Does Health Insurance Cover Drug & Alcohol Detox Services
Medically Verified: 2/1/24
All of the information on this page has been reviewed and verified by a certified addiction professional.
Addiction is a serious and urgent medical condition for which you need medical treatment and support in order to ensure an effective and safe recovery. Professional addiction treatment guarantees your safety throughout the detox program and increases your chances of retaining sobriety and making a full recovery from addiction.
Unfortunately, for many, the high cost associated with attending a reputable rehabilitation program can be discouraging. If you are considering seeking treatment for your drug or alcohol addiction and are trying to work out how to cover the costs you may be wondering, does health insurance pay for detox?
Will Health Insurance Cover Drug & Alcohol Detox?
Fortunately, the answer to this question is yes. Of course, there are always exceptions but, generally speaking, your health insurance will provide coverage for drug and alcohol detox.
The Affordable Care Act (the ACA or “Obamacare,”) is still currently in effect in the US. The ACA requires carriers to treat drug abuse treatment prevention as essential health benefits. Therefore, all plans bought through your state’s ACA marketplace are subject to this law and are required by law to provide some level of coverage. How much coverage you get will vary from plan to plan.
Similarly, if you are insured privately or through your employer, it is hard to anticipate whether or not insurance carriers will honor the Mental Health Addiction Parity and Equality Act of 2008, which also required insurance carriers to provide equal coverage for drug abuse treatment. But they are required by law to do so.
This parity law applies to both private health insurance companies and Medicare/Medicaid. Though the details and level of coverage will vary from state to state, if you are enrolled in your state’s Medicaid program you should be able to obtain significant insurance coverage for your time in detox.
If you run into issues obtaining coverage, or if your insurance denies your initial claim there are many steps that you can take in order to obtain coverage. It is important to remember that you are entitled to this treatment under the law, since detox can prevent the occasionally fatal side effects of withdrawal it is a medical necessity.
How Much Coverage Will I Get?
The level of health insurance coverage for detox will vary from plan to plan. Depending upon your insurance company and which plan you have, you may pay for nothing or for most of your stay in detox.
Other factors that might affect the cost of your stay include:
- Length of stay
- The nature of the treatment program (whether it is inpatient or outpatient)
- Receiving medication as a part of MAT (medication-assisted treatment)
- How many times you have attended a detox or rehab program
- The additional services you receive (like one-on-one counseling)
- Whether you have exhausted your health insurance company’s plan limits
If you are considering a stay in detox and need to obtain health insurance coverage for your stay, admissions counselors can sit down with you and help you to determine what level of care is right for you based on your situation. Once you know exactly what kind of program you are looking for you can better determine the price and subsequent health insurance coverage for detox that you may be able to obtain.
How to Get Insurance Coverage for Detox
Your drug rehab will have professionals on sight who are well-versed in navigating health insurance claims. They can be an incredible asset to you as you try to work out your health insurance plan’s coverage terms.
Bring your summary plan description (SPD) to any meetings you have with staff. This document will contain your health insurance provider’s terms of coverage and specific plan details. However, it is important to remember that this document is not comprehensive.
As you move forward and professionals at your rehab center help you to navigate the billing process, you may discover fine print terms, such as limits to the number of days you can attend a detox center or the number of treatments you are entitled to receive.
If at any point you feel you are being denied coverage for treatment unfairly, all insurance providers provide an appeals process. While one would hope to avoid a dispute, it is important to get the coverage you need.
Get The Help You Need Today
Don’t wait another day to get started in the process of recovering from your drug and alcohol addiction. Contact us at Charlotte Detox Center and take the first steps on your road to recovery.
The compassionate, knowledgeable professionals at Charlotte Detox Center can work closely with you to help maximize your plan benefits and to make certain that you get the absolute best coverage you can to pay for the highest caliber of care. Call today to get started.