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What’s the Deal with Insurance and Rehab Coverage?

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In a world plagued by drug addiction and the opioid crisis, it’s more important than ever to figure out whether your insurance will cover rehab services. This might seem daunting at first.  Of course, there are a lot of options out there. Especially with the release of the Affordable Care Act. 

If you’re not sure about what that is or how it relates to rehab services, this is the article for you. I’m going to explain how that law relates to rehab services and insurance policies. I’ll give a few examples of how to apply this knowledge as well!  Stay tuned!

What is the ACA Anyway?

The Affordable Care Act, or ACA, was made law on March 23rd, 2010.  It was adapted by the Health Care and Education Reconciliation Act on March 30th, 2010. The Department of Human Services has a website, https://www.hhs.gov/answers/health-insurance-reform/what-is-the-affordable-care-act/index.html, that details what this act is. In short, the law deals with health insurance coverage, preventative care, and health care costs. 

You might wonder why this is important.  Well, there are a few reasons.  The ACA aims to lower health care costs and provide necessary services to all United States citizens via wider availability.  It includes substance abuse care as one of the ten parts of the listed essential health care benefits.

If you’re unfamiliar with insurance coverage like I was, this might sound like jargon.  That’s okay!  The key part here is that if you have a health insurance policy through the ACA, it should cover behavioral and mental health in some way or another. This means your insurance should apply to rehabilitation services. 

You might wonder why this is the case.  Part of it is the opioid crisis that has plagued the United States since the 1990s.  With so many people impacted, the government has been trying to step in more. The Affordable Care Act including rehabilitation services in health insurance policies means that more people will have these services available to them. 

How do I Find Out if My Insurance Covers Rehab?

Well, like I mentioned earlier, if your policy is part of the ACA coverage, it should.  You can contact rehab centers to make sure, of course.  One example of this is Blue Cross Blue Shield rehab – you can contact them to inquire about insurance coverage and other costs.  They have their own policy in the ACA marketplace. 

That’s not the only option, of course.  You can call pretty much any rehab center and inquire about insurance within. Wherever you end up, you will probably get access to a social worker, psychologist, psychiatrist, or any other mental health professional you might want and/or need. Substance use disorders require care, often from several types of professionals.

Most insurance companies ask that you utilize preferred providers within their systems.  This is important to keep in mind as you consider seeking treatment. While it’s not a bad thing, it is a stipulation to be conscious of.

What’s Important About Rehab?

If you’re not familiar with rehabilitation services, you might be wondering why these things are covered by insurance at all. Maybe you think you can detox at home and that’s all you need!  Unfortunately, this is very often not the case.

I have alluded to it before in this article, but one of the biggest reasons the ACA considers rehabilitation services so critical is the opioid crisis.  The government has an overview of it right  here if you’re interested in reading a lot of details about it. This crisis significantly impacts public health.

Some examples of opioids are fentanyl, heroin, and prescription pain relievers.  Because pharmaceutical companies assured people in the 1990s that pain relievers weren’t addictive, a lot of doctors prescribed them liberally.  Unfortunately, as we’ve now seen, these substances are in fact highly addictive. 

This has led to a lot of substance abuse disorders surrounding opioids in particular. Unfortunately, a lot of people overdose on opioids and can even die from this.  While the government has agencies that are doing their best to mitigate these problems, the ACA took a big step in determining rehab services one of the essential health needs for American Citizens.

What Causes Addiction, Anyway?

I’ve spent a lot of time explaining rehab services, why they’re important, and why the ACA has been so critical in treating substance misuse problems.  The root of the problem here is, of course, addiction. What is addiction, and why is it so destructive?

Officially, addiction is called “substance misuse disorder.” It can apply to drugs and alcohol.  It’s a disease that impacts a person’s brain. Often, they continue using harmful substances even when they negatively impact their life.

As a person continues to use a drug, they get more and more chemically dependent on it.  Their brain might need the drug just to feel okay enough to get through the day. Obviously, this is not good for overall health. It can impact relationships, jobs, and your overall well-being.

Symptoms of Addiction

There are a lot of varying symptoms for substance misuse disorders. Some of these might not seem like traditional “symptoms” like we think of them for mental health problems, but they are symptoms all the same. Some of them are:

  • Stealing to obtain the drug
  • Taking larger amounts of the drug than you originally planned on taking
  • Having withdrawal symptoms when you try to stop using it
  • Experiencing urges or intrusive thoughts about the drug that stop you from focusing on anything else
  • Performing risky activities while under the influence of the drug, that you might not otherwise do

There are other symptoms as well, of course.  As you can see, a lot of these are really detrimental to a person.  That’s why rehabilitation services for drug misuse disorders are so important.

It’s a good thing the Affordable Care Act considers these services essential for United States citizens.  Hopefully, as insurance policies cover rehab more and more, the crisis will lessen, and more people will heal.  After all, that’s the overall goal.

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