Providing Accessible Care to Anyone Looking for Drug Rehab Programs

insurance options to cover drug rehab cost

If you are seeking treatment for a substance use disorder, you may be wondering: Can I afford a quality Drug Rehab Program? Will I be covered?

In this article, we will discuss how health insurance works for addiction recovery, the important facts about PPO, HMO and EPO plans and how we at Quest 2 Recovery have made our treatment programs accessible by partnering with trusted insurance providers.

The Importance of Accessible Care for Drug Rehab Treatment

According to the Substance Abuse and Mental Health Services Administration, around 22.7 million people are in need of Addiction Treatment Services each year but unfortunately only 11% will find their way into a program.9,8 While there are many reasons someone with an addiction would forgo treatment, one serious barrier is out of pocket costs.

Many individuals considering treatment are at a low point in their life and as a consequence are suffering financially. This creates a serious challenge for recovery programs and insurance providers to work together make quality care more affordable and obtainable.

Does the Affordable Care Act (Obamacare) Cover my Addiction Treatment?

In short, yes. The Affordable Care Act [ACA] has provisions in it that not only guarantee addiction and mental health coverage for all its recipients as an essential health benefit, but it also prevents the insurance providers from:

  • Charging high premiums or denying care for mental health and SUD as a preexisting condition3
  • Placing restrictions on mental health and addiction treatment they wouldn’t place on general medical care3

PPO VS HMO: What to Expect as You Look for Drug and Alcohol Abuse Treatment

PPO vs HMO

The out-of-pocket costs associated with a recovery program can be expensive. That’s why in addition to quality care, your highest priority is to find a program that is in your network. In most cases this will be determined by the type of insurance plan you have.

HMO

An HMO or a Health Maintenance Organization, offers more affordable premiums and lower deductibles but strictly limits coverage to doctors and medical facilities that are in-network.1 Here are some other things to know:

  • HMO plans often require you to select a primary care physician [PCP].
  • Your primary care physician decides what treatments you need and refers you to medical specialists 6
  • If you are seeking addiction treatment, your primary doctor may have to provide a referral before your insurance will cover costs.6

PPO

A PPO is a Preferred Provider Organization. It has a larger network of doctors and specialists and even allows you the option to go outside your network while still receiving some coverage. With a PPO you can also expect:

  • The freedom to see a doctor or specialist without consulting your PCP.6
  • Higher plan premiums and larger deductibles.6

EPO

An EPO or an Exclusive Provider Organization, limits care to a small network of contracted providers. This kind of plan combines the cost effectiveness of an HMO with some features of a PPO.

  • You don’t need to choose a primary care physician
  • You do not need a referral to see a specialist
  • In-network providers have lower negotiated rates
  • Provides out of network coverage in the case of emergency
  • If you were to choose a rehab center that was out of your EPO’s network, you would have to pay out of pocket.

Employer Healthcare Plans

employee assistance program

Employer insurance can vary greatly, some plans are expansive offering gold or platinum coverage while others meet the “minimum value standards” for insurance coverage.4

Requirements for the Minimum Value Standard

  • Insurance pays 60% or more of your medical costs4
  • Must provide considerable coverage of “physician and Inpatient hospital services”4

Exploring Market Options; Benefits and Restrictions

Many who are dissatisfied with their employer’s health insurance might find more substantial coverage in the open marketplace. Here are some of the advantages and drawbacks of going this route.

  • According to a survey, employer insurance on average covers 82% for single coverage and 70% for family coverage7
  • If your employer’s insurance meets the minimum standard, you will not be eligible for financial assistance and other government incentives for a Covered California Health plan and other market plans. This is also the case for individuals with an existing market plan who change jobs and are offered employer insurance.1

 

MHN and First Health: Our Partners in Healthcare

Quest 2 Recovery’s relationship with First Health and MHN, now allows Q2R to be a in-network provider for many HMO’s, PPO’s and EPO’S health plans. Its partnership with MHN and First Health, patients can get a higher quality of care and personalized support at Quest to Recovery without running to the risk of high out of pocket costs similar to those of an out-of-network facility.

