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Affordable Care Act

Under the Affordable Care Act, addiction is no longer considered a pre-existing condition for insurance purposes. In addition, the act required insurance companies, including Medicare and Medicaid, to include addiction and mental health benefits as part of their insurance benefit plans.

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An Introduction to Affordable Rehab

One of the biggest concerns you may face after deciding to seek addiction treatment is how to pay for treatment. While the overall cost of rehab will vary depending on your unique treatment needs and the type of program chosen, it can be costly. However, it is essential to remember that the cost of treatment is inevitably far less expensive than the price (financially, emotionally, physically, and often legally) of chronic addiction. The team at My Recovery knows there are affordable treatment options for everyone and will work with you to help ensure you learn more about them. Although committing to an addiction treatment program may bring about financial concerns, addiction treatment is an essential first step to attaining and maintaining long term sobriety and recovery. 

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Obamacare

An Overview of The Affordable Care Act and Drug Rehabs

Before 2010 and the passing of the Affordable Care Act, paying for addiction treatment was often far more complicated. Insurance companies could limit or entirely omit addiction and mental health treatment services from their benefit plans. In other cases, addiction was labeled a “pre-existing condition,” therefore making it something the insurance company did not need to cover. Prior to 2010, many people who needed addiction or mental health treatment were unable to get essential care because it was financially impossible. 

In 2010, the Affordable Care Act (also known as Obamacare) passed provided vital options to help people pay for addiction treatment. Under the Affordable Care Act, addiction is no longer considered a pre-existing condition for insurance purposes. In addition, the act required insurance companies, including Medicare and Medicaid, to include addiction and mental health benefits as part of their insurance benefit plans. Under the Affordable Care Act, mental health, behavioral health, and addiction treatment services are viewed as essential health benefits. All Health Insurance Marketplace plans must cover behavioral health treatments, mental and behavioral health inpatient services, and substance abuse disorder treatment. 

Today most rehabs across the nation accept insurance as a way to pay for addiction treatment. The coverage level will depend on the type of rehab and the type of insurance you have, so it is essential to make sure you confirm your benefit information before committing to a specific addiction treatment program. The team at My Recovery can help you find a rehab that works with your insurance and will work to ensure you understand your coverage, so there aren’t any unpleasant billing surprises at the end of treatment.

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Does the Affordable Care Act Help Me Pay for Rehab?

The Affordable Care Act sponsors insurance plans which can be purchased through the Health Insurance Marketplace. These programs provide benefits for addiction and mental health treatment similar to those found with private insurance.  As previously mentioned, the Affordable Care Act also expands services for addiction treatment for those patients covered by Medicaid and Medicare. 

Under the Affordable Care Act, insurance companies are required to provide benefit coverage that is equal to that of any other medical procedure. For example, suppose the program would cover eighty percent of another procedure, such as treatments for a chronic heart condition. In that case, addiction treatment must be provided with the same coverage levels. With a plan purchased on the healthcare marketplace, you can expect coverage for a variety of addiction-related treatments and procedures, including:

  • Intake evaluations
  • Addiction treatment medications
  • Clinic visits
  • Alcohol and drug testing
  • Family counseling
  • Medical detox
  • Inpatient and outpatient treatment programs

The percentage of addiction treatment covered by an Affordable Care Act sponsored program varies. There are five types of plans available on the marketplace, and each provides a different level of expense coverage. The lowest tier is a Bronze plan, which provides sixty percent coverage and the highest level is a platinum plan providing ninety percent coverage. Silver and gold plans are also available with seventy and eighty percent coverage, respectively. 

Since 2010, the Affordable Care Act has provided over thirty million Americans access to vital substance abuse and addiction treatment. Many addiction treatment centers across the nation accept health insurance plans purchased on the Health Insurance Marketplace. If you are without health insurance, plans can easily be purchased online during open registration periods. In some cases, depending on individual situations, plans can also be purchased outside of the regular registration window (or “open enrollment period”).

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Mental Health treatment covered by insurance

How Does the Affordable Care Act Affect Mental Health?

Before the Affordable Care Act opened up insurance options to millions, more than forty-eight million Americans went without health insurance. A large majority of these were those with mental health concerns. The Affordable Care Act expanded access to insurance coverage for mental health care by mandating insurance companies, including Medicare and Medicaid, cover ten essential health benefits, including mental health (counseling and therapy) and prescription medications. Similar to coverage for addiction, the Affordable Care Act ended annual lifetime and benefit caps for mental health services. It also ensured plans could no longer deny coverage or impose cost barriers because of a pre-existing mental health condition. Studies have shown that the Affordable Care Act has provided greater coverage benefits among low-income adults with mental health conditions. It has also improved access to therapy and treatment or mental health patients who previously went without assistance due to cost restrictions. 

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Find Rehabs that Accept Affordable Care Act Sponsored Plans

Deciding to seek addiction treatment can be a difficult decision. For some, it will be one of the most difficult you will voluntarily make. Addiction recovery can be a long and challenging process. It is crucial to find the right rehab program as it will vastly improve your chances of getting and staying sober. Historically, rehab’s financial cost has forced many to forego much-needed addiction and/or mental health treatment services. Today with the benefits provided by the passing of the Affordable Care Act, paying for addiction treatment has become easier for many. However, not every program offers the same treatment program options or accepts every insurance plan provided on the health insurance marketplace. The team at My Recovery can help you determine which treatment programs in your area accept your insurance. If cost has prevented you from taking the first steps towards sobriety, call My Recovery today. 

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