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does health insurance cover detox


Does Health Insurance Cover Detox?

When a person who suffers from addiction to alcohol or drugs begins exploring treatment options, they have a lot of questions. Chief among them is how they will pay for it. One common concern centers around this question: Does health insurance cover detox? 

The good news is that many companies do. Modern times mean that the insurance industry has a greater understanding of the severity of addiction than in previous generations. The responsibility to determine if your insurance company offers coverage for what you need falls in your hands. The following guidelines will help simplify the process for you. 

Health Insurance and Detox Programs

Many of the most popular insurance plans cover some or all of the costs of substance use disorder programs. They may cover detox programs as part of their plans.  These include companies such as Aetna, Anthem, Cigna, Humana, and Kaiser Permanente. A host of other insurance plans cover it, too. 

When you are asking yourself the question of does health insurance cover detox, remember that power is knowledge. If you have access to your insurance plan’s guidebook, consult with it. They may have given you a paper copy or provided one for online access. Look for sections related to the treatment of substance use disorder,  addiction, behavioral health, or mental health. See if they break it down into categories, such as detoxification, residential, inpatient, or hospitalization programs.

You must determine ahead of entering treatment that your insurance company will cover the program you need. Usage of a program or service prior to insurance approval may result in denial of coverage. This will leave you with the responsibility of paying the full bill. 

Does Health Insurance Cover Detox? A List of Questions for Your Insurance Company

Compile a list of questions and take advantage of your insurance company’s phone number or website chat options. A company representative can help you answer any questions you have. Remember you have a right to ask all the questions you like. This is your policy and your health at stake. Some questions to consider asking:

  • – Exactly how much of the cost of detox does insurance cover?
  • – Are there any out-of-pocket expenses for you? If so, how much?
  • – Is there a limit to how long you can stay in a detox program and still be covered?
  • – If it is determined you need a lengthier stay after you have entered treatment, will that be covered?
  • – Will your policy cover more than one stay in detox?
  • – Is there a list of pre-approval detox programs?
  • – Is additional follow-up treatment after your release from detox covered?


To-Do Lists May Be Required Before Insurance Approval

Insurance companies often have a checklist of tasks that must be completed before approval of a detox program is granted. Tasks may include:

  • – Completing blood and other lab work
  • – Medical and/or psychological profile done by clinicians
  • – Recommendation for detox treatment by a physician
  • – Evaluation for any needed medications
  • – Approval by the insurance company of chosen detox facility
  • – A plan for post-detox treatment
  • – Drug screening test


The Affordable Care Act Covers Addiction Treatment

The Affordable Care Act (ACA) may be the right choice for detoxification treatment. Passed in 2010, and often referred to as “Obamacare”, the ACA was created to help middle-class and low-income individuals. 

The ACA determined that mental and behavioral health, which includes substance use disorders, falls under the heading of being essential to a person’s overall health. In what proves important for many, substance abuse as a pre-existing condition will be covered under the ACA. The same applies to mental health issues, which often accompany addiction. 

The ACA does not limit the dollar amount of coverage needed. Make sure to check with your state’s policies, as they can vary from state to state. While addiction services may show as covered by any of the individual plans available under the ACA, not all of them include detoxification programs. 

Other Options for Paying for Detox Treatment Services

Another resource to consider when wondering if health insurance covers detox is Medicaid. Medicaid may be an option to assist in paying for addiction-related services, including detoxification. Medicaid is a federally-funded and state-funded insurance program. Each state has its own policies related to coverage, so be sure to contact your state’s office for information.

Determination for qualification for Medicaid factors in things like a person’s income, age, if they have children, and their access to other health plan coverage. If you apply for Medicaid and are accepted, remember to utilize the list of questions posed above. 

The Medicaid website states that almost 12% of Medicaid recipients over 18 have a substance use disorder. Health insurance companies spend $24 billion dollars in treating addiction to drugs and alcohol. Medicaid accounted for 21% of that amount.

Detox Help in California

Are you ready to face your addiction to drugs or alcohol? The first step is detoxifying to cleanse your system and be prepared for your new life in recovery. MD Home Detox offers a professional detox service in the privacy of your home. 

A nurse will supervise your detox progress round-the-clock. We also provide access to a doctor. Other concierge services are available upon request. Call MD Home Detox now at (888) 592-8541 or click here to email them. If you are wondering if your insurance covers detox, visit our insurance verification page and quickly find out.

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