First Health

An expansive PPO insurance network spread across the US. According to internal data, they provide access to over 5,500 hospitals, almost 115,000 specialist facilities and more than 1.5 million service locations.2

MHN

A behavioral health insurance provider and a part of Health NetTM insurance network. “They over 40 years of experience in healthcare, 63,000 credentialed practitioners and 1,500 hospitals and care facilities”.10

The Addiction Treatment Services We Provide

At Quest 2 Recovery we offer a broad range of addiction treatment solutions from evidence-based therapeutic approaches, 24/7 medical support, relapse prevention and much more. These are our core programs:

  • Detox
  • Residential Inpatient Treatment
  • Dual Diagnosis Treatment
  • Interventions
  • Aftercare

Are You in our Network?

If you or a loved one are curious about whether our services are covered by your insurance plan, contact us at 1-855-783-7888 or click here to use our confidential insurance verification tool.

 

 

 

 

Citations

Employer coverage and financial help. Covered California. (n.d.). https://www.coveredca.com/learning-center/employer-sponsored-coverage/employer-coverage-and-financial-help/.

First Health. (n.d.). Medical Network Options. https://providerlocator.firsthealth.com/1001.

HealthCare.gov. Mental health and substance abuse health coverage options. https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/.

HealthCare.gov Minimum value – healthcare.gov glossary. https://www.healthcare.gov/glossary/minimum-value/.

HMO vs. PPO: Knowing the difference in healthcare plans. (2020, July 2) The Checkup. https://www.singlecare.com/blog/hmo-vs-ppo/.

HMO vs. PPO Insurance Plans. Medical Mutual. (n.d.). https://www.medmutual.com/For-Individuals-and-Families/Health-Insurance-Education/Compare-Health-Insurance-Plans/HMO-vs-PPO-Insurance.aspx.

Miner, J. (2020, August 12). What percent of health insurance is paid by employers? Hassle-Free Health Benefits. https://www.peoplekeep.com/blog/what-percent-of-health-insurance-is-paid-by-employers.

Recovery Village. (2021, June 10). How much does rehab cost with insurance? https://www.therecoveryvillage.com/insurance/faq/how-much-does-rehab-cost-with-insurance/.

SAMHSA. (2014, September 4). Results from the 2013 national survey on drug use and Health: Summary of National Findings. SAMHSA.gov. pg. 81 https://www.samhsa.gov/data/report/results-2013-national-survey-drug-use-and-health-summary-national-findings.

MHN. (n.d.). Why MHN? https://www.mhn.com/about-us/why-mhn.html.

 

 

Connection Between Mental Problems and Drug Abuse

connection between mental health and drug addiction

According to multiple National Population Surveys, there is strong Connection Between Mental Problems and Drug Abuse. People with Drug and alcohol abuse problems tend to have Mental Issues and vice versa. Though these kinds of findings are very few related to youth, but adolescents are prone to these kinds of mental issues. Out of the total of Drug abuse, 60% cases of adolescents going through Drug Rehab Programs also meet mental health experts.

According to these population surveys, Substance Abuse Disorder are connected to:

  • Anxiety Disorder
  • Panic Disorder
  • Post-Traumatic Stress Disorder
  • Depression and bipolar disorder
  • Antisocial personality disorder
  • Borderline Personality Disorder

Usually, Adolescents have a developing mind and they certainly mature last as far as their cognitive decisions are concerned. According to another study, youth, and adolescents with developing bipolar disorder, may develop Substance Abuse Disorders.

Above findings prove the Connection Between Mental Problems and Drug Abuse. Now, let’s discuss a bit more about this relation in details below.

 

Is Addiction a Mental Health Disorder?

is addiction a mental health disorder

What we commonly understand as addiction is classified as substance use disorder [SUD]. It is characterized by an uncontrollable impulse to use a substance regardless of the personal costs and consequences one experiences.

Medical organizations like the National Institute on Drug Abuse [NIDA] and the American Psychological Association [APA] consider it an illness of the brain 1. This has been observed with brain scans. They reveal reduction in activity of the prefrontal cortex: the area of the brain that regulates decision making of addicted individuals.

But SUD is not just an illness of the brain. It’s effects on the user alter, thoughts, feeling and actions which according to the National Institute on Mental Illness qualifies it as a mental disorder2.

