Substance abuse disorders and addictions are chronic illnesses characterized by impulse control issues, physical health problems, and disruptions in an individual’s emotional, mental, and behavioral functioning. Substance use disorder can form at any time in an individual’s life. Dependencies on prescription medications, over-the-counter medicines, illicit drugs, and frequent, heavy alcohol use can all lead to the development of an addiction. Even individuals who do not intentionally misuse these substances can develop a misuse disorder over time if they are not careful. Millions of men, women, and even children struggle with these disorders every day in the United States. Few of them will enroll in rehab to receive the treatment they need.
Yet, despite the difficulties and challenges drug and alcohol abuse may present, all such conditions are capable of healing. Addiction is a treatable condition, even though it can prove unpredictable, changing its line of cause and effects on a person-to-person basis. The challenges of substance abuse recovery aside, there are several complex processes that potential rehab clients must undergo before beginning treatment.
First, an individual who believes they may be suffering from a condition that has to do with drug or alcohol abuse must visit their primary care physician. Upon visitation with their doctor, they must gain an official diagnosis of their condition before most rehabilitation providers consider the client for treatment. Of course, lacking a formal diagnosis for a substance use disorder will never bar individuals from receiving the treatment they need. Nevertheless, when the individual has their diagnosis in hand, it makes the enrollment process and beginning of treatment much more straightforward. They can move on in the enrollment process by beginning the search for a rehab center. The future resident and their family members must do their best to choose a rehab facility they believe suits their needs appropriately.
Once they find a recovery center they believe will suffice for their treatment, they must begin the individual rehab intake process and insurance verification with that particular company. During this phase, the future resident ensures the treatment programs they need and wish to receive align with the rehab they are choosing. During this phase of the recovery journey, the client will work out how they will pay for treatment.
Insurance in The Realm of Substance Abuse Treatment
Drug and alcohol abuse recovery programs are designed to be affordable for clients from all different walks of life. As a result, recovery centers cater to luxury, lack of funding, and even those that ride the line between primary and supplementary services and procedures. Regardless of their amenities, looks, and the prowess of their rehabilitative programs, doctors, and recovery staff, all rehab facilities are subject to working with health insurance companies per law. Essentially, State and Federal law have the individuals back, even when securing addiction treatment. A client or their family does not need to worry about being denied financial assistance from their health insurance plan.
Substance abuse disorders and additions are chronic health conditions. As chronic health conditions affect millions of individuals every year, substance abuse disorders and addictions are subject to treatment coverage from many, if not all, insurance packages. Of course, the process for receiving such coverage can prove a little more confusing than the average insurance policy inquiry. Individuals who plan to use their health insurance to aid in their financial endeavors through the recovery process will likely have to jump through a few hoops to get the assistance they need. Of course, the amount of financial aid they receive will be based on the company they hold a coverage plan with, how much the individual pays into their policy, and what types of services they seek while in recovery. Additionally, the therapies a health insurance provider may cover for addiction treatment may fluctuate widely based on the individual, the insurance provider itself, and the State where the client is trying to use the policy. All of these added measures tend to end up making understanding addiction treatment costs and financial aid challenges.
The good news is, challenging does not mean impossible. With a bit of extra study, patience, and the willingness to ask the insurance provider and rehab company multiple questions, families and their loved ones wrestling with drug or alcohol abuse can begin to understand addiction coverage and how it pertains to them. If an individual or loved one is seeking drug or alcohol addiction treatment in Jacksonville, FL, specifically, or anywhere else within the Sunshine State, admissions counselors in facilities like St. John’s Recovery Place (SJRP) can help guide potential residents and their families through the enrollment process. These admissions counselors may also be able to explain their particular company’s insurance use and policies within the treatment. They may be able to answer basic questions clients have about personal policy plans as well. In the end, a client who wishes to know more about their health coverage will need to contact their insurance provider directly to find out more information.
The Benefits of Having Health Insurance Coverage
To help individuals and their families understand a bit more about insurance in the realm of recovery, here is a brief explanation about different types of health coverage and what benefits these policies may bring. There are two primary insurance formulations for individuals and their families to use, private and public coverage plans and policies. Public insurance policies are those including Medicaid, Medicare, and other programs that cover the cost of health care for veterans and active military. Private insurance policies are offered through individual employers or individuals initiated with insurance providers on their terms.
Whether a company offers public or private insurance options, mental health services and addiction treatment are included in individual coverage. Of course, there are instances in which an insurance plan may not cover substance abuse rehab or services. Still, there is always a way to receive financial aid and assistance to cover at least a portion of their recovery costs. Both private and public health insurance plans have their benefits. However, in many cases, private health insurance plans have proven to be more flexible with their coverage policies, allowing clients to engage in a broader range of recovery services and activities. Otherwise, benefits of public and private insurance include:
- Emergency services and assistance
- Ambulatory patient services (treatment services received outside of hospitals)
- Hospitalization (overnight stays and surgery)
- Annual well visits
- Prescription medication cost coverage and assistance
- Laboratory and blood work services
- Preventative care
- Essential pediatric care
- Pregnancy, newborn, and maternity essential and emergency care services
- Mental health services
- Substance abuse recovery services
- Benefits Exclusive to Private Insurance Policies Include:
- Inpatient addiction rehab services more likely to be covered
- Clients can utilize a broader spectrum of addiction treatment services with coverage
- Opportunities to engage and enroll in more rehab facilities
- Option to register in higher-end treatment facilities
- Opportunities to engage in rehabs with more holistic treatments and services
Private insurance companies may be able to keep clients from paying more out-of-pocket expenses as well, in addition to the traditional health coverage policies even public companies provide their residents. Attempting to understand health insurance can prove an overwhelming task, even at the best of times. Trying to make sense of a personal insurance policy while navigating the enrollment process for addiction rehab can be an even more harrowing experience.
