Using Health Insurance for Rehab at Purpose Following a Relapse
From hard-won experience, many of us in recovery know that substance abuse treatment isn’t always a one-and-done deal. The rate of relapse is highest in the first 90 days following detox, especially for individuals who don’t have the right support in place and those who are not ready to fully give up their chosen substance.
If you or your loved one have relapsed and want to try treatment again, you may be left wondering, “How many times will insurance pay for rehab?” Rest assured, you will find answers in our latest resource from Purpose Healing Center.
Health insurance companies are now legally required to offer some coverage for the treatment of a drug or alcohol problem. This often includes inpatient services like rehab and outpatient services like therapy, mental health treatment, and support groups.
These are considered essential benefits that must be included in both private and public insurance plans. However, whether your particular health insurance plan will cover a second (or third) stint in rehab depends on things like policy limits and whether rehab seems effective for you.
Keep reading to get answers about how many times will insurance pay for rehab, and finding effective programs of support that accept many, many insurances at Purpose Healing Centers in Arizona!
Will Insurance Cover Rehab if I Relapse?
Insurance covers inpatient and outpatient rehab services for patients because of the Affordable Care Act. Passed in 2010, the Affordable Care Act established essential health benefits including treatment for addiction, mental health conditions, and behavioral conditions. It also made access to in-network services easier using the Health Insurance Marketplace.
As we mentioned above, in many cases, health insurance providers will cover rehab following a relapse. This may change depending on things like the number of times you have been through addiction treatment, how recently you’ve sought treatment, and the specifics of your health insurance coverage for rehab.
For those who have attended addiction treatment facilities more than once, your insurance company may also consider how effective rehab has been for you in the past and what could be done differently for a better outcome.
At Purpose, we are ready and waiting to help you advocate for additional rehab support, and our Joint Commission-accredited facilities are looked upon favorably by insurance companies.
How Many Times Will Insurance Pay for Rehab if Relapse Occurs?
There is no set standard for the number of times that insurance providers cover substance abuse treatment. However, many insurance policies cover addiction treatment following relapse.
While effective programs have a lower rate of relapse, an average of two-thirds of individuals relapse within the first few months following treatment. There is approximately an 85% chance of relapse within the first year.
While these numbers are high, you should never let that discourage you from seeking treatment for alcohol or drug addiction. Things like the treatment center you work with, support in place following treatment, attending aftercare programs, and committing to a better lifestyle all improve your chances of recovery.
At Purpose Healing, our evidence-based approaches have helped thousands of clients across the US achieve sobriety, and no matter how difficult it may seem right now, we can help you or your loved one find lasting recovery success!
How to Find Out if Your Insurance Provider Offers Rehab Coverage
If you are still wondering about your exact policy and asking yourself, “How many times will insurance pay for rehab?”, the easiest way to find out is to call our team at Purpose. We will verify insurance promptly and confidentially over the phone.
Making it easier for our clients to get the quality treatment for substance abuse issues that they deserve is only one service we provide.
By letting us verify health coverage details, you won’t waste time on hold like you would when contacting an insurance provider directly. We can also discuss alternative treatments or payment plans if insurance won’t cover rehab.
Does Insurance Cover Dual Diagnosis Treatment Programs?
Dual diagnosis is addiction treatment that focuses on recovering from substance abuse while simultaneously treating mental illnesses that may contribute to substance use disorders. It is not uncommon for individuals dealing with untreated mental illness or unresolved trauma to use substances as a form of self-medication.
In most cases, providers do offer insurance coverage for dual diagnosis treatment. For individuals who would benefit from mental health services, dual diagnosis treatment programs are significantly more effective than substance abuse treatment on their own.
Do I Have to Use an In-Network Treatment Center?
Public and private insurance companies contract with certain healthcare providers so services are available to members at a lower cost. Members sometimes pay a monthly or yearly premium or have copays.
Some public insurance coverage options are also free depending on factors like a person’s income limit and their ability to work. We are incredibly proud to be among the leading rehabs in Arizona that accept AHCCCS insurance and are also JCAHO-accredited.
If you attend rehab at an out-of-network treatment center, you will have to pay out-of-pocket for the total cost of treatment. At Purpose, we are in-network with several insurance companies, and even in some cases when we are out-of-network, insurance will still cover all the costs.
Even if you are not covered under insurance, we can help you look at options for payment plans or financial assistance.
What if My Health Insurance Policy Won’t Cover Rehab?
There are times when an insurance company will not cover rehab multiple times if they occur in the same calendar year. They also may not pay for treatment for individuals who have exceeded the coverage limits of their insurance policies.
That being said, we can help you navigate this process and get options no matter your insurance carrier and their initial decision.
Appealing an Insurance Denial of Rehab Decision
If you believe that your insurance provider should cover your inpatient treatment plan, then you can appeal their decision with an internal or external appeal. In either case, you’ll have a chance to provide information on why you believe that your health care should cover rehab.
Internal reviews are conducted within the insurance company while external reviews are conducted using a third party. In either case, a judgment in your favor means that insurance will cover the costs of rehab. At Purpose Healing, we can help provide documentation to support such an appeal in many cases.