Stereotypes and Stigma Behind Addiction and Mental Illness

More than a quarter of Americans live with a mental health disorder 3. So why are those who suffer from it so frequently misunderstood? One reason is that people tend to associate a disease with physical symptoms while symptoms of mental illness are less obvious; leaving people with mental health conditions to suffer in silence.

Another common misconception is that people with these conditions are trying to make excuses for their behavior. But as the research shows, this couldn’t be farther from the truth.

Unfortunately, many individuals with SUD, and those suffering from other mental health disorders can find themselves dealing with friends and family who overestimate their ability to exert control. They may feel wronged because of the actions of the addicted individual and as a result are not understanding or supportive. In turn the person struggling with addiction may try to get clean alone when they really need treatment and social support.

Comorbidity: When Addiction and Mental Health are Intertwined

When a person seeking Addiction Treatment is comorbid it means they have one or more additional illnesses to contend with. Comorbidity with a substance use disorder can create additional challenges for recovery; especially in treating and retaining patients in rehabilitation.

In the addicted individual, the interplay between substance abuse and other psychiatric disorders such as: schizophrenia, anxiety, depression, bipolar disorder, and BPD are often complex, multi-varied and multi directional. Here are the primary ways that a person with addiction develops a comorbidity4.

  • The person began using to cope with or self-treat an existing mental health disorder.
  • The person’s drug use led to changes in the brain that played a role in the development of the mental disorder.
  • Genetic, neurological, or environmental factors (e.g., injury or stress) played a role in the development of the addiction4

Comorbidity is Common

Comorbidity is common among people with mental health problems. According to one study, 27% of individuals have a psychiatric disorder. Among them, 45% have one or more disorder 5. It is even more prevalent in people with SUD. According to Sheidow et al., 36% to 40% of young adults both in and out of treatment condition with a mental health disorder could also be diagnosed with substance use disorder 6.

Best Treatment for Addiction Comorbidity

addiction comorbidity treatment

As new research uncovers the urgent prevalence of comorbidity, many addiction centers are getting wise and increasing both treatment options and specialization of care.

If you have a comorbidity, your highest priority is to find a program with a “wide range of treatment methods”7. As your treatment progresses, you also want to feel confident that you can work closely with staff to modify your treatment plan as needed.

Before pulling the trigger on a Rehabilitation Center, you need to determine what treatment setting is best and whether these final contenders offer the evidence-based treatment options you need. Here are some questions you can ask:

 

  • What is the length of the program?
  • What is your program retention rate?
  • How do you work to individualize your treatment plans?
  • Do you have a multi-disciplinary staff (Psychologists, Psychiatrists, medical doctors, nurses, wellness specialists, spiritual-based counselors etc.)?
  • What family support do you offer (Family therapy and visits)?
  • What evidence-based practices do you use?
  • Do you offer a true 24 hour medically assisted detox?
  • Are you covered by my insurance?
  • Do you offer post-treatment support?

Types of Care

types of care available for drug addicts

Depending on what step of the journey you are in, you will need a program that can get you to the next level. As noted below some programs are designed to be intensive and highly involved in while others focus on reintegration and accountability.

Inpatient Treatment

Patients receive full time care in a hospital facility. They undergo a 24-hour detox treatment as well as comprehensive and structed care over a period of 30-90 days.

Traditional Outpatient Treatment

Individuals receive addiction treatment for a few hours a week while living at home.

Residential Treatment

Individuals receive highly intensive, and structured treatment in a non-hospital setting.

Sober Living Homes

A treatment that simulates a home environment to offer more freedom to prepare the person to transition back to living at home.

Nobody should have to go through addiction alone. If you or a loved one is dealing with drug related disorder, Contact Us now at 1-866-233-9439 to learn about a variety of recovery resources available to you

 

Sources

Chi, T. (2017, April 28). Is addiction a mental illness? Talkspace. https://www.talkspace.com/blog/addiction-mental-illness/.

Choosing the right rehab. Choosing the Right Rehab for You. (n.d.). https://startyourrecovery.org/treatment/rehab-centers/choosing.