Understanding addiction insurance coverage does not have to be an anxiety-inducing process. But, heading into addiction treatment, individuals and family members should try to minimize any additional stress as much as possible. Gaining a basic knowledge of the processes involved with health insurance coverage can help better prepare clients to embark on their treatment journey. Thus, allowing them to focus more on their recovery and feel more well-balanced in their knowledge of the working world. Every living person today can benefit from learning more about the basics of insurance policies. But, what happens to individuals who need assistance with a drug or alcohol abuse issue and do not hold an insurance policy?
What Happens if a Client Does Not Have Insurance?
It is not impossible to attend substance abuse rehab without an insurance policy. Of course, it can make the enrollment process a little more tricky and complicate an individual’s quest to get their treatment financially covered, but it does not make it impossible. If an individual or loved one who wrestles with a substance use disorder does not have insurance, finds their policy will not cover the entirety of their rehabilitation program, or finds their insurer is unable to assist the individual through their recovery services at all financially, they still have other options available to them. There are different ways individuals can employ to help them pay for their health care costs. Additional financial aid options for individuals without insurance may be able to exploit include:
- Rehabilitation scholarships
- Recovery Grants
- Sponsorship through private organizations
- Recovery center payment plans
Not every alcohol and drug recovery facility offers repayments plans as an option to pay for their recovery services, just as some companies may not be able to accept every insurance plan held by individuals. Regardless, even if an individual cannot pay for their treatment upfront, many organizations and individuals are willing to help financially support the recovery process. Addiction Treatment in the Sunshine State is made to be affordable for anyone who wishes to start a new lease on life.
Health Insurance Coverage at St. John’s Recovery Place for Addiction Treatment
St. John’s Recovery Place (SJRP) is a holistic drug and alcohol rehab facility that calls the Sunshine State home. With several satellite admissions and partial hospitalization locations in Jacksonville, Fort Lauderdale, Melbourne, Deland, and the main campus positioned in Crescent City, FL, St. John’s is a company that works with and for the people of Florida. Specializing in traditional, complementary, and alternative substance abuse recovery practices, SJRP accepts many different forms of health insurance. For Jacksonville rehab and all other regions within the Sunshine State, St. John’s works with over 20 different insurance companies to provide residents and their families with a sense of peace. Clients can rest knowing SJRP will meet their health care needs as the company works alongside their insurer.
As a recovery facility working within several insurance in-networks, SJRP makes sure to provide past, present, and future clients with affordable care. An individual’s insurance coverage can aid in paying for various rehab programs, including inpatient services, medical detox, outpatient recovery services, and more. The insurance providers SJRP works most often with include:
- Medical Mutual
- The Empire Plan
- Coventry Health Care
- United Behavioral Health
- Meritain Health: An Aetna Company
- MHN: A Health Net Company
- ComPsych: The Guidance Resource Company
- Value Options: Innovative Solutions. Better Health
- Emblem Health
- USA: Managed Care Organization: The National Networks of Choice
- BHS: Behavioral Health Systems
- Health Smart: Smarter Healthcare Solutions
- First Health
- Blue Cross Blue Sheild: Florida Health Care Plans
- AB: American Behavioral and IBH Company
- United Health Care
- Beacon Health Options
- Blue Cross Blue Sheild
Insurance can be challenging to understand. But, with the St. John’s admissions team aiding clients through their enrollment process, individuals can focus less on the stresses of wondering if their insurer will cover their treatment and place all of their energy into the therapeutic process. Addiction recovery is a complex process to work through, but it is worth every ounce of energy an individual puts into their rehab journey. Almost every insurance company will aid an individual on a consumer basis to gain the addiction recovery assistance they need.
Of course, not every insurance company will work in the same ways, but they will operate on a set base of procedures so clients can access the financial assistance they need. Likewise, not all drug and alcohol rehabilitation centers use the same, but many follow the same guidelines for their procedures. Even though addiction rehabs accept insurance policies, they may not work within every insurer’s network. For this reason, individuals seeking treatment must check ahead of time with their insurance provider and intended recovery network to ensure the two services can and will work together. Pursuing treatment within a facility that is not a member of an individual’s insurance in-network can potentially exclude them from receiving total financial aid from their insurer.
St. John’s Recovery Place is a one-of-a-kind, innovative rehab facility dedicated to aiding its residents along the path to recovering sobriety. Every residential member of the SJRP communi