The opioid epidemic has made addiction a widely-spread problem in the United States. Stigma and media may lead you to believe that addiction is a problem reserved for impoverished communities or certain areas of the country, but addiction actually affects people all over the country. In fact, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports that over 20 million people in the U.S. suffer from some type of substance use disorder. However, with the problem growing so quickly, only about 2.5 million people have received addiction treatment they need.
This disparity is alarming, but it can be explained by the fact that there are several barriers that can prevent a person with a SUD from receiving the help they need. Some people aren’t ready to admit they have a problem, or they may not realize their substance use has become dangerous. Other people are embarrassed by the stigma that often accompanies addiction rehab and reaching out for mental health services. In some cases, you may not know where to start looking for addiction services that are right for you.
One of the most significant barriers to treatment is how much it costs. Most treatments in the medical field are costly, and sometimes the price tag will deter people from ever seeking treatment. However, addiction is a disease that will start to seep into other parts of your life. As you continue using, you will require more and more of the drug to maintain your addiction. It will start to affect your work and school performance, personal relationships, and your health and well-being. Maintaining an addiction is expensive, and it could ultimately cost you everything.
For that reason, the cost of addiction treatment should stop you from getting the help you need. Seeking meaningful recovery is an investment in a life free of addiction, which has tremendous value. Plus, there are options to help make treatment more affordable. Insurance companies and publicly-funded services are available to help bridge the gap between people who are struggling with a SUD and the treatment that can help them.
While navigating insurance coverage and free services can be daunting, it’s possible for you to get the help you need. Here are some things you need to know about free drug rehab and insurance covered treatment services.
If you have no way to pay for addiction treatment, there are services that may be available to you that are provided by the government. In fact, a significant portion of addiction coverage is provided by federal programs. Free rehab centers are funded by either the state you live in or the federal government. They may either be partially funded, lowering your out-of-pocket expense for treatment or completely free to those who qualify.
Unfortunately, like many government services, government-funded rehab services generally have long waiting lists, lots of paperwork, and a long list of eligibility requirements. When it comes to addiction, treatment needs to be readily available, according to the National Institute on Drug Abuse (NIDA). They say, “Potential patients can be lost if treatment is not immediately available or readily accessible.” Because government services can take longer to qualify for, people struggling with a SUD may see that as a barrier to treatment and stop seeking help.
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Eligibility generally depends on a variety of factors and can change depending on the state you’re in and the treatment centers that you are considering. However, certain people may have priority over others if they meet certain qualifications.
If you are interested in government-assisted rehabilitation, you will need to provide information and documentation as per their specific requirements. Generally, this will involve showing proof of citizenship and, for state facilities, proof that you are the resident of that state. You will also have to go through an assessment to show that you meet the criteria for having a substance use disorder that requires addiction treatment. If you have Medicare or Medicaid, you will be able to use it at a government-funded facility.
Free drug rehab at a government-funded facility typically offers the full continuum of addiction services which includes detox, addiction counseling, and long-term outpatient services. In detox, you will receive 24-hour medical care to treat drug withdrawal symptoms and any other medical concerns. After detox, you will receive addiction counseling and therapies to address behavioral, cognitive, and mental health issues. In some cases, you may receive long-term outpatient treatment or medication-assisted treatment.
Addiction treatment at a private facility that offers evidence-based services is usually a better option. You stand a better chance at receiving high-quality, personalized service at a private addiction rehab facility than a government-funded rehab center. Addiction treatment center will typically accept most private insurance providers. On the other hand, insurance companies will cover treatment at a private facility if it meets certain criteria. Your insurance provider may already work with certain addiction treatment facilities; these are known as in-network services. It will be easier to get approval at a facility that your insurance company already knows.
You may be able to receive coverage from an out-of-network provider, but your insurance company will look for certain qualification. Typically, they want to see that a company offers evidence-based treatment, which means the foundation of your treatment plan will be therapies that are backed up by scientific evidence.
They are also more likely to approve a well-established treatment center with a clean track record of quality service. If you are considering a reputable treatment center with a solid history and quality services, you are likely to receive some coverage.
Unfortunately, most private rehab centers will not accept federal coverage like Medicaid. Government insurance providers generally offer very low payouts, leaving the health care provider or the patient to foot the majority of the bill.
Medicaid also requires paperwork and red tape that’s so time-consuming, doctor’s offices usually need to hire more people to cover the extra workload. Considering the low payout, it’s usually cost-prohibitive for private treatment centers to accept government insurance coverage.
The specifics of your insurance policy will tell you what exactly is covered and for how much. However, private insurers typically offer some coverage for the full continuum of care. If there is a medical need, they will cover medical detox, particularly if you are seeking treatment for a SUD involving a depressant like alcohol or benzodiazepines, which can be dangerous during withdrawal.
After detox, you will be placed in the next level of care based on your needs. Insurance may cover inpatient services, intensive outpatient, or outpatient services that involve behavioral therapies, addiction counseling, and a variety of other services. According to NIDA, the ideal length of the full continuum of addiction treatment services is 90 days, depending on individual needs. Your insurance provider may not cover you for that long, but your treatment center may work with them to get you the coverage you need.
If you or a loved one might be suffering from a substance use disorder and you aren’t sure if you are covered for treatment, we can help you navigate your insurance policy. Call the addiction treatment specialists at Delphi Behavioral Health Group to learn more about addiction treatment and to find out if you are covered. A call to 844-899-5777 can be your first step toward meaningful recovery.
Lipari, R. N., & Van, S. L. (2017, June 29). Trends in Substance Use Disorders Among Adults Aged 18 or Older. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28792721
National Institute on Drug Abuse. (2018, January). How long does drug addiction treatment usually last? Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment
National Institute on Drug Abuse. (2018, January). Principles of Effective Treatment. Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/principles-effective-treatment
Renter, E. (2015, May 26). You’ve Got Medicaid – Why Can’t You See the Doctor? Retrieved from https://health.usnews.com/health-news/health-insurance/articles/2015/05/26/youve-got-medicaid-why-cant-you-see-the-doctor
Opioid Overdose Crisis. National Institute on Drug Abuse (NIDA). (2020, June 10). from https://www.drugabuse.gov/drug-topics/opioids/opioid-overdose-crisis