Kessler, R. C. (2005, June 1). Prevalence, severity, and comorbidity of 12-Month DSM-IV disorders in the National Comorbidity survey replication. Archives of General Psychiatry. https://jamanetwork.com/journals/jamapsychiatry/article-abstract/208671.

Mental health conditions. NAMI. (n.d.). https://www.nami.org/About-Mental-Illness/Mental-Health-Conditions?fbclid=IwAR397_yQAYLQAgOYTWWA9oXbkDAjtfZejKUFhxxX1exJAww-JjC6Ih28Rco.

Mental illness and substance abuse. NBER. (2002, April 4). https://www.nber.org/digest/apr02/mental-illness-and-substance-abuse.

NIDA. (2010, September). Comorbidity: Addiction and Other Mental Illnesses. Drug Database. https://www.drugabuse.gov/sites/default/files/rrcomorbidity.pdf

Sheidow, A. J., McCart, M., Zajac, K., & Davis, M. (2013, September 9). Prevalence and impact of substance use among emerging adults with serious mental health conditions. Psychiatric rehabilitation journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767039/.

 

 

Is it Safe to Go to Drug Rehab During the Coronavirus Epidemic?

With the recent spread of the Delta variant strain of the Covid-19 virus, rates in the US are climbing. The data published by the CDC’s Covid Data Tracker shows that the current 7-day average of infections has risen to a level not seen since May and is steadily climbing (2021).

Even with the vaccine now widely available and mask mandates, social distancing and occupancy now relaxed, many are concerned that the vaccine alone will not be enough to keep them safe.

Yet the situation around Covid-19 is changing every day. If you are in the recovery community and thinking about whether now is the right time­ to go to a drug or alcohol rehabilitation center–here are some things to consider.

Rehab Centers Are Adapting

Inpatient and Partial Hospitalization programs (PHP’s) are doing their part to provide safe addiction treatment during Covid-19. With that being said, even when strictly following CDC guidelines no place is 100% safe.

Because rehab centers may vary in their response to the pandemic, you should call and ask what safety measures have been put in place before you decide which program to attend.

Here is a little cheat sheet of some questions you can ask:

  • Are you requiring Covid-19 testing Upon entry?
  • How often do you screen clients and staff for Covid-19 symptoms?
  • Are you adjusting group sizes for counselling and living arrangements to safe levels?
  • Are you holding in-person group and individual counselling?
  • Are you limiting the number of outside visitors to your clinic?
  • Do you regularly test your own staff for the Covid-19 virus?
  • What safety procedures and equipment are employed to keep your patients and staff safe.
  • How often are you sanitizing the areas inside your facilities?

The Pandemic is Causing Some Limitations for Patient Care

The primary goals of any drug and alcohol rehabilitation facility is keeping their residents both free from addictive substances and providing a safe place to do so. Unfortunately, the pandemic has shown us that sometimes these two things can be in conflict.

  • Use of Sanitizers: Both personal hand sanitizers and sanitizer stations have become indispensable since the pandemic began. In a rehabilitation environment, however, they also carry a risk for abuse. Keeping sanitizing stations around helps to prevent the spread of Covid-19 but making them easily accessible requires more supervision.
  • Medicine Pick-Ups: Some patients that are receiving medicine for withdrawals are finding themselves having to take public transportation to pick up their daily medication. This could lead to a rise in infection rates among people in sober living facilities.
  • The Telehealth transition: The telehealth industry has emerged from the pandemic stronger than ever. Many rehabilitation centers are now providing counselling via the web and making use of phone applications to provide treatment services to patients in recovery.

Web counselling is a necessary compromise for the times that we are living in. While it is a viable option for many, it does not provide as much of the human element as face-to-face interaction does.

Balancing the Risks

Individuals suffering from substance abuse disorders and mental health problems have been hit particularly hard by the pandemic.

Since “shelter in place” orders were announced, reports of relapse and overdoses have been on the rise. This can be attributed to feelings of isolation, anxiety about the future, concern for loved ones, and fear that having too much free time will lead to feedback into addictive thoughts and actions.

These unprecedented times carry a sense of urgency with them. Addiction is a disease– and like any disease choosing to forgo treatment can be life-threatening.

