Affording Addiction Treatment

Paying for Addiction Treatment

There are plenty of barriers between people who need addiction treatment and the services that will lead them to meaningful recovery. However, two of the most significant concerns people have are the cost and finding the right addiction treatment program for their individual needs. However, cost shouldn’t stop your path to recovery. Addiction doesn’t only affect your health. It affects multiple aspects of your life including your relationships, finances, and your ability to maintain an income. If you don’t get the help you need to take back your life from the oppression of addiction, it may cost you your health, your money, and your relationships.

Becoming free from active addiction is invaluable. It not only means saving your life, in many cases, it also means having the freedom to pursue a productive life free from the burden of compulsive substance use. Because effective addiction treatment is so valuable, the cost should never deter you from getting effective addiction treatment.

Throughout the 20th century, we have learned more about addiction and we’ve come to understand that it is a complex and chronic disease. Furthermore, it’s a disease that can be treated with a variety of treatment options. With this discovery and America’s current opioid epidemic, insurance companies have also come to consider that addiction is a complicated but treatable disease and most private insurers cover addiction treatment.  

Still, insurance coverage is always difficult to navigate and insurance for addiction treatment is no exception. But at New Perspectives, we are committed to making the process of financing your recovery as simple as possible. Continue reading to learn more about financing options, how to get help navigating insurance coverage, and what insurance companies usually cover in addiction treatment.

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Substance Abuse Insurance Coverage

Addiction treatment comes in a wide variety of options. With the addiction epidemic continuing to wreak havoc with no signs of stopping, clinicians, researchers, and other professionals in the field of addiction treatment are working to come up with new ways to treat addiction. Plus, there are also dozens of existing treatment options all with varying degrees of effectiveness. While it’s true that most insurance companies cover addiction treatment, they might not cover every type of therapy or every type of treatment center.

Some treatment centers already have relationships with insurance providers and it will be easier to get treatment at that center rather than a facility that is otherwise unknown to your provider. That doesn’t mean out-of-network facilities are off the table. You still may be able to get coverage at another facility if you believe that it would be a better fit for your need. However, your insurance company will need to evaluate that facility to determine that it meets their qualifications. Your insurance provider will look at a number of factors including:

  • The type of treatments it provides
  • Whether it is in-state or out-of-state
  • Whether it is privately or publicly funded
  • and other factors

Again, you don’t have to navigate insurance coverage on your own. You can find help from your doctor, your insurance provider, and the facility in which you are interested. But it’s important that you also investigate what type of treatment center would be best for your needs. At New Perspectives, we are dedicated to helping you not only navigate your insurance plan and what it covers but also understand the type of treatment that is ideal for you.

What Is Covered?

Different insurance companies may have different policies concerning addiction treatment coverage. Though they often look for similar things, like a reputable treatment center, treatment models grounded in scientific research, and a clear need for treatment, they may cover you at different points in the treatment process. Generally, insurance companies will cover the complete continuum of care, especially for highly addictive drugs. The continuum of care includes:

  • Medical detox, the highest level of care in addiction recovery. This includes 24-7 medically monitored treatment. As the highest level of care, insurance companies look for a clear medical need. Some drugs cause uncomfortable withdrawal symptoms but have a low risk for medical complication and some insurers will try to avoid covering you for detox.
  • Inpatient services and partial hospitalization are the second highest level of care. This level also involves a clear medical or psychological need. It will also offer intensive clinical programs designed to help you get to the root of your addiction.
  • Intensive outpatient programs offer more than nine hours of clinical services every week but allow clients to live at home. This is an ideal level of care for people who need intensive clinical services but their medical, psychological, and cognitive needs are manageable on their own.
  • Outpatient services are the lowest level of formal treatment. This is ideal as the last stop on the continuum of care after higher levels are completed. It involves less than nine hours of clinical services.

When deciding on whether or not they will cover and treatment center or clinical service, insurance companies will look for two specific things. The first is the use of evidence-based treatment modalities. This refers to therapy options that are backed up by research and can be reproduced in a number of clinical settings.Behavioral therapies are generally the most recommended therapy option for addiction treatment.

Second, insurance companies look for progress. They want to see a record of positive progress and success from a treatment center. If you aren’t making any progress in a treatment center, they may try to discontinue covering treatment at that facility.

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