How Does Insurance Work For Substance Abuse Programs In Florida?

Drug and alcohol addiction are health problems, and that means treatment is covered under most government-provided and private health insurance policies. The process of filing insurance or getting your company to reimburse your costs can be confusing. If you’re entering treatment in Florida, your admissions counselor can help you complete the insurance process, Here’s a rundown of how it works.

Which Comes First, Insurance or the Treatment Center?

If you already have a health insurance plan, that’s the logical place to start when you’re looking for treatment. You simply have to find a facility that accepts your insurance. In the state of Florida alone, there are more than 25 detox facilities, 29 residential treatments centers, and 96 outpatient programs. That’s in addition to transitional housing, maintenance programs, and the hundreds of 12-step programs that are in nearly every town and hamlet.

This leaves a pretty large group of options to choose from. Once you find a facility that’s a match for your circumstances, an admissions counselor will walk you through the process of when and how often you’ll need to file a claim with your insurance, and details regarding additional costs not covered by your insurance. They’ll also help you fill out any forms you’ll need for reimbursement, claims, or referrals, and act as an advocate on your behalf if you run into problems with your insurance company.

Public Insurance Vs. Private

If you don’t already have health insurance coverage, you should be aware of your options. Under the law, pre-existing conditions must be covered, but this could change at any time. Check with your company’s rules and terms of service to make sure.

Public insurance includes Medicare, Medicaid, and Veteran’s or active duty military insurance. All of these options are required to cover all or part of the cost of drug rehab, related medical or mental health treatment, maintenance programs, and any prescription medication required as part of your treatment. However, you may be limited to certain facilities, and some costs may be capped or restricted.

Private insurance coverage includes individual plans and employer-provided health insurance. These plans often have a wider range of benefits, and there are more treatment facilities that accept them. Some of the advantages of private insurance are:

Broader access to treatment facilities

Fewer out-of-pocket expenses

In-patient drug rehab is more likely to be covered

Availability of high-end treatment at places that offer more amenities and alternative or holistic care options

The Law is On Your Side

The opioid crisis and better understanding of the nature of addiction have led to government intervention that ensures people can get the help they need. Several laws have been enacted that require insurance companies to pay all or part of the cost of treatment. These laws are applicable at both state and federal level, and whichever offers the greatest benefit in your situation will be applied. You should also note that part of the medical costs for your treatment may be tax deductible.

The Mental Health Parity and Addiction Equity Act of 2008 was actually signed into law in 2010. This act requires employers with 50 or more full-time employees who offer group health insurance plans to add coverage for mental health treatment as well as drug and alcohol rehab. It doesn’t cover small employers or individual plans, but the Affordable Care Act (ACA) does a lot to fill that gap.

If your insurance company balks at paying for treatment, find out if you are protected under the scope of state or federal health coverage mandates. You shouldn’t be concerned about what will happen to your job if your employer finds out you’re going into rehab. You’re protected by the Family and Medical Leave Act. You may also qualify for short-term disability in some circumstances, which means you can still receive at least part of your salary while you’re in treatment.

Is Treatment Still Accessible If You Have No Insurance?

Money shouldn’t stop you from seeking treatment for your substance abuse. If you don’t have health insurance, or if your insurance doesn’t cover the cost of your treatment, you still have options. The goal of treatment centers in Florida is to make rehab accessible and affordable regardless of coverage or ability to pay.

Most communities have public drug rehab centers that are at least partially subsidized by state and/or federal funds. Nearly all facilities accept Medicare and Medicaid, and a counselor can help you determine your eligibility if you’re not already enrolled in one of these programs. Some private drug treatment facilities have affordable plans available for self-paying patients, and a few centers even have scholarships available for those who are serious about getting clean but have no resources.

Your Health Insurance Coverage Checklist

The less outside stress you have, the better you can focus on your recovery. That’s why it’s essential to do all the legwork and have your insurance or payment options taken care of before you begin treatment. There are several things you should find out from your insurance company ahead of time.

Does your plan include coverage for substance abuse treatment? Often, this is done under mental health treatment. If you have Medicare, it will be covered under your Part A hospitalization Plan.

Do you need a referral from my primary care physician?

Does your treatment facility accept your insurance, and are any medications you’ll need covered?

How much will you have to pay out-of-pocket for co-pays, co-insurance, and deductibles?

Are all of the counselors and doctors at your treatment center in your network?

Are you allowed to go out of network for any facet of your treatment?

Are their any caps, restrictions, or other limits on your care?

Are inpatient and outpatient rehab treated differently? Are both covered?

Ready to Begin?

Our treatment center accepts most major health insurance plans, We also have a patient funding interface set up where friends and family can contribute directly to help cover out-of-pocket expenses like personal items and co-pays. Counselors are standing by 24/7 to talk to you at 877-978-3148. When you’re ready to begin the recovery process, we’re here to help.