Florida Insurance for Drug Rehab
If you or someone you love is suffering from addiction, it can be hard to know where you can turn for help. Thankfully, Florida has drug rehabilitation programs throughout the state that offer the care that you need to begin your recovery. Insurance programs are available that can help people with addiction get help.
Florida’s Addiction Statistics
Individuals seeking help for addiction should know that they are not alone. The Florida Department of Children and Families reports that, in the 2015-2016 fiscal year, over 24,000 people sought treatment for alcohol dependence alone. Additionally, over 13,000 sought treatment for addiction to opioids such as heroin, Oxycontin, and Vicodin.
Do Insurance Plans Have to Offer Addiction Coverage?
Federal parity laws prohibit insurers from discriminating between the coverage they offer for physical maladies and the coverage that they offer for mental health issues. These mental health issues include substance abuse. As a result, your coverage for healthcare, in general, will be equal to the coverage that you have available for addiction recovery services. For instance, if you have a $500 deductible, this deductible is the same whether you are seeking care for mental health or physical health issues.
Additionally, mental health coverage is considered an essential health benefit under the Affordable Care Act. Qualified ACA Marketplace plans must offer mental health and substance abuse coverage.
As of 2015, parity laws also apply to Medicaid coverage to ensure that low-income Americans have access to needed benefits like addiction recovery care.
Insurance plans cannot discriminate based on substance. Coverage must be offered for treatment for addiction whether it is to heroin, cocaine, marijuana, methamphetamine or another drug.
Types of Drug Rehab Facilities in Florida
Those who are investigating treatment facilities will find that there are a number of facility types which can offer different environments and different types of care. Talk to representatives from the facility as well as someone from your insurer to find out what is covered for you.
Most plans, for instance, cover detox services. This stage of recovery involves the period of time where drugs and alcohol are leaving the treated individual’s system. Depending on a number of factors, there may also be withdrawal symptoms to be treated. Because of the risk of medical complications, detox is typically offered on an inpatient basis.
Luxury rehab facilities often look more like hotels than healthcare facilities. These facilities may offer comfortable amenities such as large rooms, massages, saunas and more to keep residents comfortable during treatment. The cost of these facilities will often exceed the coverage that is offered by private insurance plans. However, many will allow for hybrid payment where insurance covers some of the associated costs and the individual being treated can self-pay for the remainder.
It’s estimated that around four million people nationwide have what is known as a dual diagnosis: they suffer from both addiction and mental health problems. Between 12 and 16% of people who seek treatment for substance abuse also seek mental health treatment within six years. Many individuals find that the most effective treatment is one that addresses both their mental health issues and their addiction. Plans that are compliant with the requirements of the Affordable Care Act offer coverage for both addiction and mental health treatment.
Holistic treatment facilities may offer alternative therapies that include meditation, acupuncture, homeopathic treatments and naturopathic care. In some cases, these facilities will offer conventional medical treatment, as well. It is important to consult with the treatment facility and your insurer, as many policies do not cover holistic care. Some facilities may offer a sliding scale for those who wish to seek treatment there on a self-pay basis.
Florida Insurance Plans for Alcohol & Drug Treatment
In Florida, private health insurance can be purchased through the Federal Marketplace. The companies offering insurance coverage varies by year. For instance, Aetna, which previously sold health insurance policies in the state, will no longer offer coverage in Florida as of January 1, 2018. Individuals can only enroll in plans offered through the Affordable Care Act during the open enrollment period every year unless they experience a qualifying event. Qualifying events include losing health insurance, a change in residence that involves a move to a different ZIP code or county, or a change in the household such as getting married or divorced. At the time of this writing, health coverage that includes drug rehab and recovery can be acquired from these major insurers.
Florida Blue offers a range of HMO and PPO Plans at the ACA’s Silver level. The costs that you will see on these plans depends largely on where in Florida you live, whether you qualify for a tax credit and the specifics of the plan that you choose. A plan with a higher deductible will typically have a lower monthly cost. Plans also have out-of-pocket maximums; after you have reached these limits, you will no longer have to pay anything toward covered medications and services.
Cigna is another company that continues to offer health insurance plans in the state of Florida. Under their Cigna Connect 4500 policy, an individual’s deductible will be $4,500 a year. They’ll pay $30 for a visit to their primary care physician and $60 to see a specialist, including specialists in mental health and addiction recovery.
Sunshine Health’s Ambetter program offers a range of insurance plans at different price points. A 44-year-old man with an income of $35,000 a year would pay around $150 per month for a Bronze level insurance policy with a deductible and maximum out of pocket of $6,800. For a Silver level plan with a maximum out of pocket cost of $7,040, the cost would be around $275 per month.
Molina offers insurance through the federal Marketplace. Their plans range include Bronze, Silver and Gold level insurance policies. Under a Bronze plan, an individual would have a $6,650 maximum out of pocket cost. By contrast, a more costly Gold plan would have a $1,025 per year maximum out of pocket cost.
If the person who needs treatment is under the age of 19 and you meet income requirements, they may be able to get coverage through Florida KidCare, the state’s CHIP insurance program. KidCare enrollment is open year-round. Premiums are on a sliding scale and are often no more than $15 to $20 per month due to subsidies. KidCare programs typically do not involve any share of cost or copays.
Medicaid for Florida Drug Rehab
Medicaid may also be an option in certain circumstances. Because Florida did not accept the Medicaid expansion under the ACA, most adults without children will not qualify for Medicaid coverage. However, children, pregnant women, and adults who care for minor children may qualify for some coverage based on income limits. Individuals who do not qualify for full Medicaid may be eligible for what is known as “medically needy” coverage. This coverage also called “share of cost”, will cover portions of medical cost after minimum outlays are met.
Other Insurance Options for Addiction Treatment
Using Insurance For Recovery Treatment In Florida
The choice of a drug rehabilitation program is highly personal. No one program is a good fit for every individual with addiction. By investigating a range of options and choosing the one that fits your situation best, you or your loved one can get the care that they need to work toward health and lasting recovery.