Addiction treatment is vital to overcome addiction. Unfortunately though, addiction treatment isn’t free. Luckily, there is health insurance that can cover most of the costs of addiction treatment. The question now becomes, does insurance cover therapy? and, Does health insurance cover psychologists? When it comes to insurance for therapy, there are affordable options.
What Insurance Plans Offer Coverage for Behavioral Health Issues?
Because of the Affordable Care Act, all marketplace insurance plans offer some behavioral health coverage. This includes mental health and addiction treatment coverage. In fact, the Affordable Care Act requires that all health insurance companies provide the same amount of coverage for behavioral health issues such as substance addiction and mental health care as they do any physical ailment. This rule especially applies to marketplace insurance plans.
Marketplace Insurance for Therapy
Marketplace insurance plans are federal and state insurance plans offered to law-abiding citizens, families, and small businesses. The amount of coverage offered by different health plans in different marketplace insurance deals can vary though. Thus, the specific health insurance benefits that you’ll receive for your addiction treatment program will depend on the state that you live in and the health plan that you choose. Whether your health plan coverage is big or small, though, all plans provide some form of coverage for behavioral health treatment like rehab, psychotherapy or counseling, and inpatient services.
When using a marketplace health insurance plan to treat your behavioral health issues, you can’t be charged more or be denied coverage because of a pre-existing condition. If when receiving an assessment for your condition you discover that you already have a pre-existing mental illness, you would still receive the same amount of insurance for therapy that you would if your mental illness wasn’t pre-existing. In other words, marketplace insurance coverage for therapy begins the same day that your insurance starts.
Marketplace insurance plans aren’t even allowed to put yearly or lifetime dollar limits on the amount of coverage that you can receive for behavioral healthcare such as addiction treatment or mental health treatment. This is because, according to the Affordable Care Act, addiction and mental health treatments are essential health benefits.
Also, any type of limits that are given to addiction and mental health treatments cannot be more than those given to the treatment of regular physical ailments. This rule is started with the Mental Health Parity and Addiction Equity Act.
Group Health Plans
According to the Mental Health Parity and Addiction Equity Act (MHPAEA), all group health plans and health insurance insurers that provide mental health and substance use disorder treatment cannot impose less favorable benefit limits on behavioral health issues than physical, medical, and surgery issues. Note though that the Mental Health Parity Act doesn’t require large group health plans or health insurance issuers to cover mental health and substance use disorder benefits. The Affordable Care Act, on the other hand, requires mental health and substance use disorder coverage in individual and small group plans.
Employment-related group health plans are either insured or self-funded. Insured group health insurance plans are ones that an issuer in the group marketplace purchases. Self-funded group health insurance plans are ones that pay for coverage directly without buying health insurance from an issuer. People receive private employment-related group health plans through their employer.
The U.S. Department of Labor regulates private employment group health insurance plans. The Affordable Care Act and the Health Care and Education Reconciliation Act regulate the other public sector, or non-Federal, group health insurance plans.
Addiction Treatment Options That Insurance Can Affordably Cover
When you do receive health insurance for therapy and addiction treatment, you can receive all different forms of treatment. These forms of treatment range from telehealth to outpatient treatment.
Telehealth Treatment
Telehealth treatment is a substance use or mental health treatment that’s online. In a day and time when people must socially distance themselves from one another due to the pandemic, telehealth treatment has become more and more popular.
One benefit of telehealth treatment is that it’s affordable. This is because patients don’t have to pay for all of the amenities and services that’s offered at a treatment center. Receiving telehealth therapy and treatment also saves patients money by not making them have to put gas in their cars or hire a babysitter just to attend therapy or addiction treatment.
Another benefit of telehealth treatment is that it saves patients time. This is because patients don’t have to commute to and from their treatment center. In fact, patients can simply attend telehealth therapy or treatment immediately after getting up or going somewhere. In other words, telehealth therapy and treatment is very convenient.
The most effective way to receive telehealth addiction treatment or telehealth therapy is via video. That way you can visually connect with your therapist or addiction treatment specialist. Other ways that you can receive telehealth therapy or treatment include computer messaging and phone calls.
Intensive Outpatient Program Treatment
Intensive outpatient program (IOP) treatment occurs for only a few hours a day, three to five days a week. Because intensive outpatient program treatment is outpatient and thus, doesn’t require patients to live in the facility that they’re receiving care at, it too is an affordable option that your health insurance can likely cover.