If you are finding it increasingly difficult to stay sober and if you are engaging in risky patterns of use and behavior, does it make sense to forgo treatment?

Considering Your Overall Health

According to the National Institute on Drug Abuse, people with substance use disorders are more likely to have underlying health conditions (CDC). By choosing to get vaccinated, you greatly reduce your risk of experiencing life-threatening symptoms.

What If I Am Vaccinated?

There are a lot of misconceptions about the Delta variant. People are wondering: Can I still get sick if I am fully vaccinated? The answer is a little complicated…

According to MIT Medical, getting fully vaccinated will likely prevent you from getting seriously ill from Delta and other strains of Covid-19 (Schive, 2021). To put that further into perspective, data for the month of May found that fully vaccinated individuals made up only 0.1 percent of Covid hospitalizations and less than 1 percent of deaths (Johnson & Stobbe, 2021 as cited in Schive, 2021)

Does Having a Substance Abuse Disorder Make the Vaccine Unsafe?

No, according to the Centers for Disease Control and Prevention, people with underlying health problems related to addiction or people taking medications for opioid use disorder, such as methadone or buprenorphine, are still able to get the Covid-19 vaccine (CDC, 2021).

Closing Thoughts

While pandemic still poses risks to people experiencing drug and alcohol addiction, rehabilitation centers are taking important steps to reduce transmission and keep people safe.

Because people with a substance abuse disorder are more at risk, we strongly encourage vaccination as a way to give individuals greater safety and peace of mind while in treatment.

Nobody should have to go through addiction alone. Contact us now at (866) 609-7314

to learn about a variety of recovery resources available to you.

 

Citations

Centers for Disease Control and Prevention. (2021, July 13). COVID-19 and people at increased risk. Centers for Disease Control and Prevention. https://www.cdc.gov/drugoverdose/resources/covid-drugs-QA.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fneed-extra-precautions%2Fother-at-risk-populations%2Fpeople-who-use-drugs%2FQA.html.

Centers for Disease Control and Prevention. (n.d.). CDC COVID Data Tracker. Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#trends_dailytrendscases.

COVID-19 & substance use. National Institute on Drug Abuse. (2021, May 27). https://www.drugabuse.gov/drug-topics/comorbidity/covid-19-substance-use.

Schive, K. (2021, July 15). Delta’s here; I’m vaccinated; how cautious should I be? MIT Medical. https://medical.mit.edu/covid-19-updates/2021/07/deltas-here.

 

Top 5 Tips for Rehab Newbies

Deciding to check yourself into drug addiction treatment for the first time can be intimidating. The good news is the decision to get help is often the most difficult one. Here are some tips that will help prepare for drug or alcohol rehab.

What comes next? Mentally preparing for treatment, securing your finances, and providing for your family in your absence demands careful consideration. It may feel overwhelming at first but taking it step-by-step and giving yourself time to get everything in order will remove a lot of unnecessary stress as you begin the road to recovery

Preparing To Leave

Reaching Out to Your Job

One of the larger concerns people have while contemplating drug addiction treatment is how it will affect their relationship with their employer. Any good employer should be understanding and supportive of your choice to seek care for addiction, but it is still best to give them as much notice as possible.

The Family and Medical Leave Act (FMA) “provides certain employees with up to 12 weeks of unpaid, job-protected leave per year while maintaining their health benefits” (US Dep of Labor). It also covers people seeking leave for drug and alcohol addiction.

Before you pay out of pocket, consult your employer: they may offer additional leave support for full time or even part-time employees.  If you are working part-time, you may also be eligible for the FMA leave. For more information, click here. (Hyperlink: https://www.dol.gov/agencies/whd/fmla)

Family obligations

Many people entering rehabilitation will be leaving behind loved ones. If you have any dependents, ageing parents, children, or pets make sure provisions are made for them before you enter treatment. Most rehabilitation centers allow family visits. Figure out when those are and set aside that time; you will be happy you did.

