Will Insurance Pay For Me To Go To Detox?

Addiction recovery is a lifelong journey, and one that is unique for every person who undertakes it. Yet many people find that the first stage of recovery is one of the most challenging and difficult. 

Depending on the substances involved, a person’s level of dependence, and other factors, acute withdrawal can put the body and the mind under tremendous strain in the days after discontinuing drug or alcohol use. The symptoms people experience during this process can be extremely difficult or even dangerous in certain situations. 

Fortunately, medical detoxification and other rehabilitation services are available to help you and others navigate this process safely under the guidance of trained medical professionals. And using health insurance for detox and other recovery services not only is possible, but also may be able to help make your treatment far more affordable than you might at first expect. 

Using Insurance For Detox

If you’re worried about the cost of rehab treatment, you aren’t alone. Financial concerns and affordability are some of the biggest barriers that keep people from participating in addiction treatment services. And these concerns are well-founded. According to a recent report published on the JAMA Network, the average one-year substance use disorder (SUD) treatment cost for each employer-sponsored health insurance enrollee with an SUD diagnosis in 2018 was $15,640. This amounts to a total cost of over $35 billion for employer-sponsored insurance providers nationally. 

Although the cost of SUD treatment can be high, resources are available to help you afford the care you need. This includes your health insurance benefits, which typically include coverage for substance abuse treatment. In fact, plans sold through the Health Insurance Marketplace are required by law to cover addiction as an essential health benefit, thanks to the Affordable Care Act, also known as Obamacare. This means that policyholders don’t need a special detox insurance, addiction can’t be considered a preexisting condition, and coverage starts immediately if you don’t have insurance but purchase it during open enrollment or another eligible enrollment period. 

While the coverage provided by each specific insurance plan will vary, medical detoxification is typically covered, along with other SUD treatment programs and services, including:

• intake assessments and treatment planning
• residential treatment
• outpatient treatment
• behavioral therapy
• psychoeducation
• medication-assisted treatment
• dual diagnosis treatment
• peer support sessions
• aftercare planning

You can either contact your insurance provider directly to determine your coverage details, or reach out to a treatment provider like Ark Behavioral Health for an estimate and cost/coverage breakdown. 

Understanding Your Health Insurance Benefits

While all ACA-compliant health insurance policies are required to cover SUD treatment as an essential health benefit, there are some other details about your health insurance that you should be aware of.

These include your plan’s:

• premium: the monthly amount you pay for your coverage
• deductible: the amount you have to pay for medical costs before your plan kicks in
• copay: a set amount you pay for specific medical services, such as doctor’s visits
• coinsurance: a percentage of your medical care’s cost that you pay after your deductible has been met but before your out-of-pocket maximum is met
• out-of-pocket maximum: the total amount you would be required to pay for medical care in the course of a year, after which your medical care will be covered at 100%
• in-network providers: treatment providers who have contracts with specific health insurance providers, making costs cheaper for people who have health insurance through those providers

Once again, different insurance plans have different terms and requirements, so it’s a good idea to call ahead and have your coverage and estimated costs verified whenever possible. But don’t let the potential costs of addiction treatment prevent you from getting the care you need.

Recognizing Dependence And Addiction

Only a medical professional can diagnose an SUD. If you are concerned that you may have an SUD or that discontinuing drugs or alcohol may cause withdrawal, talk to your doctor or reach out to us at Ark Behavioral Health. Our specialists can provide guidance, including approving you for a full assessment. 

Some of the warning signs that you may be experiencing dependence or addiction include:

• You struggle not to use a substance or substances even though you want to quit or have tried before.
• You spend a lot of time getting drugs or alcohol, using drugs or alcohol, and recovering from their use. 
• Substance use has impacted your relationships, personal responsibilities, and how much you enjoy other things in life.
• If you go too long between doses, you begin to feel sick, or you experience strong cravings or compulsions.
• Substance use is impacting your sleep, eating or appetite, and overall health or physical appearance.
• You are moodier, more withdrawn from others, and more secretive than you used to be.

Recognizing that you have a problem and that you may need help to solve it takes courage. Addiction specialists are ready to help you get your recovery started as soon as possible. 

Detox Vs. Addiction Treatment

Even though drug withdrawal may be highly uncomfortable and difficult but not always life-threatening, treatment is still often recommended due to the potential risks that are involved, including returning to substance use to stop the withdrawal symptoms.

In some cases, withdrawal without proper support can be deadly. This can be due to a specific symptom itself, such as seizures, or due to complications of withdrawal such as dehydration following withdrawal-related heavy sweating and vomiting, mental health emergencies (including suicide), and relapse leading to fatal overdose. 

However, because of the increased awareness around the potential severity of withdrawal, outcomes are vastly improving. For example, StatPearls reports that the estimated mortality rate of delirium tremens (DT), an uncommon but very serious form of alcohol withdrawal, was historically as high as 20%, but is now closer to just 1%, due to advances in critical care and prompt diagnosis and treatment.

This is why it is often important that people with SUDs stop using drugs or alcohol with medical support and guidance, which medical detox programs provide.

However, medical detoxification is never an effective stand-alone treatment for addiction. After you complete detox and achieve stabilization, it is important that you transition to other SUD treatment services designed to help you develop the motivation, coping skills, and habits you’ll need to avoid relapse in the future, and to get back on track if it does occur.

 Depending on your situation and needs, these treatment services may include: 

• short- or long-term residential treatment
• intensive outpatient treatment options, like an IOP or PHP
• regular outpatient treatment
• local aftercare support and self-help groups

If you aren’t sure what level of care is right for you, there are professionals who can help. Talk to your doctor, reach out to an addiction treatment provider like Ark Behavioral Health, or call the 988 crisis hotline.

Common Drug Or Alcohol Withdrawal Symptoms

While withdrawal can vary from substance to substance and situation to situation, some of the most common symptoms people experience during the process include:

• anxiety or depression
• irritability and mood swings
• sweating
• nausea or vomiting
• muscle tremors or convulsions 
• excessive yawning
• insomnia 
• nightmares
• fatigue
• restlessness
• headaches
• changes in blood pressure
• muscle pain or stiffness
• changes in appetite

During medical detox, your symptoms will be monitored closely, and care and support will be provided to keep you safe and more comfortable until your symptoms subside. This usually takes around five days, though this period can also vary. 

Detox Safely With Ark Behavioral Health

Drug or alcohol withdrawal isn’t easy, but you don’t have to go through it alone. Ark Behavioral Health’s medical detoxification and addiction treatment services can help you get started in recovery safely and confidently, guiding you through your withdrawal symptoms in a safe, medically supported, and comfortable treatment setting. 

With comprehensive addiction treatment services and aftercare coordination available, we can seamlessly transition you from detoxification into the next right step in treatment for you, with care, support, and clarity through each step of the process. 

If you have any questions about using insurance for detox or other treatment services, please contact us today. Our team will be happy to check your insurance benefits for you, estimate your costs, and share exactly how our leading rehab and mental health treatment services can help you begin your recovery journey the right way.