When you or a loved one is struggling with addiction, seeking rehab is the first step to reclaiming your life. Rehab treatment at a qualified treatment center is crucial to ensure long-term success. Yet, rehab can be expensive. So, it is essential to understand your insurance benefits for rehab to ensure you maximize them.

Understanding Your Insurance Policy

Reviewing your policy is the first place to start when wanting to know what insurance benefits you have for rehab. Your policy will contain various information and details that can seem confusing. However, when you keep the following terms in mind, it will be easier to navigate your policy.

Coverage

Coverage is the amount your insurance will pay for rehab. This can be a percentage amount or a maximum dollar amount. The coverage limits will vary from one policy to another.

In-Network/Out-of-Network

All plans will have in-network providers with whom they have agreements to provide rehab treatment and services. Some insurance policies also have coverage for out-of-network providers. However, the amount covered by insurance could be less with an out-of-network provider.

Referrals/Preauthorizations

Some insurance companies require a referral or preauthorization before you can receive rehab treatment services. You may need to visit your primary care physician first to get the referral. For preauthorizations, you can ask the rehab center to request it on your behalf.

Copays/Deductibles

Most insurance policies will have copays and deductibles. Copays are payments you pay out of pocket for various services. For example, you may have a $25 copay for office visits. Deductibles are specific amounts that you must pay out of pocket. Once you reach your deductible amount, you have no more out-of-pocket expenses unless you exceed your coverage limits.

Types of Rehab Covered by Insurance

Most insurance providers include insurance benefits for rehab for various treatments and services. The extent of coverage can vary based on the plan and may include the following:

Detox
Mental Health Services
Medication-Assisted Treatment
Inpatient Rehab
Partial Hospitalization Programs
Intensive Outpatient Programs
Outpatient Programs
Holistic Therapies
Aftercare

Steps to Verify Your Insurance Coverage

There are different options and steps you can use to verify your insurance coverage for rehab. You could call your insurance provider directly and get assistance reviewing your rehab benefits. If your insurance provider has a client portal, you could also verify your benefits online.

Another option to verify your insurance coverage is to contact the rehab treatment center you are considering. You can speak to an intake specialist, who should be able to verify your insurance. They can also provide you with copays, covered services, and other helpful information.

Common Insurance Pitfalls and How to Avoid Them

When seeking rehab treatment for addiction, it is important to ensure you have taken the necessary steps before starting treatment. One common mistake is not choosing a facility your insurance covers. So, you want to make sure the facility you choose is an approved provider.

Another mistake people make is not getting a referral or preauthorization when required. It is easy to avoid making this mistake. Simply find out if you need a referral or preauthorization to use your insurance benefits for rehab.

Next, you will need to find out if there are any exclusions in your policy. Exclusions are certain services that may not be covered for various reasons. If you want excluded services, you must pay for them yourself. Otherwise, you can let the treatment facility know your insurance does not cover them, so you do not want them.

Lastly, there can be a limit on the duration of different treatments. For example, with inpatient rehab, they may be only covered for up to 90 days. However, other treatments and services may be covered for longer. They may also have no duration limits other than your coverage maximum.

Working with Your Insurance Provider

To maximize your insurance benefits for rehab, it is important to work with your insurance provider. Start by researching your insurance coverage to see what benefits are available. You can do this online or by calling your provider.

Next, ask for a list of rehab facilities that accept your insurance. This will help you narrow down your options much faster. If the facility you want to go to is out of network, ask what benefits, if any, are available.

Furthermore, ask if your plan has additional benefits, such as holistic, health, and wellness coverage. These services are often a part of a comprehensive addiction treatment program.

Supplemental Coverage Options

If you have supplemental insurance, like Aflac, it may provide coverage to help pay for rehab. For example, Aflac offers short-term disability coverage. If you are unable to work and are considered completely disabled due to addiction, you may qualify for this benefit. You need to check your supplement coverage benefits to determine your available benefits.

What to Do If Insurance Denies Your Claim

If your insurance denies your claim, you can dispute it. You can start by finding out why the claim was denied. Sometimes, it could be a simple error, like a diagnostic code wasn’t included.

Have the treatment facility refile the claim with any needed corrections. Your insurance will also deny claims for non-covered services or if you haven’t met your deductible. This is why it is important to fully understand your insurance benefits for rehab.

Making the Most of Your Rehab Coverage

Making the most of your rehab coverage starts by understanding your insurance policy and benefits for rehab. You should also choose a covered in-network facility to maximize the amount your insurance will cover and pay. It is equally important to ask questions to verify what services are covered and if any are not. Lastly, be aware of any copays and deductibles you may have.

Start Rehab at Ohio Addiction Recovery Center

Maximizing your insurance benefits for rehab at Ohio Addiction Recovery Center is easy. We are in-network with most major insurance plans. If you have commercial health insurance, rehab could be covered up to 100%. For further details and to verify your insurance benefits, contact us today.