Addiction to alcohol, prescription drugs, marijuana, cocaine, heroin, or other illicit drugs can make your life unmanageable. In fact, admitting that you can no longer control the addiction is the first step towards recovery. However, knowing that you need and want help and paying to receive it are two different things. You may wonder if your health insurance plan will cover some or all of your treatment costs for Alabama drug rehab. If you don’t have insurance, you might assume that you can’t receive treatment at all. InsuranceDrugRehab.com is here to help you navigate the insurance maze so you can get the help you need to overcome addiction.
Statistics from the National Institute on Drug Abuse
The Substance Abuse and Mental Health Services Administration (SAMHSA) records national data on drug abuse statistics and figures in the United States. In its most recent report, SAMHSA indicated that 23.5 million people over age 12 sought treatment for alcohol or drug abuse and that just over 11 percent of these people received help through a specialized inpatient facility. One reason for this is that they often don’t know where to find the help they need to beat addiction. Another is that they either don’t have the financial resources or understand the insurance benefits they do have available to them.
In Alabama, the problem with home-grown marijuana is increasing as is the import of stronger drugs such as cocaine, heroin, and methamphetamine. Nearly 80,000 of the state’s 4.5 million population is either in prison or on probation, often due to crimes committed obtaining drugs or while using drugs. It doesn’t have to be this way for you. You can choose to stop today and find an Alabama drug rehab facility where you can beat your addiction and discover a healthier way of life.
Alabama State Parity Laws
In 2008, Congress passed the Mental Health Parity and Addiction Equity Act (MHPAE) to provide the same level of insurance coverage for these conditions as any other type of health condition. At the federal level, MHPAE laws apply to the following:
- Individual market plans
- Medicaid managed care programs
- Medicaid alternative benefit plans
- Children’s Health Insurance Program (CHIP)
- Large employer-funded health plans with 51 or more covered employees
- Small employer-funded health plans with 50 or fewer covered employees unless grandfathered
Two exceptions to mental health and substance abuse parity exist at the federal level. A large or small employer-based plan can request an exemption if it can prove that administering MHPAE has increased its administrative costs by at least two percent in the first year or at least one percent in subsequent years. Additionally, self-insured health plans covering non-federal government employees can request to opt out.
At the state level, Alabama mandates coverage for serious mental illness for individual and HMO insurance policies as well as group policies covering at least 50 people. It does not mandate alcohol or substance abuse treatment.
State and Federal Insurance Programs for Addiction Recovery Treatment in Alabama
Medicaid is a federal program administered by individual states that provide health insurance to low-income individuals and families, people with disabilities, pregnant women, blind persons, and parents of children under age 19. This program does offer some coverage for drug and alcohol addiction, but you must first apply and meet the eligibility requirements established by the state legislature. A single person cannot have an annual income greater than $15,800. The income guideline for a family of four is $32,319 per year and $54,384 for a family of eight. For each family member over eight, the state adds additional income of $5,533 per year.
As a Medicaid recipient, you may need to pay a small co-payment for some services related to your drug and alcohol rehabilitation. However, these are typically not more than a few dollars and are much less than you would need to pay with private insurance. You may be able to qualify for Medicaid to help with the cost of a substance abuse treatment program even if you have other health insurance available to you. Additionally, you can apply to the Medicaid program for assistance in paying your other private health insurance premiums if you meet the income requirements.
The amount that Medicaid contributes towards your Alabama drug rehab or alcohol treatment depends on the facility you attend, your personal and household income, and other individual factors. If you know that you’re considering inpatient or outpatient treatment, check with your caseworker to inquire about specific coverage benefits and limitations.
Medicare is a federal health insurance program for people over age 65 and those with certain medical conditions. It can be a complicated program with four different parts called A, B, C, and D. Many people refer to Part A and Part B as original Medicare. Part C covers Medicare Advantage and Part D offers prescription drug coverage.
If you need inpatient alcohol or chemical dependency treatment, coverage for it falls under Part A of the federal Medicare program. The maximum stay per year is 190 days. For 2018, the out-of-pocket annual deductible is $1,316. You would pay no co-insurance for the first 60 days of hospitalization and then a set amount per day based on your benefits. You can also receive outpatient counseling for drug addiction for a pre-determined co-pay as well as services such as detoxification and aftercare treatment.
Private Insurance for Alabama Drug Rehab
Aetna does offer coverage for drug and alcohol treatment, but the amount paid towards your services depends on the specific plan that you choose. You can expect to pay a deductible, co-payment, co-insurance, or a combination of the three to get the help you need. It’s common for Aetna insurance plans to pay approximately 80 percent of the cost of treatment after you have met the deductible. This amount can vary considerably.
As with most insurance companies, Aetna offers better coverage when you choose an addiction recovery program in its preferred network of providers. Going out-of-network can cost considerably more, so it’s in your best interest to work with your insurance representative to locate the most affordable in-network treatment program.
Assurant Health offers both group and individual health insurance policies in Alabama. Participants can choose from among four plan types. These include:
- Platinum, which covers 90 percent of out-of-pocket costs
- Gold, which covers 80 percent of out-of-pocket costs
- Silver, which covers 70 percent of out-of-pocket costs
- Bronze, which covers 60 percent of out-of-pocket costs
Benefits for Alabama drug rehab and alcohol rehabilitation treatment programs depend on your specific plan. Generally, plans with the richest benefits and highest premiums offer coverage for addiction treatment while health plans that cost less may not. Keep in mind that you will need to pay at least 10 percent towards any deductible or co-insurance with Assurant Health.
BCBS of Alabama considers mental health and substance abuse disorders as one of the 10 essential services it provides to plan members. Its insurance plans offer coverage to evaluate, diagnose, and treat these issues. Coverage may include detoxification service, outpatient treatment, inpatient treatment, and follow-up care. Most plans have a deductible and co-insurance. The more that you or your employer pay for your premium, the less out-of-pocket expense you will incur for alcohol or substance abuse treatment. Most services have limits, such as a 28-day inpatient stay at a drug rehabilitation facility.
If you have a choice of health plans with BCBS of Alabama, you can opt for one that includes alcohol and substance abuse treatment for a slightly higher premium. You will not be able to get the addiction services you need through your insurance company if your specific plan does not include coverage for it.
United Healthcare includes coverage for alcohol and chemical dependency treatment in most of its plans. It currently offers a choice of four plans with increasingly rich benefits as the premium increases. These include Value Select, Plus Select, Copay Select, and Plus Elite. Additionally, it offers short-term coverage plans of up to three months and permanent coverage.
For addiction treatment, you would likely need to pay a deductible that can range from a low of $1,000 to a high of $12,500. Once you have met the deductible, co-insurance ranges from 60 to 80 percent until you reach your out-of-pocket maximum for the year. Only the Plus Elite plan does not require payment of co-insurance.
Additional Insurance Information In Alabama
Take the First Step Today
Dealing with insurance can be complicated and frustrating, but think of it as something you must do on your way to a healthy, drug-free life. All insurance companies have customer service representative who can help you understand the specifics of your coverage so you can finalize your plan for treatment.
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