Drug Use in Arkansas and Across the Nation
In 2015, the inhalant use among high school students in Arkansas was 3 percent higher than the national average: The same is true for cocaine use. However, marijuana use among these students was 4 percent lower than the national average.
The state of Arkansas ranks within the top 20 percent of the states prescribing the most painkillers (per capita). Furthermore, the death rates related to drug use in the state of Arkansas are one of the highest in the country. In addition, Governor Asa Hutchinson states that Arkansas ranks eighth in the nation when it comes to the percentage of overdoses occurring due to prescription drugs.
Substance Use Disorders and Type of Health Insurance Statistics
Health Insurance Marketplace
Nationally, the prevalence of substance use disorders for individuals aged 18 to 64 years is nearly 15 percent: Whereas, in the state of Arkansas, individuals within the same age group with substance use disorders total almost 13 percent.
Health Care Independence Program
Nationwide, the prevalence of substance use disorders in people between the ages of 18 to 64 is slightly over 14 percent: Whereas, in the state of Arkansas, individuals within the same age group who are dealing with a substance use disorder equals nearly 12 percent.
The Arkansas Mental Health Parity Act of 2009 requires group policies to cover mental illness and substance use disorders; however, a plan is exempt if implementing these regulations would result in an increase of 1.5 percent (or more) in the cost of the coverage. The Treatment of Alcohol and Drug Dependency citation requires that group and health maintenance organization (HMO) insurance policies provide coverage for the treatment of drug and alcohol dependencies. Arkansas Code ST § 23-86-113 outlines the minimum benefits required for mental illness in group health policies, group accident policies or subscriber’s contracts.
Plans Available in the Health Insurance Marketplace
All of the plans available in the Health Insurance Marketplace are required to cover behavioral health treatment (inpatient and outpatient) as well as substance abuse treatment. In addition, these plans are not allowed to place yearly or lifetime dollar amounts on mental health or substance use treatment. The specifics related to the amount of coverage, deductible and copay requirements an individual has is determined by the plan that he or she chooses. The plans listed below demonstrate monthly premiums when no discounts have been applied. In addition, there are no exclusions listed in relation to the type of drug addiction being addressed through treatment (e.g., marijuana, cocaine, alcohol, etc.).
The Silver Plan AW1 is a PPO plan that has an individual deductible of $2,800 and a monthly premium of about $419. There is an out-of-pocket maximum of $7,350. The copay amount for outpatient behavioral health care provided by an in-network provider is $25 after the deductible is met and inpatient care is $800 a day after the deductible has been met. Outpatient behavioral health services rendered by an out-of-network provider have a 50 percent coinsurance amount after the deductible is met and inpatient services also have a 50 percent coinsurance amount once the deductible is met.
The Bronze Plan 1 is a PPO plan. The individual deductible is $5,000 and the monthly premium is approximately $320. The copay for outpatient behavioral health services from an in-network provider is $40 and for inpatient services, the coinsurance amount is $500 a day after the deductible is met. Outpatient treatment for behavioral health from an out-of-network provider has a coinsurance amount of 50 percent after the deductible is met. For an inpatient stay at an out-of-network facility, once the patient meets the deductible, there is a coinsurance amount of 50 percent. The maximum out-of-pocket for this plan is $7,350.
QCA Plans in Arkansas
QCA Health Plan Silver Classic Saver 3500 is a PSO plan with a monthly premium of approximately $430. The annual deductible is $3,500 and the out-of-pocket maximum is $4,500. Once the deductible is met, there is a 10 percent coinsurance amount for inpatient and outpatient services rendered by an in-network provider. Once the deductible is met, there is a 30 percent coinsurance amount for inpatient and outpatient services rendered by an out-of-network provider.
QCA Health Plan Silver Classic 6500 is a POS plan that has a monthly premium of around $461. The annual deductible is $6,500 and the out-of-pocket maximum is $7,350. Outpatient services from an in-network provider have a copay amount of $80 and inpatient services cost $800 a day (with deductible). Outpatient services rendered by an out-of-network provider have a 50 percent coinsurance amount after the deductible is met and inpatient services have a coinsurance amount of 50 percent after the deductible.
Ambetter From Arkansas
Ambetter from Arkansas Health & Wellness · Ambetter Balanced Care 6 (2018) is a PPO plan with a monthly premium of about $362. There is an annual deductible of $3,000 with an out-of-pocket maximum of $6,500. Outpatient services that are rendered by an in-network provider have a copay amount of $30 and inpatient services have a $750 copay per day with deductible. Outpatient services at an out-of-network provider have a 50 percent coinsurance amount and inpatient services have a 50 percent coinsurance amount after the deductible is met.
