
  • Anti-craving medication
  • Family counseling
  • Medical detox programs
  • Aftercare

The ACA has provided millions of uninsured Americans with plans. According to the Addiction Center, the ACA has provided 32 million Americans with access to substance abuse treatment. This accessibility has caused addiction treatment costs to reduce, extending funding to new health centers, and providing employer-based insurance options. There are many addiction treatment centers that accept ACA-sponsored insurance plans.

The ACA-sponsored plans are designed to insure a combination of factors:

  • Bronze Plan – 60% of expenses covered
  • Silver Plan – 70% of expenses covered
  • Gold Plan – 80% of expenses covered
  • Platinum Plan – 90% of expenses covered
  • Catastrophic Plan – 60% of expenses covered

You may qualify for ACA-sponsored insurance if your income is between the federal poverty level or 4 times the federal poverty level. If you’re 26 and under, you may still qualify to be under your parent’s insurance. These plans are extended to those under the age of 30 or other extenuating circumstances. After you create an online account and complete the application on healthcare.gov, reach out to your representative for available plans.

Does Medicare and Medicaid Cover Addiction Treatment?

So, let’s say you’ve made the decision to seek addiction treatment after 8 years of alcohol addiction. If you are experiencing financial hardship, see if you qualify for Medicare or Medicaid. You may qualify for both if the circumstances permit. Reach out to your local agent to determine what benefits you may be eligible for.

Medicare is a monthly premium for individuals over the age of 65 or with disabilities. Medicare can cover the costs of inpatient and outpatient addiction treatment. The four main parts of Medicare include:

  • Part A – covers the cost of inpatient rehab, up to 60 days without co-insurance. Those under Part A must pay a deductible with up to 190 days of inpatient care within a lifetime.
  • Part B – covers the cost of outpatient rehab, eligible for up to 80%. Therapy, medications, treatment for co-occurring disorders, and professional interventions are covered in Part B. 
  • Part C – Is designed for those who wish for additional coverage through private insurance. This may pose out-of-pocket costs and coverage could be more expensive.
  • Part D – Is designed to cover the cost of prescription medications, which can increase the chances of remaining sober. Withdrawal symptoms are recurring throughout the addiction recovery process.

Medicaid and Medicare are commonly used to pay for drug and alcohol rehab statewide. These healthcare programs may pay for all or part of your addiction treatment. With the growing recognition that addiction is a treatable disease, support has flooded in for treatment. Eligibility and treatment coverage for these programs may vary across states, so it’s important to confirm. 

Medicaid may cover the following:

  • Interventions
  • Screenings
  • Maintenance and craving medications
  • Family counseling
  • Inpatient care
  • Long term residential care
  • Outpatient care
  • Detox
  • Additional mental health services
  • Family counseling

The Importance of Addiction Treatment And Rehab Insurance

States can manage costs through affordable treatment options for their citizens. State-based plans can offer more structured support to those struggling and deviate costs from other programs such as incarceration. Emergency room costs and other services can drive up the debt, alongside the rising cases of addiction. If states take a more proactive approach to addiction treatment through assistance programs, recovering individuals can increase their fighting chance with immense support.

2020 has been a challenging year, with the highest rates of substance use-related overdoses. Declining mental health and uncertainty have been the fuel to the fire. The new healthcare laws and online resources have enabled many uninsured individuals to receive treatment, which used to be a privilege. Seeking help for addiction can be a phone call or Internet search away. There is hope for growth as the battle against these obstacles continues.

BRC Recovery Is Here For You

With addiction rates on the rise in the US, seeking treatment has become a prevalent tool as cases begin to flood. Addiction treatment should be affordable and accessible to those working to ensure progress for themselves. BRC Recovery is dedicated to your needs and yearns to be the rescue boat in the sea of troubles. If you or a loved one are struggling with addiction, feel free to contact one of our facilities. 

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308192/

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