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Addiction Treatment & Insurance: 5 Questions You Need To Ask Before Enrolling In A Plan

By Acqua Recovery on December, 4 2020


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Have you or a loved one been struggling with substance abuse? Many people use their financial situation as an excuse to avoid seeking residential addiction treatment, but it doesn’t have to be a barrier. The truth is, the affordability of treatment programs often depends on your health insurance plan. So, with the holidays right around the corner and the open enrollment deadline of December 15 approaching, now might be a good time to take a look at your own situation. At Acqua Recovery, we understand the overwhelming feeling of enrolling in a health insurance plan while struggling with addiction. Whether you’ve been to addiction treatment before or are now considering it, we can help you choose a plan that’s best for your needs! Here are 5 questions you should ask yourself before enrolling into a health insurance plan for 2021:

1. Where Should I Look to Enroll in a Health Insurance Plan for Addiction Treatment?

First and foremost, how do you find and compare insurance plans? Some individuals are covered through private insurance companies. This means that their plan is offered through a private entity rather than the government — such as an employer. If this is the case, you would need to enroll directly with the designated health insurance entity. I.e., talk to your manager or HR. 

If you don’t have private health insurance, you can shop and compare plans in the Health Insurance Marketplace online. It contains all insurances offered through the government. Here, you can see monthly payments per plan and detailed benefits that each insurance offers. The website even has a tool you can use to compare multiple insurance plans and their premiums. A premium is the monthly amount you pay to the health insurance company. Generally, the more your premium is each month, the more the insurance company will cover.

2. Why Should I Consider Addiction Treatment When Choosing an Insurance Plan?

Even if you haven’t made the decision to go to residential addiction treatment yet, it is important to consider factoring it in when choosing a plan. Addiction is a disease, and just like any other disease, it continues to ravage a person unless that individual is treated. The sooner that necessary treatment comes, the better. You can prepare for saving your life or that of a loved one by choosing the right insurance. 

Yes, residential addiction treatment programs can be expensive, but choosing the right insurance will significantly lower the cost — or even pay for the addiction treatment program altogether. Maybe you or a loved one is saying, “I can stop on my own, so I don’t need to enroll in an expensive, high-coverage plan.” Remember, substance abuse needs to be treated professionally. It’s possible to beat it, but only with the right help. (Check out our Outcomes Report to see just how effective addiction treatment in Utah can be.)

Don’t allow your loved one to use health insurance enrollment — or anything else — as an excuse to put off addiction treatment. At Acqua Recovery, we will help them renew their perspective and come back to you living a better life in recovery. We accept most insurances, and even if you choose a health insurance plan that’s out-of-network, we will gladly work with you and your insurance company to try to make residential addiction treatment more affordable for you.

3. How Much Will My Health Insurance Cover for Addiction Treatment?

The ACA or the Affordable Care Act requires that all insurance companies must offer addiction treatment coverage to a certain extent. This means that all of the insurance companies you are comparing in the Health Marketplace cover substance abuse treatment, but it’s still a good idea to look at each plan’s benefits to see how much they cover. Each insurance company in the marketplace, for example, offers different levels of coverage:

Bronze - 60% coverage

Silver - 70% coverage

Gold - 80% coverage

Platinum - 90% coverage

This means that the insurance company will pay for that percentage of the full cost of an addiction treatment program. (After your deductible is met; Keep reading, we’ll go over this later.) The more you pay for the plan you enrolled in each month (your premium), the greater the overall coverage from the insurance company. That makes sense, right? In essence, you are paying your medical bills ahead of time with monthly installments.

Even if the insurance company covers the cost, though, how much time does that mean? Insurance carriers may try to end your addiction treatment program earlier than you’d like because they believe more time is “unnecessary.” They might even try to make you do outpatient treatment before they’ll pay for residential addiction treatment. Don’t worry: Our team is skilled at working with your provider to make sure you get the care you need — no matter how long it takes.

The more you pay for your insurance each month, the more likely your insurance will cover a longer stay. At Acqua Recovery, we fight for all our patients' lengths of stay because we believe your recovery process shouldn’t be rushed. You deserve to get the help you need.

4. What if I Can’t Afford My Premium?

As we know, most residential addiction treatment programs are expensive, but health insurance coverage is expensive as well. Before enrolling in a plan, check if you qualify for Medicaid or Medicare. If your income is below a given amount, depending on which state you live in, you can receive some monetary help or even full coverage of your monthly premium. (To find out if you qualify, you can call your state’s Health Insurance Marketplace.) 

Don’t worry, though: Even if you choose a plan with a lower percentage of coverage for addiction treatment programs, we can still help you find a way. At Acqua Recovery, our caring team will work with you to figure out a plan, because you should get the treatment you deserve — not just treatment you can afford.

5. Do I Need an Insurance Plan Without a Deductible?

When looking in the Health Insurance Marketplace, you will see that some plans have deductibles. This means that you personally pay for that given amount of health care expenses before the insurance company will begin paying their percentage of care — which can also be expensive. If you currently have health insurance, your current deductible has probably been met for the year already, meaning you’d pay significantly less for addiction treatment before it rolls over again on January 1. If this applies to you, don’t wait until New Year’s, when all deductibles start over! Get the substance abuse help you need now.

Even if you chose a health insurance plan with a deductible, call our admissions team! They can tell you if your deductible has been met and what percentage your health insurance will cover. 

While it’s great to choose a plan that will support your efforts in recovery, seeking residential addiction treatment takes priority. This is your life, and you can rediscover it through recovery. Matt, Brian, and Ashlee, our admissions team members, will work with you to get help sooner rather than later. We are dedicated to making your admissions process as simple as possible and also do everything we can to make addiction treatment affordable. At Acqua Recovery you or your loved one can now begin a bright new life — without drugs or alcohol. Reach out to us today.

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The Complete Guide to Paying for Addiction Treatment

The Complete Guide to Paying for Addiction Treatment

Deciding to get help for addiction is a process that can take years. If you’re at the point of readiness, don’t let yourself be derailed at the last minute by financial issues. Maybe you found an addiction treatment center you like, but you’re out-of-network. Or, maybe you don’t have insurance at all, and the price of treatment is too staggering. No matter your financial situation, it is possible to receive the substance abuse treatment you deserve. Don’t give up. Find out how you can afford residential addiction treatment with this ultimate guide to paying for treatment.

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