Ambetter from Arkansas Health & Wellness – Ambetter Balanced Care 7 (2018) is a PPO plan with a monthly premium of approximately $380. There is an annual deductible of $5,100 and an out-of-pocket maximum of $6,250. Outpatient services rendered by an in-network provider have a copay amount of $50 and inpatient services have a $1,000 a day copay amount after the deductible is met. When outpatient services are rendered by an out-of-network provider, there is a 50 percent coinsurance amount and inpatient services have a 50 percent coinsurance amount after the deductible is met.
Medicare Coverage for Alcohol and Drug Rehab
Medicare is an insurance program that the government offers to individuals who are over the age of 65 and/or who have disabilities. While there is a monthly premium to have Medicare, it is based on the income of the recipient. Medicare can cover treatment for substance use.
There are four parts to Medicare and each covers a different aspect of the addiction recovery programs that are available:
- Medicare Part A covers hospital stays. Therefore, Part A will be used to pay for inpatient rehabilitation. Recipients receive up to 60 days of inpatient treatment without making any co-insurance payments; however, there is a deductible that must be met. Medicare will only cover inpatient care for a total of 190 days throughout a recipient’s lifetime.
- Medicare Part B covers outpatient care. Part B will cover up to 80 percent of the costs associated with treatment for addiction. Part B typically covers medications administered via professional interventions and at clinics, outpatient care and therapy. In addition, when an individual has a dual diagnosis, Part B covers the treatment for the co-occurring disorder (e.g., depression, anxiety, etc.) as well.
- Part C is a Private Insurance that has been approved by Medicare: Individuals who would like additional benefits can choose to purchase this coverage separately.
- Medicare Part D offers coverage for prescriptions; therefore, Part D helps cover the medications that are used during substance use treatment to help individuals feel more comfortable by reducing withdrawal symptoms and decreasing cravings.
Medicaid Coverage for Substance Abuse Treatment
Due to regulations set forth by the ACA, Medicaid is required to cover all the basic aspects of substance abuse treatment. However, not all treatment centers accept Medicaid.
Medicaid will cover all or a portion of a variety of substance use treatment services including screenings, craving and maintenance medications, long-term residential substance use treatment, family counseling, intervention, inpatient care, outpatient visits, detoxification programs as well as other mental health services.
Other Arkansas Insurance for Drug And Alcohol Rehab
Arkansas Drug Rehab Treatment Options
Treatments for drug addiction:
- Detoxification refers to the process of the body ridding itself of the drug.
- Medications may be used to help the patient feel more comfortable during the stage of recovery when withdrawal symptoms and cravings are present.
- Evaluating and addressing co-occurring mental health issues. When an individual has an addiction in conjunction with a mental health issue like anxiety, this is referred to as a ‘dual diagnosis.’ Successfully treating addiction requires that the co-occurring issue also be addressed.
- Behavioral health treatment by way of counseling and psychotherapy.
- Relapse prevention through long-term follow-up.
- Holistic treatments include behavioral therapies. During these treatments, caregivers work towards changing the attitude a patient has in relation to his or her drug use as well as to modify the behaviors associated with the addiction. These therapies also encourage the patient to continue with the other forms of treatment being utilized (medications, group therapy, etc.). Furthermore, these caregivers promote the implementation of healthy lifestyle skills.
Most of the treatment centers in Arkansas are the standard 28-day programs that use the 12-step model as their guideline. While this method is effective for many, some people choose to attend a non-traditional treatment facility. These treatment facilities may be holistic and/or faith-based. However, these non-traditional centers are usually not covered by insurance companies.
Enhanced traditional drug treatment facilities will use the 12-step method; however, additional aspects may be incorporated into their programs. Furthermore, to avoid the ‘cookie cutter’ approach to treatment, these facilities usually try to offer a higher-degree of client-specific customization.
Luxury facilities typically offer private rooms and program enhancements that include yoga, gourmet chefs, and equine therapy.
Ultra-Private rehabilitation centers cater to those who prefer to receive treatment in a center with very few patients. For the most part, beds are limited to no more than 10. Due to fewer patients, the professional to patient ratio is very high.
Long-term residential treatment generally takes place in a non-hospital setting. Therapeutic communities are the most well-known residential treatment models. Patients remain in these communities from 6 to 12 months. These communities focus on developing the patient’s personal responsibility and accountability in addition to encouraging a socially productive life. Activities are designed to assist patients in adopting new, more harmonious ways to interact with those around them.
Outpatient treatment costs less than inpatient or residential treatment does. Outpatient treatment is ideal for individuals who have a job and/or a great support system around them. These programs are low-intensity, which means they may offer little more than educational information related to drugs and drug use. However, outpatient intensive day treatment programs are similar to the residential programs, in relation to the services offered and effectiveness. There are also outpatient programs to treat individuals who have a dual-diagnosis.
In conclusion, treatment for substance abuse should include mental health services as well as medical care. Tailoring a treatment program to meet the needs of the patient and offering follow-up options are vital to a successful recovery. Follow-up care can include family- and/or community-based support systems.