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).

Gateway CEO Rallies Alcohol & Drug Rehab Industry to Reach More Patients

drug rehab, industry, iadda, Gateway Treatment Centers

Michael Darcy, President & CEO, Gateway Foundation Alcohol & Drug Treatment, speaking at IADDA’s annual meeting on Sept. 4, 2014, at Hilton in Lisle, Ill.

Michael Darcy, President & CEO, Gateway Foundation Alcohol & Drug Treatment, urged members of the alcohol and drug rehab industry attending IADDA’s annual conference at Hilton in Lisle, Ill., on Sept. 4 2014, to focus on attracting consumers who need treatment for substance abuse  with private pay insurance. Inspired by Gateway’s own successful model of treating the insured population, Darcy explained to a packed ballroom of industry leaders that treating the insured population will help the industry fulfill its collective mission of supporting individuals who can’t afford alcohol and drug rehab.

“More than 80 percent of Americans have private health insurance. And, with the Affordable Care Act in effect, the majority of Americans now have access to treatment for substance abuse issues through their health insurance benefits. With state budgets in flux, treating the insured population will ensure future viability of the alcohol and drug rehab industry so those who may not be able to afford treatment will have access to help when they need it,” says Michael Darcy, President & CEO, Gateway Foundation Alcohol & Drug Treatment.

As the soon-to-retire leader of one of the largest substance abuse treatment organization in the U.S., Darcy has dedicated his career to evolving treatment and expanding accessibility and recovery support throughout Illinois and beyond. Since 1968, Gateway Foundation has steadily improved its expertise and capacity, growing capabilities to treat more than 9,000 individuals daily through successful programs and treatment centers spanning five states.

“In the long run, it is best for the consumer and society at-large if America has a vibrant substance abuse treatment industry that works seamlessly with health care professionals, hospitals and insurance carriers on behalf of patients in the primary healthcare arena,” explains Darcy.

For more information about Gateway Treatment Centers and its executive leadership, please visit RecoverGateway.org.

Now Covered: Treatment for Substance Abuse Enters Primary Care Arena

alcohol or drug issues, healthcareFinancial barriers are a big reason individuals generally prolong seeking professional treatment for alcohol and drug abuse issues. However, that barrier is no longer an issue for hundreds of thousands of Americans. That’s because treatment for substance abuse is now recognized as one of the 10 essential health benefits covered by health insurance per the provisions of The Affordable Care Act.

As of January 1, 2014, hundreds of thousands of Americans who need help working through addiction issues now have access to professional treatment via health insurance.

In this new era of healthcare, it is more important than ever for individuals to practice preventative health care management to promote healthy aging. And, while it may be tempting to twist the truth about how many drinks you consume each week, it is in your best interest to be honest because you just may learn something new like:    

  • Where you range on the scale between moderate and binge drinking.
  • The risks associated with the use of prescribed medications, especially opioids.
  • How symptoms of anxiety or depression may relate to alcohol or drug use. 
  • Why you need to be extra vigilant about adhering to moderate drinking if a family history of alcoholism exists.

 Make the most of your medical check-ups by being honest about your alcohol and drug use because an open dialogue with your healthcare professional is just what the doctor ordered.

If alcohol or drug use is a problem for you or a loved one, Gateway Treatment Centers offer Outpatient Treatment Programs available in the morning and evening hours and centers located throughout Illinois, including Chicago. To learn more about our free, confidential consultation, please call Gateway at 877-505-HOPE (4673) or visit RecoverGateway.org.

 

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