A prospective patient should start by figuring out what benefits your insurance will cover.
- The first thing you should do is speak to a customer service representative with your insurance carrier. You should ask them to help you determine your eligibility for benefits.
- Be aware of the power given to you by the Affordable Care Act (ACA) – It states that substance abuse treatment is the same as any other chronic illness and that insurance policies mandated to have substance abuse benefits on their written policies. Some policies, such as certain unions or health and welfare funds are able to carve this option out of their package
- Once you’ve determined that benefit eligibility exists in your plan, you should contact our New Directions Admissions Office at (888) 786-0509. From there we can discuss with your provider about the benefits available for you, and help you determine the best option for your recovery program.
- Some providers may ask you to try a lower-level care program first, such as a part-time, outpatient program where you will attend 3-4 days a week, at 3-4 hours per session. This program may work with some people, especially those who are extremely career-oriented, but we always recommend an in-house care when available. This is determined by the principle of medical necessity.
- Certain addictions, such as alcohol or nicotine, may carry less medical necessity because their withdrawal symptoms are not as life-threatening as opioids or benzodiazepines.
- This does not mean that the lesser medical necessity conditions are any less dangerous than those with high medical necessity. You should seek professional care in any addiction circumstances.
- Deductibles, coinsurance, copayments and out of pocket limits may vary between the different carriers. Generally, the more you pay for a premium (annual bill for insurance), the less your other fees will be. We will outline these terms below:
- Deductibles – One time fees each time you use a service.
- Coinsurance – When an insurance will cover a % of the treatment, expecting the patient to cover the remaining balance.
- Copayments – When an insurance will cover the cost of treatment after the patient pays a flat fee.
- Out of Pocket Limits – The maximum amount you would be expected to pay for treatment in a given term, usually a year.
Image Creative Commons Attribution: cheapfullcoverageautoinsurance.com