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Does Insurance Cover Rehab in Massachusetts?

The cost of rehab is one major obstacle that stands in the way of people seeking help for addiction. Many people who seek treatment do so because they are suffering from a severe addiction, and, as a result, may be low on money and financial resources. After all, many people who suffer from addiction spend excess money on their substances and get themselves in poor financial shape.

According to the National Institute on Drug Abuse, longer treatment programs are directly associated with positive treatment outcomes. In fact, they suggest that a 90-day program is the minimum amount of time a person should receive treatment for substance abuse.[1] While 90 days may not seem like a long time in the grand scheme of things, 90 days is a long time to be responsible for paying for treatment. And, the longer you spend in rehab, the more expensive you can expect your bill to be.

This leaves many people like you wondering whether or not your insurance will cover rehab in Massachusetts. While each person’s insurance coverage varies, the good news is all health insurance providers are required to cover substance abuse treatment and mental health services.

Understanding the Affordable Care Act (ACA)does insurance cover rehab in Massachusetts

The primary reason you can be sure your insurance will cover rehab in Massachusetts is due to the Affordable Care Act (ACA). The ACA was originally passed in 2010 and is a health care system law that accomplished many things. The ACA:

  • No longer considers addiction and mental illness pre-existing conditions for insurance purposes
  • Sponsors insurance plans that are for sale on a sliding-scale basis on the Health Insurance Marketplace
  • Provides need-based tax credits to low-income individuals who otherwise would not be able to afford health insurance

These provisions make it so that addiction treatment coverage is just as complete and comprehensive as coverage is for any other medical procedure or treatment. This rule applies to both private health insurance plans and ones purchased through the Health Insurance Marketplace. Lastly, the ACA reduces addiction rehab costs, increases options for treatment, and extends benefits provided by group employee insurance plans.[2]

Regardless of whether you get your insurance from a private entity, your workplace, or state or federal medical plans, your insurance should cover some portion of drug and alcohol rehab in Massachusetts.

Substance Abuse Treatment Services Covered by the ACA in Massachusetts

As a result of the introduction of the ACA in 2010, health insurance providers cannot discriminate against people with pre-existing conditions or deny coverage for those with pre-existing conditions. Health insurance plans must provide coverage for:

  • Medical detox services – Detox may involve inpatient and overnight stays, medications, and around-the-clock support.
  • Inpatient behavioral health services – Inpatient rehab can last 30, 60, or 90 days and involves individualized counseling, treatment medications, and housing.
  • Outpatient counselingOutpatient programs involve group and individual therapy as well as medication management on a flexible and affordable basis.

Only services that are deemed medically necessary are required to be covered by your insurance. Additional services, such as acupuncture, massage, recreation programs, or meal plans are less likely to be covered by your plan. Instead, you may be responsible for those out-of-pocket costs.

Finding a Rehab Facility that is In-Network With Your Insurance Provider

While the ACA mandates insurance companies to cover mental health and addiction rehab services, it does not specify whether or not they have to provide coverage for all facilities. For instance, your insurance provider may cover treatment at one rehab in Massachusetts, but not the next. That is because there are in-network and out-of-network options. In-network options are usually cheaper.

To figure out who is in-network with your insurance provider, you can do one of two things:

  1. Contact your insurance provider and ask them which facilities are in-network with your insurance plan.
  2. Speak to an admissions counselor and let them verify your insurance.

Dealing with insurance companies can be confusing and stressful, so we always recommend the latter. Plus, an admissions coordinator can help match you with the right rehab facility so you are able to obtain affordable and quality care.

Verify Your Insurance and Start Rehab in Massachusetts Today

If you’re wondering whether or not your insurance will cover rehab in Massachusetts, we can help. Our dedicated admissions counselors are standing by ready to take your call, verify your insurance, learn about your treatment needs, and help you begin your recovery journey. Don’t wait any longer. Affordable and effective rehab that doesn’t break the bank is only a phone call away.

References:

  1. https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-long-does-drug-addiction-treatment-usually-last
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308192/

Ready to Make a Change?

We know that overcoming addiction is not easy and requires courage to ask for help. At Woburn Wellness Addiction Treatment, our team of professionals has decades of combined experience in helping men, women, and families overcome substance abuse.

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