 

What to Bring

  • A weeks’ worth of clothes: Most rehab clinics provide laundry services so no need to overpack but be sure to bring comfortable clothes like sweatpants and hoodies as they will help keep you in a more positive mood.
  • Current prescriptions: You may end up having to take medication to manage withdrawals. Make sure the medical staff knows what you are taking so that they can safely prescribe to you.
  • Medical insurance information: Upon checking in, avoid any confusion by determining upfront what costs will be covered by your insurance provider.
  • Hygiene products and other toiletries: Visits to the store will be less common. By bringing what you need, you will be better prepared and save some money in the long run.
  • Grab your old music player: Since most rehab facilities don’t allow cell phones, laptops or anything with an internet connection, your old iPod from 2009 that’s packed in the back of your “everything drawer” just became super important again.
  • A credit or debit card: Even while staying in a sober living facility you may be expected to pay for groceries and other consumables.
  • Running shoes and gym clothes: Exercise is a healthy way to blow off steam while promoting a healthy mindset. Many rehab facilities have gyms and courts so why not take advantage?
  • Books: Books are great for downtime or at night when you have trouble sleeping. Try to bring some reading that is inspiring or motivating to you.

 

Reach Out to Your Rehab Center

Every rehab center is different. You want to make sure that everything that you are bringing is approved. The best way to do this is to call or email your chosen facility and ask for a list of acceptable and non-acceptable items.

 

Preparing for Detox

After arriving at the facility an assessment will be run to guide the detoxing process. Detox is the first step of rehabilitation and your journey to recovery. It presents unique challenges for everyone as dependency has its origins in both the body and the mind.

How Long Does Detox Last?

Based on the type of substance, the frequency and the length of use, detox can last a few days or a couple of weeks.

If you are seeking treatment for a particular substance, do some research (Hyperlink: https://www.addictioncenter.com/rehab-questions/how-long-does-detox/). This way you can get a feel for how long it may take and what symptoms to expect. Remember, you can also call your local rehab center if you have any questions.

Most importantly, take some time to mentally prepare for the process ahead and don’t lose heart. You are taking the first step on your road to recovery; a step that many others have taken, and you are in good hands. During your stay, you will be detoxing in the safest possible environment. Medical professionals are available 24 hours a day and ready to assist you if withdrawal symptoms get out of hand. You got this.

Staying Occupied

This is crucial especially during the detox process where you will be dealing with physical withdrawal symptoms and fending off the urge to use.

As disused briefly in tip #2, bringing things like books, music players and journals can be a great way to pass the time.

Psychical Activity

Others may enjoy exercising. Whether that’d be lifting weights in the gym or playing a game of tennis with your housemates. Don’t forget those shorts and running shoes.

In any case, the best way to ensure you will be able to keep busy is to be prepared¬– you won’t be at home surrounded by all your favorite distractions and that’s a good thing! Pack plenty of approved items to keep you occupied and make good use of what is made available to you at your rehab center.

Be Willing to Make Friends

Opening up to people around you who are also on the front lines of addiction will help you as you meet the challenges of rehab experience and remind you that you are not alone. You may also meet veterans of this process. These people can fill you in, keep you out of trouble and help you acclimate to your new environment.

Social Support Systems

One of the fundamental aspects of recovery is how to build and maintain social support systems. While in group and individual therapy, these and other skills are developed.

A large part of what empowers addiction is fear. Fear of change, fear of not being good enough and fear that what’s inside won’t be accepted by others. The choice to seek treatment is a rejection of the life-defining fear which pushes others away.

By showing and being willing to learn, listen and contribute you will get the most out of your recovery. You will also gain the opportunity to forge life-long friendships.

 

Nobody should have to go through addiction alone. Contact us now at (866) 609-7314 to learn about a variety of recovery resources available to you.

Citations

Bezrutczyk, D. (2021, June 15). How long does detox take? Find a detox program. Addiction Center. https://www.addictioncenter.com/rehab-questions/how-long-does-detox/.

Family and medical leave act. United States Department of Labor. (n.d.). https://www.dol.gov/agencies/whd/fmla.

 

 

Why is Outpatient Treatment Important?

Imagine you have been stranded on an island, and you need to find your way back home. The first step on to road to recovery is a lot like that. Joining an Inpatient care program is a commitment to getting clean and finding your way back.

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