Considering Alternative Types of Substance Abuse Treatment
Several alternative rehabilitation treatments offer support to individuals in detox and recovery, too. For individuals struggling with chronic relapse, getting help at a sober living facility may be an option.
Other alternative treatments include partial hospitalization programs or intensive outpatient programs covered by insurance, often more readily than inpatient offerings. These programs last several hours each day, but you’ll still return home to sleep, go to work, and attend to other responsibilities. At Purpose, we provide a full continuum of care that offers both PHP and IOP services at convenient locations throughout the Greater Phoenix Valley.
In many cases, insurance will cover drug and alcohol addiction treatment year-round outside of inpatient treatment. Many insurance plans cover access to addiction medicine, individual therapy, and group therapy.
Attending support groups like Alcoholics Anonymous or Narcotics Anonymous are another alternative, as well as groups like SMART Recovery and ongoing outpatient services that are less structured than PHP or IOP.
How Much Does Drug and Alcohol Rehab Cost?
The total cost of drug and alcohol rehab depends on the type of addiction treatment, insurance coverage, and the rehab center that you choose. Choosing an in-network facility can also lower costs.
The average cost of residential treatment in the United States is less than $40,000 per month, though insurance will generally cover some (or all) of these costs.
Choosing the Most Effective Substance Abuse Treatment Program
Most people who have struggled with addiction will say it is not easy to stay sober. Even after being sober for years, social situations, big life events, and trauma can all trigger relapse. This is why your choice of substance abuse treatment centers in Arizona truly does matter.
The Mental Health Services Administration and Evidence-Based Practices
The American Medical Association considers drug use to be an epidemic. With rates of addiction and overdose climbing, resources like the Substance Abuse and Mental Health Services Administration (SAMHSA) exist to establish a standard of care.
At Purpose Healing Center, we understand that you have options when it comes to addiction treatment. Our staff is trained in the latest evidence-based practices and therapies from SAMHSA. Furthermore, we are Joint-Commission Accredited and have locations in Phoenix and Scottsdale to make treatment more accessible to our clients.
Other Things to Consider When Choosing a Rehab in Arizona
Other things to consider when choosing a rehab program include insurance coverage and out-of-pocket expenses, the quality of services offered, and whether you think you’d be comfortable at the facility.
At Purpose, we have many amenities you’d find at luxury centers including the availability of private rooms, meals and nutritional services, and therapeutic activities including yoga, meditation, and using the swimming pool.
However, these come at a more affordable cost, especially with public or private insurance. We work with Ambetter, Banner Health, many forms of Medicaid in Arizona, and other health insurance policies to make our treatment centers accessible to those who need and deserve access to quality care.
What to Expect During Drug and Alcohol Rehab at Purpose
During intake, you may be asked questions about your medical history including trauma and mental conditions, substance use habits, treatment history, stresses in your life, and rehabilitation services you have already tried. Then, we’ll discuss whether outpatient or inpatient rehab would work best for you.
Inpatient Rehab at Our Residential Facilities
Purpose Healing Center offers several therapies as part of 30-, 60-, and 90-day inpatient programs at our rehab facility, including:
- Dual diagnosis treatment
- Individual, group, and family therapy
- Rational emotive therapy
- Cognitive behavioral therapy
- Relapse prevention training
- Client-centered treatment
We also provide detox center services to help our clients manage the symptoms of withdrawal, including medication-assisted treatment and detox. All this is offered in a comfortable setting with access to recreational activities including guided meditation, mindfulness, yoga, a swimming pool, and more.
Outpatient Services and Ongoing Therapy Options
For those who don’t think residential services would be a good fit, Purpose still offers several types of treatment. Outpatient options are typically more affordable than inpatient rehab. Some clients also use them to provide support as they return to their lives.
Intensive outpatient (IOP) and partial hospitalization programs (PHP) both involve attending rehab for several hours a day on different days of the week. This may be a combination of individual and group therapies and other types of support.
Group therapy is especially helpful because it builds a sense of community, fosters healthy relationships, and makes struggling individuals feel like they aren’t so alone. It can also help individuals discuss stressors and triggers in their lives with a group of people who might be able to offer help with relapse prevention.
Outside of these programs, there are options like working with a psychiatrist or therapist or attending group therapy. We will also help you find meetings like Alcoholics Anonymous or Narcotics Anonymous, SMART Recovery, and others, near your home.
Having access to meetings like these is an important part of developing a support system in recovery.
Use Your Insurance Now to Cover Our Rehab Programs at Purpose
Whether you are seeking addiction treatment for the first time or need help conquering a history of chronic relapse, our staff at Purpose is here to support your success. We make it easy to verify your insurance and create an individualized treatment plan that will give you the best chance at lasting recovery.
Please speak to one of our staff members about how Purpose Healing Center can help start the recovery process today. We understand that seeking treatment isn’t always easy, so we aim to make getting help as easy as possible. Seize the momentum and give our caring team a confidential call now!
480-579-3319