Tips for Getting Addiction Treatment Covered by Health Insurance

heatlhcare addiction treatmentGateway Alcohol & Drug Treatment urges Illinois residents—even if denied health benefits for alcohol or drug rehab in the past—to check their current healthcare plan to determine if substance abuse treatment is covered by insurance. Now that federal parity laws, Illinois Parity, and The Patient Protection and Affordable Care Act have all taken effect, many health plans include the same coverage benefits for treatment of mental health/substance use disorders (MH/SUD) as they do for general medical and surgical treatment.

“There are thousands of Illinois residents who need care for addiction issues and now more than ever they have access to treatment through their health insurance. Our goal is to help people understand their treatment options and their insurance benefits” says Michael Darcy, President & CEO, Gateway Alcohol & Drug Treatment.

Here are the top five tips Gateway provides to those seeking coverage for drug or alcohol rehab their health
plans:

1. Know Your Illinois Parity Rights: In the state of Illinois, unless an insurance plan is exempt, large employer plans are required in each calendar year to cover the following for substance use disorders:

2Understand What Insurance Plans Must Follow Federal Parity Laws:

  • Health plans sponsored by private and public sector employers with 51 or more employees including self-insured and fully insured arrangements.
  • All insurance plans sold inside and outside the state exchanges, which are available to individuals and smaller companies with 50 or fewer employees.
  • Some state and local government health plans.

3. Understand What Health Insurance Plans Do Not Have to Follow Federal Parity Laws:

  • Medicare
  • Individual plans not purchased through the health insurance marketplaces
  • Group plans with 50 or fewer employees.
  • Plans who received an exemption based on increase of costs related to parity.

4. Look for a Reputable Treatment Center: Substance Abuse Treatment is a specialty service and it’s important your Financial Counselor is an accomplished expert who can work on your behalf to gain the most from your insurance coverage.

5. Don’t Take No for an Initial Denial: If your health plan meets the criteria of state and federal parity, it’s important to realize an initial denial does not always mean no coverage is available. Knowledgeable Financial counselors may be able to obtain insurance coverage for treatment by exploring different avenues with your insurance company.

“Substance use is a treatable healthcare disorder – and people should know it is covered by insurance, similar to diabetes, hypertension and cancer.” says Michael Darcy.

To learn more about treatment options or insurance coverage for treatment related to alcohol or drug abuse, call Gateway at 877-505-HOPE (4673).

About Gateway Foundation Alcohol & Drug Treatment Centers
Every year Gateway Foundation Alcohol & Drug Treatment helps thousands of adults and teens get their life back on track and gives renewed hope to those who care about them. With 50 years of treatment experience, our specialists take the time to understand of the specific needs of each individual. We then develop a customized treatment plan with recommendations for the most appropriate care based on an individual's substance abuse and mental health history. As the largest provider of alcohol and drug abuse treatment in Illinois, Gateway has 11 treatment centers throughout the state. Gateway outpatient and residential substance abuse treatment programs are not one-size fits all, but unique treatment plans that give an individual the highest chance for a successful outcome. With insurance acceptance and a track record of success, Gateway Treatment Centers help thousands of individual’s successfully complete treatment each year, and find the hope they need to live again.

Comments are closed.

%d bloggers like this: