Rehab Insurance Coverage

Does Insurance Cover Rehab?

All policies are a bit different and each individual’s situation is different, due to this, it is hard to know for sure if your insurance will completely cover your time at a rehab. To know for sure, please take a moment to verify your insurance with our team.

What Kind of Rehab Does Insurance Cover?

Unfortunately, not all insurance policies cover all rehab programs. However, insurance companies are more likely to cover some programs than others. For example, they often cover more of the bill for outpatient rehab than inpatient treatment. One reason is that inpatient treatment is more expensive than outpatient treatment.

However, that doesn’t mean that insurers don’t cover a wide range of programs. Once again, the specific coverage depends on each insurance plan. Certain policies simply offer more coverage than others.

Determining which kind of rehab insurance coverage that an individual has isn’t difficult. It simply requires contacting Renaissance Recovery. Our friendly staff can verify people’s insurance and determine their coverage.

Medi-Cal As Payment For Drug Rehab

Medi-Cal is accepted by state-funded and county-overseen community-based public health providers. Public drug rehab facilities often receive Medi-Cal as a form of payment.

In short, Medi-Cal plans are low-cost or free versions of the same health plans offered under Covered California. Additionally, they possess the same benefits.

In order to find a provider that accepts Medicaid or Medi-Cal, SAMHSA’s Behavioral Health Treatment Services Locator can assist. They also offer current information on local drug rehab and mental health care providers. 

The California Public health care system is run through a managed care system that offers addiction treatment services on local and community-based levels. 

In order to acquire drug abuse and addiction treatment services, you will often begin the process with your primary care physicians. Specialty services, such as drug rehab, usually need to be ordered as “medically necessary” by your physicians before being provided by the state.

Women with a child on the way, people in immediate need of help, individuals dealing with mental health concerns, people using drugs via syringe, and parents with young children who may be at risk are generally given first priority treatment. They are given addiction treatment at drug rehab facilities that accept Medi-Cal for payment.

Your Medi-Cal provider will usually possess a referral line for information on how to acquire specialty services like drug rehab. The Medi-Cal Member and Provider Helpline can offer assistance as well.

Medi-Cal Costs

Medi-Cal coverage is often free. It is used as payment like any other health insurance plan to render for services like an addiction treatment drug rehab.

If premiums are required as an additional benefit of Medi-Cal, they are often low, cost-efficient, and usually based upon the on income level of the household. Drug rehabs may need to be preapproved before applying Medi-Cal.

It is important to remember that drug rehab services and options while covered by Medi-Cal, not all programs are covered or even covered by any type of insurance. You will need to pay for these non-accepted programs out of pocket.

Policy Coverage for Substance Abuse Disorder Treatment

With the historic help of policy covers for Substance Abuse, 2015 the U.S. government agreed to California’s Drug Medi-Cal Organized Delivery System (DMC-ODS) Waiver. The approval greatly increased services to include more people. This Amendment requires more evidence-based practices to be more widely open for the ways addiction is treated and substance abuse disorders are eased.

The Affordable Care Act (ACA) ensures that most Medicare health plans give a wide array of Essential Health Benefits (EHB) including but not limited to the following:

• Outpatient treatments
• Emergency treatments
• Hospitalization
• Maternity and newborn care
• Mental Health and Substance Use Disorder Treatments
• Prescription drug Treatments
• Rehabilitative services and devices
• Laboratory services
• Preventative and wellness services and chronic disease management

The following addiction treatment services are available for beneficiaries who live in an opt-in San Bernadino county:

• Outpatient Rehab Center services
• Intensive Outpatient Rehab Center services
• Residential treatment
• Withdrawal aid
• Narcotic and Drug Rehab treatment services
• Recovery services
• Case Managers
• Physician aid and consultation
• Supplementary Medication-assisted treatment
• Partial hospitalization Programs

Beneficiaries who do not live in an opt-in San Bernandino county have the following benefits available:

• Outpatient addiction treatment services
• Intensive outpatient addiction treatment services
• Perinatal residential treatment
• Narcotic addiction treatment program services