Now that the American Medical Association recognizes substance use disorder and alcohol use disorder as legitimate medical conditions, health insurance companies must recognize these diseases for coverage by their policies. The Affordable Care Act of 2008 and Mental Health Parity and Addiction Equity Act also empower heroin-addicted individuals to seek treatment by requiring health care benefits be provided for heroin rehab and substance abuse treatment to the same extent benefits are provided for other medical conditions.
The Affordable Care Act helps even more by prohibiting policy providers from denying coverage for substance abuse treatment. This means that even heroin-addicted individuals who are actively trapped in substance abuse can acquire health policies for coverage of heroin rehab treatment.
What Policies Cover for Heroin Rehab
Individual health policies vary according to the level of compensation they will provide, as well as for which services coverage is allowed. But most heroin rehab coverage includes compensation for one or more of these services:
- Addiction assessment – usually fully covered
- Detox from heroin – nearly entirely covered in many cases, with the exception of rapid or ultra-rapid detoxification methods
- Residential (inpatient) treatment – frequently partially covered
- Treatment on outpatient basis – often entirely covered
- Other medically necessary treatments or services – usually covered when proven “medically necessary”
By gaining a professional addiction assessment by a doctor or other trained addiction specialist, addicted individuals gain greater strength in their case for coverage of heroin rehab. This pre-rehab assessment is a big factor in the amount of heroin rehab paid for by health policy providers.
Investigating Whether Heroin Rehab Will Be Covered By Your Policy
To find out what your health care policy covers for San Antonio, Houston, or Austin heroin rehabilitative treatment, contact your health insurance provider. You should remember to have your policy information, such as group number and membership identification number available for this call. Take good notes during your conversation, even ensuring you note the name of the representative handling your questions.
Below are some things you should inquire about:
- “Levels of care” for heroin addiction treatment (such as assessment, detox, inpatient, outpatient, hospital based, partial hospitalization, etc.)
- In-network and out-of-network provider coverage, with percentages covered for each
- Out-of-pocket maximum
- Criteria for the policy provider’s determination of medical necessity
An Easier Method of Determining Health Policy Coverage of Heroin Rehab
There is an alternative to contacting your health policy provider. Instead, you can simply call the heroin rehab treatment center you’re interested in and ask them to determine what your policy covers for their programs.
San Antonio Recovery Center admissions representatives are ready to help you learn more about their programs for treatment of heroin addiction and how your health care policy can be used to cover the road to recovery. It’s imperative that you don’t wait to call for help.
Your health policy may provide for treatment in more ways than you expect. Call San Antonio Recovery Center today at 866-957-7885 for more information.