16 Sep Does Insurance Cover Rehab in Delray Beach?
Addiction treatment can become expensive, especially if you need inpatient treatment. Thankfully, most insurance plans will cover rehab and various forms of mental health treatment. However, the extent to which your insurance will cover substance abuse rehab depends on a variety of factors. These factors may include your policy’s exact mental health benefits, the rehab program you are attending, your particular needs, and more.
So, in short, yes, insurance does cover rehab in Delray Beach, but many factors determine how much of your rehab that your insurance will cover. Let’s take a look at different types of insurance and whether they cover rehab in Delray Beach.
Does Insurance Cover Addiction Treatment?
Health insurance typically covers the cost of treatment for substance use disorders and mental health conditions, as these issues are relevant to personal health. Your particular insurance plan will determine how much of your treatment is covered and how much you will have to pay out-of-pocket. Before committing to a rehab program, it is best to contact your insurance provider to understand the details of your coverage.
Nearly 90% of Americans have some form of health insurance in 2021.[1] To add, most types of addiction treatment will be covered by health insurance policies. Depending on your specific policy details, insurance typically covers these types of addiction treatment programs in Delray Beach:
- Partial hospitalization program (PHP)
- Outpatient treatment
- Medication-assisted detox
- Medication-assisted treatment (MAT)
- Dual diagnosis addiction treatment
- Continuing care programs
- Maintenance medications to support long-term sobriety and other forms of MAT
How Long Does Insurance Pay for Drug Rehab in Delray Beach?
How long an insurance policy will cover the costs of drug rehab in Delray Beach depends on several factors. Typically, each insurance policy will have a time limit specific to the plan and type of insurance you have. However, many insurance providers assess your needs before deciding how long they will pay for treatment. For example, individuals suffering from an opioid addiction usually are provided with more coverage for detox services by their insurance provider than individuals with a meth addiction. This is because opioid addiction causes more symptoms of withdrawal than meth addiction. The term for this limitation is “medically necessary”, meaning the provider will deem what treatments are medically necessary for their client and only cover those services.
Additionally, insurance plans follow something known as “quantitative treatment limitation” or QTL. These are limits to coverage based on the frequency of treatment, the number of visits, days of coverage, or days in a waiting period. These limitations will be based on a numerical value, like an annual limit of 50 outpatient visits.
Lastly, it is important to consider whether the drug rehab you are attending is in-network or out-of-network for your specific insurance plan. In-network means that the treatment facility and its staff members are in a contract with your insurance plan, causing your insurance to cover the costs of medical and behavioral health services. When a rehab program is out-of-network, they do not have a contract with your insurance provider. This means that services may be only partially covered or not covered at all.
Will Medicare or Medicaid Cover Rehab Costs?
If you have Medicaid, your rehab costs will be covered by your insurance as long as the rehab center you attend is in-network with Medicaid. This insurance plan is intended for individuals with low incomes and financial strain. Additionally, nearly 12% of individuals who are covered by Medicaid suffer from a substance use disorder, making this coverage vital for the company.[2]
Medicare is a type of insurance that is federally funded for individuals who are at least 65 years old, or under 65 years old with a disability. Medicare does cover costs of addiction treatment for their clients, depending on these factors:
- The provider deems the services as medically necessary
- You attend a rehab that is in-network and approved by the provider
- Your provider sets up your treatment plan
While these insurance plans cover addiction treatment costs, not every rehab accepts Medicaid and Medicare. Make sure to contact the treatment facility to confirm your coverage.
Using TRICARE for Addiction Treatment in Delray Beach
TRICARE is a form of insurance for active and retired military service members and their families. As of 2017, TRICARE made significant changes to their mental health benefits. Due to these changes, they now cover the costs of addiction treatment.[3] Alcohol and drug abuse have always been common issues among members of the United States Military, and these alterations to TRICARE have helped active duty and retired service members get the help they deserve.
TRICARE may cover the following addiction treatment services:[3]
- Inpatient rehab
- Detox
- Intensive outpatient programs (IOP)
- Intervention programs
- MAT
- Family therapy services
- Partial hospitalization programs (PHP)
- Residential treatment
Consult with TRICARE providers to determine which services are covered by your specific plan and ask for a list of in-network drug rehab programs in Delray Beach. Florida Recovery Group’s PHP and IOP programs are in-network with TRICARE.
Attending Florida Recovery Group
Are you in need of addiction treatment but cannot afford to pay out-of-pocket? If so, you have come to the right place. At Florida Recovery Group, we accept most forms of health insurance, including TRICARE. For more information on our addiction treatment program, which types of insurance we accept, and how to get started – contact us today!
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