Most major medical plans do cover alcohol and drug rehab treatment as well as a host of other psychiatric issues. Some plans will have annual plan limits for outpatient and inpatient care.
Also, some individual major medical plans may not have any psychiatric benefits, while others will include psych benefits but only after a waiting period of 12 months or so.
Check your policy for exact coverage and any limits.
Business Advisor, Denesha Insurance Agency, California
Coverage for chemical dependency is covered by most major medical insurers. Deductibles, copays and Rx have been increasing in an attempt to slow premium increases. Kaiser has increased from $250 day up to 5 days/admission to $290/day, 5 days max on a Platinum $0 deductible plan. Yes, it is a rich plan and the incremental reduction in coverage allowed for a 5% rate increase 2015 to 2016.
Syndicated Financial Columnist, Host of the weekly talk show Steve Savant's Money, the Name of the Game, Scottsdale Arizona
Yes it does. Under ACA it is covered, however, the insurance carrier will require a person to get pre-authorization first before admission and not all facilities are considered “In-Network” so a person would have to be careful before just going into rehab.
Senior Commercial and Annuity Specialist, Freedom Brokers, Marion, Carbondale, Harrisburg IL
Under the ACA, substance abuse is covered. According to one major carrier, here are the caveats to coverage. This carrier, for inpatient services, states that you may be balance billed if preauthorization is not received 15 days prior to admission. For non participating providers there may be a penalty if not authorized 2 business days prior. Preauthorization is also required for Psychological testing, neuropsychological testing, electroconvulsive therapy, Repetitive Transcranial magnetic stimulation, and intensive outpatient treatment. Additionally, depending on the plan, and whether or not the doctor participates in the plan, you may have a deductible, and coinsurance for inpatient services up to 50%. For outpatient services you may also have a deductible and copays.
In short, if you have a family member that may need these services, and the trauma is not acute, your best choice is to plan ahead, and first go to your primary care physician; let him make that referral. If you feel that the family member needs inpatient services, get preauthorization as soon as you feel the need for some testing or therapy in order to reduce your costs, and make a tough situation easier for everyone.
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Also, some individual major medical plans may not have any psychiatric benefits, while others will include psych benefits but only after a waiting period of 12 months or so.
Check your policy for exact coverage and any limits.
In short, if you have a family member that may need these services, and the trauma is not acute, your best choice is to plan ahead, and first go to your primary care physician; let him make that referral. If you feel that the family member needs inpatient services, get preauthorization as soon as you feel the need for some testing or therapy in order to reduce your costs, and make a tough situation easier for everyone.