Why Do Some Addiction Treatment Centers Accept In Network Insurance And Others Don’t?

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Drug addiction can affect anyone and have fatal or devastating consequences. In 2016 alone, an estimated 66,000 people died from heroin overdoses, a 19.5% increase from 2015. Addiction is an epidemic that effects over twenty million people in the United States – more than anywhere else in the world – and continues to rise with cocaine, marijuana, and tobacco having the highest rate of use.

Out of the millions of people with substance abuse issues, only 11% go to a specialized drug and alcohol treatment facility to help beat their addiction. So, how do you decide which facility is a best for you?

Choosing a treatment center is a very personal decision with several factors (e.g. cost, distance, etc.) that should be considered before making any phone calls. This guide will help answer any questions you may have about paying for rehab, break down what to look for and why, and help you take the first step to living a happy, healthy life.

About Treatment Programs

There are 14,500 specialized treatment centers in the US, so choosing one can be an overwhelming and daunting task. However, the decision can be easier if you know what you’re looking for in a rehab center. Here are the different programs available (though they may vary by facility):

Medical Detox

This is the first step in the treatment process. When drugs or alcohol have been habitually used for a long period of time, stopping “cold turkey” can result in dangerous withdraw symptoms, such as seizures, heart palpitations, or irregular heartbeat. Medication and close medical supervision are used to help a person transition to sobriety. The detox process comes with unpleasant mental and physical symptoms (e.g. nausea, vomiting, shaking, coughing, etc.) and lasts as long as necessary (typically a few days to weeks). From there, a person will be placed in an inpatient program to be completed at the facility.

Inpatient

This program is based on individual needs and can last weeks or months. During inpatient rehab, the person resides at the facility and attends daily group and individual therapy.

Intensive Outpatient

This allows people to live at home while completing intensive therapy. The Intensive Outpatient Program (IOP) is usually recommended for individuals who do not require medical detox.

Outpatient

Typically, people are to continue attending groups, but do so a few times a week while living at home. Drug tests will be performed to ensure sobriety.

Partial Hospitalization Program

This is an intensive program that is focused on psychiatric care and doesn’t require overnight stays.

 

Factors That Go into Choosing a Treatment Center

Distance

Though you may want to be close to home to allow for weekly visits from friends and family, sometimes this can hurt you more than help you, especially if your family enables you. For this reason, consider going to a facility a few hours away to focus on your recovery and separate yourself from people who may not aid in your treatment.

Services Available

Before choosing a rehab center, you should inform yourself about the services available. This is a brief list of questions to ask when researching and calling facilities:

• Do you provide twenty-four-hour care?
• Is a physician available around the clock?
• How are treatment plans developed? Are they written with input from other professionals (occupational therapists, psychologists, etc.)?
• Are patients provided with at least three hours of therapy five days a week? (The minimum requirement for a licensed facility).
• Is family participation encouraged (observation, meetings, family counseling)?
• Are outpatient services available to continue therapy after completing and being discharged from the inpatient program?

Financial Considerations Going To Addiction Treatment

• Cost
Insurance Coverage
• Alternative Payment Methods

The average cost of an inpatient stay at an addiction treatment center can range from $15,000-$27,000 for supervised medical detox, partial hospitalization, inpatient and outpatient care, and a sober living house (to make the transition from rehab to homelife easier). Of course, not everyone will require all the above-mentioned programs, so the cost may be less and vary by area.

When researching treatment centers, it’s recommended to see what your insurance will cover to save money out of pocket. Some rehab centers may be in-network, which means they are contracted with the facility to deliver services for a discounted rate.

Before managed care plans, most people had fee-for-service insurance that allowed them to go to the doctor of their choosing. Now, while the choice of in-network healthcare facilities may be more limited, people are able to receive treatment more affordably.

So, if an addiction treatment facility is in-network, that means the following:

• The facility is contracted with an insurance company, so the insurance company sends them a steady stream of patients in exchange for discounted rates of service.
• The physicians have desirable educational backgrounds and credentials.
• The physicians are board certified.
• The rehab centers agree to follow the rules set by the insurance company.

Treatment facilities that are out of network didn’t offer aggressive enough discounts or meet the above criteria for any number of reasons. There are other ways to pay for addiction treatment if you opt not to use in-network insurance or you don’t have insurance.

Medicaid or Public Insurance

Depending on your income, you may qualify for Medicaid. To receive Medicaid, you must be under nineteen, pregnant, a parent, or be within a specific income bracket:

Family of 1 – Maximum of $15,654.10 per year
2 – Maximum of $21,186.90 per year
3 – Maximum of $27,121.50 per year

To apply, go to your county assistance office, fill out the necessary paperwork, and provide proof of income.

Loans

Another option to pay is a private loan. This would have to be paid back to the bank, but it’s a way for your loved one to get treatment without the immediate financial burden.

Grants

Some treatment facilities offer grants to those without insurance. Call to discuss payment options and see if you qualify. Keep in mind, though, that only a few may be available.

Remember that there is hope for those with drug or alcohol addictions. The first step to recovery is finding treatment center that meets your needs and is in-network or within your budget. The road to sobriety is a long one but a good treatment center can make the journey easier. To begin yours, call us at 888-380-0342

Just Believe Recovery is a fully licensed, Joint Commission accredited, comprehensive drug and alcohol treatment center located in Carbondale, Pennsylvania

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