Insurance programs often offer drug detoxification services, as the care provided in programs like this can help people to amend their drug use without enduring physical complications in the process. A study of the issue, in the journal Psychiatric Services, found that detoxification services were often authorized for alcoholics if they met specific risk factors for medical complications during withdrawal, and people addicted to drugs could get coverage if they were judged to be at risk for mental health problems due to withdrawal. This is good news for people who have addictions and insurance coverage, although there are some specific things these people should keep in mind before they pull out their insurance cards at the treatment facility they’ve chosen.

Authorization Issues

In general, insurance programs dislike being asked to pay for services that are already in progress. Instead, they’d like to be included in the selection process, so they can control where the person goes for care and the kind of help the person receives while in treatment. At times, insurance companies have specific contracts in place with specific facilities, meaning that the two parties have agreed on costs and treatment protocols, and these agreements can keep prices lower. Additionally, some insurance programs require a doctor’s authorization before services are provided, just to ensure that the treatments are considered medically necessary.

Calls to the insurance provider can help families to straighten out these issues. Good questions to ask include:

• What documentation do you need from our doctor?
• What facilities can we use?
• How long can we stay?
• When will the service be authorized?

Hidden Issues

While insurance might cover some of the cost of care, the family might be expected to pick up part of the tab. A copayment for each day spent in care is common, and some programs have upper limits on costs. They might agree to pay a set amount, for example, but if the program costs more than that upper amount, the family might be responsible for the rest of the cost. It can all seem a little confusing, but treatment programs often provide families with access to trained admissions counselors who have dealt with these issues many, many times before. They know just what to say to insurance companies to make issues of price clear, and they can explain the take-home price to families in reasonable language they can understand.

It’s important to note that some programs offer coverage only for detoxification. This means that the programs might provide help in order to help the person achieve sobriety, but the therapy that’s required in order to make that sobriety stick might not be covered by insurance. It’s unclear why this line in the sand exists, but it’s possible that the insurance programs pay only for the physical problems of addiction, and those problems tend to manifest during detox. The mental health issues that crop up during rehab are sometimes considered out of the purview of insurance plans. This is another issue families should clarify before detox begins, so they’ll know just what to do when the program is over and the person needs to move onto the next phase of care. Detox admissions counselors might be able to provide help with this issue as well.

Help for the Uninsured

In 2007 and 2008, 12.6 percent of people who had no insurance got addiction help at a specialty facility, according to the Substance Abuse and Mental Health Services Administration. These people likely paid for their care out of their own pockets, but it’s possible that fewer people will need to make this choice in years to come. As more and more research is conducted on addiction, it’s becoming more and more clear that addictions begin in the cells of the brain, and that medical care is necessary for long-term healing. People need to begin that work at a detox facility, and as more insurance companies become aware of that fact, it’s likely that more of them will choose to cover this kind of care. It’s also likely, due to legislative efforts, that more people will have health insurance in the future, and they’ll be able to draw upon those plans in order to get the help they need.

We have admissions counselors available via telephone to answer any questions you have, and we’re happy to work with your insurance company to get you the payment help you need. Please call us to find out more about this.