An intensive outpatient program is also affordable because it squeezes intensive treatment and therapy out in a short amount of time. Thus, patients of IOP programs can maintain their jobs and day-to-day responsibilities while receiving care.
Outpatient Treatment
Other than telehealth treatment, no other treatment is more affordable for insurance for therapy and addiction treatment than outpatient treatment. This is because outpatient treatment and therapy only occur for one to two hours, one or two times a week. Thus, the costs of attending rehab at a treatment center are minimized.
Partial Hospitalization Program
A partial hospitalization program (PHP) is an addiction or mental health treatment that occurs for about six hours a day, five to six days a week. This means that partial hospitalization program treatment will occur all day long. Because of this, many people call partial hospitalization programs “day treatment.”
Despite PHP occurring all day, patients can still live in the comfort of their own homes at night. Because partial hospitalization program treatment occurs all day, it also isn’t as affordable for an insurance company to pay for as other forms of outpatient treatment. Still, most insurance plans can cover PHP therapy and addiction treatment.
Residential Treatment
Residential treatment is a form of inpatient treatment. Therefore, it requires its patients to live in the treatment facility at which they’re receiving care. The difference between residential treatment and inpatient treatment is that residential treatment operates more as a housing community and is thus less restrictive.
Although less restrictive than inpatient treatment, residential treatment is on the costlier side for health insurance plans. Thus, although you should receive insurance for therapy and rehab that’s residential, depending on the plan you have, you may not receive full coverage.
Inpatient Treatment
Inpatient treatment is therapy and addiction treatment that requires its patients to stay at the treatment facility that they’re receiving care at. Inpatient treatment is the strictest form of addiction treatment and therapy. Therefore, it requires the most amount of time.
As a result, inpatient treatment is the least affordable form of addiction treatment for an insurance company or plan to pay for. Still, you should receive some coverage for inpatient addiction treatment and therapy.
Insurance for Therapy Options
When asking yourself, does insurance cover therapy? Or does health insurance cover a psychologist or psychiatrist, the answer is yes. As long as you chose the right insurance plan.
There are two major categories of therapy. One is individual therapy and the other is group therapy. Family therapy and telehealth therapy are also important categories of therapy. Within these categories of therapy different types of therapy occur. Examples of these different types of therapy include cognitive behavioral therapy, dialectical behavioral therapy, and eye movement desensitization therapy.
You should receive the same amount of insurance for therapy as you do addiction treatment. The exact amount of insurance for therapy that you receive is up to your health insurance plan.
How COVID-19 Is Affecting Mental Health
Because the current COVID-19 pandemic is causing people to quarantine inside, more and more people are left with their own thoughts without distractions. As a result, more and more people are discovering mental health issues that they have been masking with life activities. If you’re one of these people, now is a good time to receive mental health treatment.
If you don’t feel comfortable receiving mental health treatment in person, you can participate in telehealth therapy. If you do feel comfortable receiving mental health treatment in person, you can attend in-person inpatient or outpatient treatment.
The Importance of Discussing Your Treatment Options With Professionals
Prior to receiving mental health treatment, you should receive an assessment of your mental health condition by a medical professional. That way you can attend the right mental health treatment program. It’s also important to receive a proper assessment and discuss your addiction treatment options with physicians and addiction treatment specialists prior to receiving addiction treatment. That way you can receive the right treatment for your condition.
If you don’t receive a proper assessment of your condition and discuss your treatment options prior to receiving addiction or mental health treatment, you might overlook an underlying or co-occurring condition or attend the wrong treatment program or form of therapy for you. This could cause you to waste your time and money.
Thus, be smart and receive an assessment of your condition with professional physicians, therapists, and addiction treatment specialists prior to attending treatment. Also, make sure to discuss your treatment options with those professionals after you receive your assessment.
Harmony Ridge Is Dedicated to Helping You Receive the Best Addiction and Mental Health Treatment
We understand how stressful it is to get money to pay for your addiction and mental health treatment. That’s why we here at Harmony Ridge accept major forms of health insurance for therapy and rehab. Some of the insurance companies that we accept include Blue Cross Blue Shield, Humana Insurance, Tricare Insurance, and PEIA Insurance.
To learn about other forms of insurance that we work with here at Harmony Ridge, contact us today. If you don’t have insurance from one of the companies that we work with, we can work with you to come up with other ways that you can finance your addiction treatment programs.
References:
https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/
https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet
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