How to verify that your insurance will cover drug rehab and what to do if they turn you down
Sometimes it seems the hardest part of entering drug rehab is not gathering your courage to take the leap into sobriety or arranging for your responsibilities to be covered while you are in treatment. Instead, the greatest challenge often is getting your insurance to cover the cost of rehab. Some of the most common questions we hear from people struggling with substance abuse are not about treatment options, but about payment. If you’ve been wondering these same questions: “Will my insurance cover drug rehab? What can I do if they turn me down?” we have some tips and strategies that you can use to insist that your insurance company meets their financial obligation so you can get the drug rehab treatment you deserve.
Believe that you have a right to insurance that covers substance abuse
The federal government recognizes that mental and behavioral health services are essential health benefits, so your insurance plan probably includes coverage for treatment. 43 states have laws requiring commercial group health insurance plans, including managed care options, to cover substance abuse treatment (every state except Arizona, Georgia, Idaho, Indiana, Iowa, Oklahoma, and Wyoming).
The National Alliance for Model State Drug Laws can help you find out the laws in your state.
Be prepared to be persistent and fight to get treatment covered
Even in this enlightened time, when it is well established that addiction is a medical condition and there should be no stigma attached, you may feel reluctant to fight for coverage for drug and alcohol addiction treatment for yourself or a loved one. Remember there is no shame in seeking help for substance abuse, and wade into the fray to get the care that you deserve.
Hold your insurance company accountable
Although insurance companies are required to comply with state laws governing payment for drug rehab treatment, many of them incentivize their employees to deny coverage for substance abuse. If your insurance covers treatment for drug addiction but you are still being denied authorization for treatment, don’t give up! You have paid for this coverage, and the insurance company is obligated to provide it. Here are some strategies that will help you access to the benefits your insurance company should provide:
- Read your employee handbook carefully so you know exactly what your coverage entails
- Document all interactions with your insurance company regarding treatment, and keep copies of all correspondence.
- Go straight to the top. As part of their strategy to wear down their subscribers so they give up on trying to get coverage, insurance companies sometimes will send you from one department to another, without ever sending you to someone who can actually approve the cost of treatment. Find out the top officer in your insurance company and send an email with all of your associated documentation. Follow up by mailing a hard copy by certified mail.
- Ask for assistance from your state or local legislator. He or she may be able to intervene If you still are not having any success getting treatment approved.
Don’t delay treatment
The fight with your insurance company can stretch out into weeks and sometimes even months as they fight and delay to avoid providing coverage. In the meantime, your or your loved one’s addiction is not in limbo, it is continuing to damage the mental, physical, and emotional well-being of the addict. Drug addiction gets more serious and difficult to treat the longer it goes on. Your best choice may be to use a private payment method. Some drug rehab treatment centers will work with you with monthly payment plans and other creative funding methods so you can get the treatment you need now.
If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.