Are Treatment Programs Covered by Insurance?


There once was a time when no insurance company covered any addiction treatment programs for any kind of addiction. When the Affordable Care Act (ACA) passed in 2010, health insurance companies were required to provide coverage for treatment programs. This meant that any insurance that was sold via the health insurance marketplace was required to cover treatment. They were required to cover treatment for substance use disorders, as well as behavioral and mental health conditions. In addition, the Mental Health Parity and Addiction Equality Act (MHPAEA) guaranteed that private insurance companies cover treatment to the same extent that they cover other medical concerns. The intention is to create a balanced coverage of all conditions.

The amount of coverage provided by an insurance company or a state plan may vary based on the company or the state. Each company has different plans that may provide more coverage than others. They may also have some plans that do not cover treatment plans at all. You must understand your coverage options. It is also possible that your insurance company covers part of the insurance but not all of it. You should not just assume that your insurance plan covers all treatment programs.

It is important to understand how the insurance may cover addiction treatment. There are various parts of treatment programs and all or some parts may be covered. These parts include inpatient care, outpatient care, detox programs, counseling, maintenance medication, and co-occurring conditions. If there are parts of your treatment that are considered no necessary, it may not be covered. The insurance company may determine that something is not necessary, even if you believe that it is. These items include gourmet food, recreational programs, holistic care, and other non-medical items. An insurance program may also decide not to cover a relapse. They may cover the initial visit to a treatment program, but not subsequent ones as a result of relapse.

There are still a large number of people that do not have access to insurance. The ACA went a long way to help millions of people access affordable insurance, there are still so many millions more that do not have it. For those that do not have insurance, some treatment programs are available at no fee. You may need to search for programs that offer programs for those with no or low-income situations. Substance abuse is a complex issue that is often severe and impacts a large swath of people from all walks of life. If you or someone you love has a substance abuse problem, please get help today. A substance abuse problem that is left untreated may decrease life expectancy and ruin relationships. Often people feel they have nowhere to turn, especially if they do not have a way to pay for treatment. Seek help for yourself or a loved one. There are options available, but you will not know about them if you do not ask. Check out to find more resources for assistance.


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