Delaware Insurance for Drug Rehab

Drug rehab programs offer an opportunity to address substance abuse and start working on realistic plans for recovery. The challenge is identifying ways to pay for the treatment without facing financial strife. When you obtain health insurance in Delaware, your insurance provider may offer coverage to help pay for the costs of rehab treatments.

Rates of Addiction in Delaware

Substance abuse is a problem in the state of Delaware due to the high rates of substance abuse. According to the Drug Enforcement Administration, drug overdose deaths in Delaware have increased by 2.7 percent between 2014 and 2015. Although the rates increased across the state, some counties saw a decline in drug-related deaths.

The majority of the deaths associated with an overdose were prescription drugs, followed by heroin and then cocaine. The Drug Enforcement Administration reports that nearly 3.4 percent of individuals over 12 years old seek treatment for substance abuse or have admitted to using an illicit substance in surveys. The rate is higher than the national average, which is 2.6 percent in the same year.

The high rates of substance abuse in Delaware raise concerns for residents and individuals in the state. If you are concerned about your use of substances or you notice signs of substance abuse in a dependent loved one, then you want to evaluate your insurance policy to clarify your coverage. Many policies offer some coverage for drug rehab, but the exact coverage depends on the policy you purchase.

Types of Delaware Health Insurance Policies

Delaware has a variety of health insurance policies available throughout the state. The policies break down into categories based on the coverage and the type of policy you obtain.

A catastrophic policy, which is also called a value plan, is a high-deductible policy with a low monthly cost. In a catastrophic policy, you will have coverage for unexpected emergencies and high-cost medical bills, but it may limit your coverage for drug rehab treatments. You will usually pay a high deductible before any coverage applies to your policy. For example, it may require a deductible of $10,000 or more before your coverage applies to your medical needs.

A bronze policy, or a basic policy, is a high-deductible plan with reasonable coverage. The policy may have a deductible of $4,000 to $5,000 per person, but it also provides coverage for most situations. It may cover a portion of the costs of rehab, but only when you seek treatment from an in-network provider. The policy usually pays 60 percent of the costs of your treatment after you pay the deductible. You are responsible for the remaining 40 percent as well as any stated co-payments. Bronze policies are usually a HSA policy, or a health savings account policy. You can save money in a health savings account and use the funds to pay for the costs of your medical care.

A silver policy, which may also be called a traditional policy, is usually a PPO policy in the state of Delaware. A PPO policy means you have the freedom to choose your medical providers, but you will pay more for an out-of-network provider when compared to an in-network provider. The policy will usually cover a portion of your rehab treatment costs, but only after you pay the deductible and the co-payment for your treatment. The deductible is usually a mid-range cost, such as $2,000 per person. The coverage will usually pay around 70 percent of the treatment costs after you pay the deductible, but you may pay more for out-of-network treatments. For example, it may only cover 50 or 60 percent of the out-of-network treatments.

A gold policy, or a comprehensive policy, is the policy with a low deductible and a higher monthly cost. You will usually pay around $1,000 or less for your deductible before your policy covers the cost of treatment. The policy usually has coverage for substance abuse after you pay the deductible and the co-payment. A co-payment depends on the type of rehab treatment program, so you may pay $10 to $15 for each visit when you seek outpatient care. In-patient treatments usually require a percentage of the treatment costs as your co-insurance. Gold policies cover around 80 percent of the costs after you pay the deductible. You should be aware that the policy is usually a PPO policy, which means you will pay more for out-of-network treatment programs.

A platinum policy is the most comprehensive insurance plan in Delaware. It has the lowest deductible and the highest monthly costs, but it also offers the most insurance coverage. The policy generally covers 90 percent of treatment costs after you pay the deductible and the co-payment. It offers coverage for addiction treatments, but you should ensure that you work with an in-network treatment provider. It will cost more for out-of-network treatments with a platinum policy.

In Delaware, you also have options for short-term health insurance. The policy is designed to help you transition between jobs and careers, so it may not offer coverage for rehab or the coverage may be limited in the policy. Short-term policies usually focus on a set time frame, such as 3 months, so it does not offer the same amount of coverage as more comprehensive policies. It may offer some coverage for outpatient care.

Insurance Providers in Delaware for Drug Rehab

Delaware has insurance policies available through five different insurance providers. The most common policies are available through Aetna and Highmark Blue Cross Blue Shield. Aetna offers bronze, silver and gold policies throughout the state. Highmark Blue Cross Blue Shield offers catastrophic, bronze, silver, gold, and platinum policies.

Although the primary providers of health insurance are Highmark Blue Cross Blue Shield and Aetna, you do have policies available through Celtic Health Insurance, John Alden, and Time Insurance. Celtic Health Insurance offers PPO and HSA policies that provide basic, traditional and comprehensive coverage. You also have short-term policies available from Celtic when you are planning to move into a new career or job.

John Alden provides a value plan, a traditional plan and core medical plan in Delaware. The policies are primarily PPO plans that give you the flexibility to select your doctor. Time Insurance also offers traditional, value and core medical plans in Delaware.

Other Insurance Options for Delaware Drug Rehab

Delaware Cigna

Delaware Humana

Delaware United Healthcare

Drug And Alcohol Rehab Coverage in Delaware Policies

The coverage for drug rehab in Delaware varies based on the policy you purchase or your employer offers through a company. Most policies will offer some coverage for drug rehab and addiction recovery. The coverage usually ranges from 60 to 80 percent of the treatment costs after you pay the stated deductible. You should be aware that some policies will only pay the stated amount if you seek treatment from an in-network treatment provider or rehab facility. The policies do not usually differentiate between different substances, like heroin, cocaine or marijuana.

Co-payments and co-insurance rates vary based on the type of treatment you consider for your recovery goals. A co-payment applied to outpatient care will usually range from $10 to $25 per visit. In-patient treatments are usually charged according to a co-insurance rate, which is a percentage of the treatment costs after your deductible. Some policies, like catastrophic policies or value policies, may limit coverage for drug rehab and treatment programs.

Types of Rehab Facilities to Help With Recovery

When you understand the coverage available in your insurance policy, you want to focus on the type of treatment available in a facility. Treatment programs are usually broken into outpatient and inpatient care. Outpatient treatment programs focus on helping you or a loved one recover from substance abuse while staying at home and continuing your responsibilities. A 12-step program is an example of an outpatient treatment program. Inpatient programs mean you stay in the facility for the duration of your treatment.

Within each type of program, you have different treatments available. Holistic programs take a well-rounded approach to the recovery process. They offer traditional treatments, like counseling and cognitive therapy, as well as alternative programs, like art therapy, animal therapy or meditation. The programs consider each individual as a person and develop a personalized plan.

A program may also take an evidence-based approach to treatment. In an evidence-based program, the facility offers treatments based on studies and factual data. It focuses on traditional approaches, like counseling, cognitive behavioral therapy, and medication-assisted treatments.

When you or a loved one need treatment for substance abuse, you want to start with evaluating your health insurance policy. Your policy may cover the treatment or a portion of your treatment costs. You should also be aware that the coverage and the standards differ for each insurance provider and the plan you purchased. Follow any standards set by your insurance provider when seeking treatment for substance abuse in Delaware to start working on your recovery goals.


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