Getting help for addiction can be expensive, but rehab centers that accept insurance can make it more affordable. However, figuring out what’s covered can be confusing as different plans cover different treatments.

This guide aims to help you learn how the Affordable Care Act (ACA) provides greater access to treatment, the types of plans that cover treatment, and how to find rehab centers that work with your insurance. This way, you can focus on getting the care you need without worrying about the cost.

How the Affordable Care Act Expands Access to Treatment

The ACA makes it easier for you to get treatment for addiction and mental health issues. Before the ACA, many insurance plans didn’t cover rehab or had very limited coverage. Now, the law requires insurance companies to cover addiction and mental health treatment just like they cover physical health conditions.¹

Here’s how the ACA helps you:

• Required Coverage – Insurance companies must include mental health and addiction treatment in their plans. This means your insurance is more likely to cover rehab.
• No Denial for Pre-Existing Conditions – Before the ACA, insurance companies could refuse coverage if you had a history of addiction. Now, they can’t deny you treatment because of past substance use.
• Medicaid Expansion – More people qualify for Medicaid, which covers addiction treatment. If your income is low, you might be eligible.
• Essential Health Benefits – Addiction and mental health treatment are considered essential. This includes therapy, inpatient rehab, outpatient programs, and medication-assisted treatment.
• No Lifetime or Annual Limits – Insurance companies can’t put a cap on how much they’ll pay for your treatment over a year or a lifetime.

Because of the ACA, you have more options and a better chance of getting the help you need. 

Laws That Require Minimum Coverage for Addiction and Mental Health Treatment 

Besides the ACA, other U.S. laws ensure that your health insurance covers addiction and mental health treatment, similar to coverage for physical health conditions. 

1. Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 

This law requires that health insurers and group health plans offering mental health and substance use disorder benefits provide them at parity with medical and surgical benefits. 

This means that limitations on mental health benefits, such as copayments, deductibles, and visit limits, must be comparable to those for medical and surgical care.² 

2. State-Level Mental Health Parity Laws

Many states have enacted their own parity laws that require insurance plans to provide coverage for mental health and substance use disorders. These laws vary by state but generally aim to ensure that mental health benefits are comparable to medical and surgical benefits.

For instance, California’s Mental Health Parity Act (originally passed in 1999 and expanded over time) requires insurance plans to cover mental health conditions equally to physical health. In 2020, Senate Bill 855 (2020) expanded the Act to ensure state-regulated plans fully cover mental health and substance use treatments like other medical care.³

Types of Insurance Plans That Cover Rehab Services

Different insurance plans can help pay for rehab services. Each plan has its own rules, but many cover addiction treatment, therapy, and medication-assisted treatment. Here’s how some major insurance providers handle rehab coverage:

1. Aetna

Aetna covers inpatient and outpatient rehab services, including detox and therapy. Your coverage depends on your specific plan. Some Aetna plans require pre-approval before starting treatment.

2. Cigna

Cigna offers coverage for drug and alcohol rehab, including inpatient stays, outpatient programs, and counseling. They also provide a 24/7 support line to help you find treatment.

3. Tricare

Tricare provides rehab coverage for active-duty military members, veterans, and their families. They cover detox, therapy, and residential treatment, but you may need a referral for some services.

4. Blue Shield of California

Blue Shield of California includes addiction treatment in many of its plans. They cover inpatient and outpatient care, but your out-of-pocket costs depend on your specific policy and whether the rehab center is in-network.

5. United Healthcare

United Healthcare covers rehab services, including detox, inpatient treatment, outpatient programs, and therapy. They also offer online mental health support for ongoing care.

Check your insurance policy or call your provider to see what’s covered. Many rehab centers can also help verify your benefits and explain your options.

Finding the Right Rehab Center That Accepts Your Insurance

Finding the right rehab center that accepts your insurance can make treatment more affordable. Here’s how you can do it:

1. Check Your Insurance Plan

Look at your insurance policy or call your provider to ask what types of rehab services are covered. Find out if you need pre-approval and whether you must go to an in-network facility.

2. Search for In-Network Rehab Centers

Most insurance companies have a list of approved rehab centers. Choosing an in-network center can save you money since they have pre-negotiated rates with your insurer.

3. Ask the Rehab Center

Call the rehab centers you’re interested in and ask if they accept your insurance. Many centers can check your benefits for you and explain what costs you might have to pay.

4. Consider Treatment Options

Different rehab centers offer different types of care, such as inpatient, outpatient, detox, and holistic therapy. Make sure the center provides the services you need and fits your recovery goals.

5. Read Reviews and Visit the Facility

Look for patient reviews or testimonials to see what others say about the rehab center. If possible, visit the facility to check the environment and meet the staff.

Get Started with OceanRock Health

If you’re looking for rehab centers that accept insurance, South Coast Counseling can help. We accept many insurance plans and offer personalized treatment programs to support your recovery. Contact us today to check your coverage and start your journey to healing.

Find outpatient & virtual services at OceanRock Health.

Sources:

1. Office of the Legislative Counsel. (2010). Compilation of patient protection and affordable care act. https://housedocs.house.gov/energycommerce/ppacacon.pdf
2. Mental Health and Substance Use Disorder Parity | U.S. Department of Labor. (2018). Dol.gov. https://www.dol.gov/agencies/ebsa/laws-and-regulations/laws/mental-health-and-substance-use-disorder-parity
3. (n.d.). Senate Bill 855 – Mental Health as a Medical Necessity [Review of Senate Bill 855 – Mental Health as a Medical Necessity]. https://www.calbhbc.org/uploads/5/8/5/3/58536227/sb_855_-_fact_sheet_and_background_info.pdf