Does My Insurance Cover Opiate Treatment Centers?

There are a lot of reasons why people avoid getting treatment for an addiction problem. In some cases, it’s nothing more than a bunch of rationalizations being used to support a continuation of drug abuse. That’s very unfortunate, but you can’t get people to seek treatment until they are ready. In the rest of the cases, the addicts feel they have legitimate reasons for not seeking help. Chief among those reasons is financial considerations.

The cost of drug and alcohol treatment varies for a lot of reasons. For the most part, there is a direct correlation between the cost and the quality of care that’s being provided. With that said, addiction treatment does require financial resources.

Thanks to the Affordable Care Act (ACA) of 2009, most Americans have some form of healthcare insurance. It’s only natural that someone needing addiction treatment would want to know if insurance is going to cover the costs. Prior to 2009, many healthcare insurance carriers excluded addiction treatment on the basis of it being an elective treatment. For that reason, far too many people were prevented from getting treatment because they lacked the financial resources to do so.

The ACA was passed as inclusive legislation. The government wanted ordinary people to have insurance to help offset the rising costs associated with medical care. If someone couldn’t afford a healthcare insurance policy, monies were to be provided to make sure all Americans had the coverage they deserved.

There’s something else more valuable that the ACA was able to put into place. Insurance companies became restricted from limiting coverage. The two biggest beneficiaries of this legislation has been people with preexisting conditions and people who need addiction treatment.

The ACA is very clear regarding addiction treatment. Healthcare insurance providers are required to cover addiction treatment costs the same as they would any other medical condition. However, the insurance companies do have some leeway as to the level of coverage they must provide. As the consumer, it’s your responsibility to find out to what extent your insurance provider will cover your addiction treatment costs. If you need help getting this information, most reputable rehab centers will provide a liaison who can help you get answers.

Does My Insurance Cover Opiate Treatment Centers?

Above, we have addressed the legalities related to insurance coverage for addiction treatment. The short answer to this question is yes, your insurance company is required to cover at least a portion of your treatment at a opiate treatment center. Before entering rehab, you’ll want to find out to what extent coverage will be given. Hopefully, you have a good insurance policy that will cover at least a majority of the costs.

At this point, you might benefit by knowing exactly what costs an insurance provider is expected to cover based on the ACA. Again, the extent of coverage will be dictated by your policy

Residential Treatment

Residential addiction treatment is considered the most basic form of treatment possible. While many insurance carriers might avoid covering holistic or behavioral based treatment plans, you can relax knowing a baseline inpatient treatment plan will be covered to some extent.

Outpatient Treatment

Because of the reduced costs related to outpatient treatment, it’s common for insurance carriers to offer more extensive coverage for outpatient services. They do this to promote patients getting a level of care that has less impact on the insurance company’s bottom line. It’s worth noting that aftercare outpatient services would fall into this category.


Addiction doctors will often prescribe medications for patients during the detox process. Most of these medications are prescribed to help patients stay comfortable during the detox process. In the case of an extreme opiate addiction, tapering medications (ie: Methadone) are often prescribed to help patients slowly and safely detox off the opiate. In almost all cases, medication is covered to some extent by the insurance company.

Aftercare Services

Insurance companies base prices on statistics. The statistics say more than half of the people who get treatment will have at least one relapse. With this in mind, insurance companies prefer to cover aftercare services (sober living, transitional living, outpatient counseling) as a way of perhaps avoiding having to cover continual residential visits.

If you are ready for treatment but unsure of your insurance coverage, we would be glad to help you gather the facts and provide you with treatment. You can start he process by calling one of our staff members at 770-299-1677

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