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Using Insurance to Pay for Treatment

Thanks to recent changes to health care due to the 2010 Affordable Care Act, health insurance, for many, is more confusing than ever. For those who are seeking treatment for a drug or alcohol addiction, the process can seem overwhelming. Understanding the use of insurance to pay for treatment, however, can clarify matters and make them less daunting. It is important to remember, in the end, that the treatment is what is most important because of the amazing benefits that can result from it.

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Insurance & Financing

Addiction treatment at Futures is often covered by most major insurance carriers.

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Many Effective Drug Treatment Facilities Do Not Accept Insurance

Despite the fact that drug addiction, according to the National Institute on Drug Abuse, is a diagnosable brain disease that is both chronic and recurring in nature, many drug treatment facilities do not accept insurance. In some cases, the facility may utilize holistic healing practices including acupuncture, hypnosis, or other mind-body-spirit disciplines that are not covered by insurance. In other cases, an individual may wish to seek residential inpatient treatment; however, their insurance company will only pay for outpatient care. Choosing a drug treatment facility that does not accept insurance does not mean that you cannot receive some benefits from your health Insurance. It is important to understand your specific health benefits because individual coverage plans can vary greatly. Perhaps your insurance plan will cover individual or group therapy, but they won’t pay for an inpatient room. By filing the insurance claims yourself, you may be able to receive reimbursement for at least some of the services you receive while you are residing in a treatment facility.

womenChoosing the Type of Treatment You Want

In some cases, when medical coverage does allow for inpatient drug treatment, there is a caveat that must be met prior to payment or funding. Specifically, some insurance plans require that the individual “fail” at least once, or even numerous times, in an outpatient treatment setting prior to considering the need for inpatient care. Of course, insurance companies have the right to establish their health care plans in accordance with their desires, which in many cases has less to do with health care and more to do with bottom-line profits. Outpatient treatment costs less, on average, than inpatient residential care and ultimately, the insurance company wants to pay out as little as possible. But what if you or your family member truly needs to be treated in an inpatient facility that can oversee the daily care and help to establish healthy routines that will last for a lifetime? Your insurance company may feel they have the better bead on such things, but ultimately, you know what is right for you and your family.

So, what are the differences between inpatient and outpatient care? Ultimately, the differences lie in various areas. For instance:

  • Inpatient facilities provide intensive, constant attention to drug addiction recovery while outpatient programs focus attention on recovery a few hours per day or week.
  • Residential programs can reduce the level of stress associated with recovery by eliminating the stress of daily responsibilities, such as childrearing, elderly-parent care or work.
  • Residential programs can help an individual to actively use and practice the life skills they learn in the various activities or educational resources to develop good behavioral habits.
  • Residential facilities offer around-the-clock emotional support and care from professionally trained and experienced staff members.
  • Inpatient residential facilities provide support from other patients who can encourage one another and provide stability to a common goal.

How to Raise Funds for a Self-Pay Only Treatment Facility

moneyFor some people, who may not have insurance coverage at all, the fact that a treatment facility does not accept insurance doesn’t matter. What matters are the costs involved in receiving effective treatment. According to the Substance Abuse and Mental Health Services Administration, individuals who participated in inpatient residential care have the highest rate of overall completion for drug treatment. These treatment programs are tailored to the specific needs of an individual, and because the recovering individual lives at the facility, there are fewer distractions and temptations to return to drug use. There are several avenues one can pursue to raise the funds necessary to pay for drug and alcohol treatment. The first, and most obvious, may be to ask your friends or family to help pay for the treatment. In some cases, it may be difficult to ask to borrow money from those who may have grown tired of helping you, especially if the funds they’ve loaned you in the past have been directly related to drug and alcohol abuse and addiction. However, if they have been willing to help in the past with funds to help you meet your financial obligations, like food or rent, they may be even more willing to put their money to much better use when you broach the subject of getting the help you need to stop abusing drugs.

If you have a loved one who is struggling with addiction and you want to help them raise funds for treatment, there are many ways to do it, for instance:

  • Ask family members, even extended family members, to participate in a multi-family (even multi-city) yard sale to raise money explicitly for treatment.
  • Sell recreational vehicles that are seldom used, such as four-wheel ATVs, motorhomes, boats, or the peripheral equipment, like skis, that go with them. These items can be replaced later, after your loved one has gained his or her freedom from addiction.
  • Obtain a signature loan to cover the costs so your loved one can make payments once they have completed the program and gone back to work.
  • Take out a home equity loan.
  • Cancel unnecessary subscriptions, like cable television, to increase monthly cash flow.

One possible scenario that may make it easier for a family member to obtain a loan, either through the equity in their home or an unsecured loan, might include certain caveats. For instance, your family member may need a safe, sober place to live once they have completed rehab. You could provide them with a safe place, free from the influences of drug abuse, where you could help them succeed. Rather than paying rent, their new income from post-drug abuse employment could be earmarked to repay the loan you took out on their behalf. For instance, someone who has been unable to maintain steady employment, or even finish their high school education, can reframe their life to include not only high school but college too. The money spent on drug treatment comes back in the form of higher wages and earning potential over the course of a lifetime. Did you know that the earning potential differences between someone who has not earned a high school diploma and someone who has earned a college degree equates to about $25,000 per year?  According to the U.S. Census, a full-time, year-round employee with a degree earns more than $50,000 annually, while someone who did not complete high school only earns about $23,400. This is a huge difference, particularly when one takes into consideration that the higher end of the earning spectrum includes more benefits, such as vacation time, sick leave and health insurance benefits. The individual without the college education is more likely to work longer, harder hours for less money. Receiving treatment for drug addiction is not something to be taken lightly or shirked from simply because of cost, or a preconceived notion that the one person in your life who needs help the most, even if it is you, isn’t worth the expense or effort it may take to regain their health. The most important and final cost of drug addiction does not lie in the cost of recovery, but in the ultimate price that comes with not receiving treatment at all. If you or someone you love needs treatment, regardless of whether you have insurance to cover the costs, call today. Our professional, compassionate staff can help you find the answers you need to move forward.