Using Insurance Benefits To Access Addiction Treatment

Seeking drug and alcohol rehab can be challenging in and of itself. The cost of the treatment and from having to take time off work can be one of the major factors preventing many people in need of this critical service from seeking the treatment they deserve. It’s important to understand what your options are available through your insurance, and what support you can get from your loved ones. Even though it may seem intimidating, it’s important to understand just how important sobriety is for your long-term health and financial well-being. At New Directions for Women, we want all of our women in recovery to feel happy and secure about their decision to pursue sobriety, which is why we want to walk you through the process.

Finding a rehab for pregnant women can be critical for many women who have children or are expecting one soon. These programs, such as New Directions, can offer women complimentary daycare services and educational services so women don’t have to worry about their children during their recovery, and can focus solely on getting better. Our women’s rehab in Orange County is a staple of our community, because we offer this unique service to the women who need it most.

A prospective patient should start by figuring out what benefits your insurance will cover.

1. 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.
2. 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
3. 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.
4. 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.
5. 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.

As a long-time women’s rehab in Orange County, we are aware of just how stressful, emotional, and scary the process might be for people who are just coming to terms with addiction. It’s uncomfortable to admit it to yourself, let alone talk to strangers over the phone about it. If at any point in the process your are confused, scared, or have any other difficulty in the process, we would be happy to help you. Simply give us a call at (888) 786-0509 and we will walk you through the process. The whole goal of our treatment plan is to take the burden, the stressors, and the triggers of addiction away from you, and teach you the coping skills you will need to handle them in the future. With this, you have the optimal chance at long-term recovery success.

Image Creative Commons Attribution: cheapfullcoverageautoinsurance.com