You’ve decided to get sober, congratulations. If you’re like most people you’re going to need some help getting there. Welcome to drug treatment and the often costly world of rehab. If you don’t have health insurance or health insurance that covers mental health care it’s going to set you back some green. Fortunately, there are some ways to help you pay for the treatment you need.
The first thing you need to do is start planning to purchase health insurance. If you don’t have a group policy at work you need to be careful with this. Most policies sold to individuals do not cover pre-existing conditions. Drug and alcohol issues are almost always considered pre-existing so you’re going to need to find a policy that covers conditions that you already are dealing with. Prior to the Affordable Care Act, this was almost impossible. Due to the passing of the Affordable Care Act (aka ObamaCare) though this is no longer the case. ACA policies available on healthcare.gov and certain state exchanges have to include coverage for 10 minimum essential benefits, mental healthcare being one of those. There is still a problem for most people, however. ACA plans are only available for purchase during Special Election Periods (SEP) and during open enrollment. Open enrollment only occurs one time a year between November 1)st and December 15th . You can enroll during this period and then the policy begins on the first of the new year. If you are outside of open enrollment you may still qualify for a SEP if you have had a life-changing event. Life changing events are things like loss of employer coverage and marriage. When choosing a plan make sure to find one that has your clinic or rehab provider in-network. This is a list of doctors and facilities that have contracted with the insurance company to provide services.
What happens if you need to go to a provider that is not in network? Some insurance companies offer Preferred Provider Organization (PPO) policies that allow you to go out of network for a higher price. This would be your first option if one is available in your area. Working with a local health insurance agent would be a good option in helping you find the right plan. But what if an ACA PPO is not available in your area? Me and my wife had the same situation a few years ago when we were attending a clinic. In this situation finding a Health Saving Account Plan or HSA is a good option. An HSA allows you to deposit money into a special account on pre-tax bases. This allows you to pay for all or part of your care with pre-tax dollars. Many have debit cards that you can transfer money as you need it
Lastly with the passing of the Affordable Care Act many states have expanded Medicaid. Folks who may not have qualified in the past now are eligible for Medicaid plans. If your income is under 138% of the federal poverty line ($16,753 for an individual in most states) you will likely qualify. In the last several year’s several states have started to cover Methadone, Suboxone, and other treatment options.
There is a lot that could happen in the future with health insurance and drug treatment. There has been talk about removing this as part of the ACA law and new health care proposals in Washington have often excluded this coverage. Make sure to let your elected officials know that at a time like this when drug and alcohol usage is at an all-time high, it’s not time to exclude this life-saving coverage.