Can You Get Fired for Going to Rehab in Pennsylvania?

Does Insurance Cover Alcohol Treatment?

The prospect of seeking help might scare you more than addiction and giving up drinking. You’ve likely gone a day without drinking, and withdrawal was uncomfortable to say the least. Not only that, you might be concerned about leaving your job for a few weeks, what you’ll tell your family, or even how you’ll pay for it, but we’re here to tell you that none of that matters without your health. To answer your question – does insurance cover alcohol rehab – the answer is yes. 

In 2010, The Affordable Care Act (ACA) passed and changed how insurance companies cover drug and alcohol rehab. They are required to cover at least some of the costs. Many have asked – does medicare pay for alcohol rehab? The answer is yes – this applies to Medicaid/Medicare, and private insurance. It requires minimum coverage for the following:

• Substance and alcohol use disorder treatment
• Psychotherapy and counseling for behavioral health
• Mental and behavioral health inpatient treatment

Your specific behavioral health benefits vary state by state and depend on the plan you choose. Pre-existing mental and behavioral health conditions are covered, and spending limits are NOT allowed. Marketplace plans cannot deny you coverage or charge you more because you have a pre-existing condition, such as an alcohol use disorder. Coverage for treatment of your pre-existing conditions begins the day of your coverage, and marketplace plans cannot put yearly or even lifetime limits on any essential health benefits like alcohol use disorder. 

What Does Insurance Cover for Alcohol Treatment?

As was mentioned above, the Affordable Care Act requires insurance providers to cover treatment. However, these benefits will differ from state-to-state. Something covered in Pennsylvania may not be covered in California, for example. For that reason, it’s critical to review your benefits before seeking care. The following services should be covered by your health insurance include:

• Intervention
• Screenings
• Medically-managed inpatient care
• Medical detoxification services
• Addiction treatment
• Outpatient services
• Behavioral health care, including psychotherapy and counseling
• Treatment for co-occurring disorders

Additional services could be offered. However, again, will be dependent on your plan. These include the following:

• Care management
• Preventative counseling
• Peer support services
• Risk reduction interventions
• Intensive outpatient services (IOP)
• Inpatient hospitalization for short-term care
• Partial hospitalization programs
• Medication-assisted treatment (MAT)
• Follow-up counseling

The American Society of Addiction Medicine (ASAM) states that successful recovery requires the continuum of care to ensure the individual receives support immediately as they seek help and long after they’ve started treatment. With Medicaid or Medicare, you have access to free or low-cost alcohol addiction treatment. This includes long-term residential and inpatient treatment, and even family counseling. 

What Does Insurance Not Cover for Alcohol Treatment?

Unfortunately, not everyone has access to insurance. For those that do, not everything is going to be covered. If insurance deems a service not medically necessary despite it aiding in your recovery process, they will not cover it. Some of these services include the following:

• Holistic care services
• Non-medical amenities
• Food delivery
• Recreation programs
• Private treatment services
• Alternative therapies

Health insurance providers are not obligated to cover relapses either. If you do relapse, you will need to find alternative payment options. However, some plans will cover your alcohol rehab if you relapse. If you have a care manager that advocates on your behalf, it’ll help you get the coverage you need. 

How to Find Insurance for Alcohol Rehab

The first step that you can take to find insurance for alcohol rehab is to check your policy. Contact your insurance company and ask about the types of addiction treatment your policy covers. If you have a private insurance plan, it will have the most comprehensive coverage and cover what you need for alcohol rehab. The most common insurance companies that may cover rehab costs include Aetna, Blue Cross Blue Shield, Anthem, Cigna, Humana, United Healthcare, and more. 

I Don’t Have Insurance – Now What?

Unfortunately, despite the ACA making treatment accessible, there are still many that don’t have insurance coverage. It’s quite expensive to attend treatment without any coverage – but you still can. 

• Out Of Pocket: Alcohol rehab programs accept cash and will allow individuals to pay out-of-pocket. Paying for treatment without insurance is expensive, and if you py this way, it allows you to get the help you need without insurance. 
• Payment Plan: If you cannot pay for the program in its entirety, some treatment centers offer payment plans. 
• Credit Card: Fortunately, some treatment centers give you the option to pay with a credit card. There are also personal loans that can be taken to cover your treatment. 

Does My Insurance Cover Alcohol Rehab in Pennsylvania?

Again, we understand this is a troubling period. Not only are you dealing with addiction and the problems that come with it, but now you’re trying to navigate the world of insurance and how to seek help. If you aren’t sure what your insurance policy covers for alcohol rehab, you have options. Please fill out our confidential insurance verification form, and one of our admission specialists will determine whether or not your coverage is eligible. They will reach out to you immediately and provide you your options for treatment. 

As was mentioned above, you can also directly contact your insurance company to determine your eligibility. They will provide you with specific details about your policy. However, this can be a time consuming process, and with so much going on, we’re more than happy to contact them directly on your behalf.