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George Beach Insurance Services LLC Blog

What You Need to Know About Opioid Addiction and Health Insurance

1/16/2019

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Opioid use, whether for a short or long period of time, can make you susceptible to addiction and possible overdose. There are many factors that can play a role in prescription drug addiction, including your personal background and length of use, but there really is no sure way of knowing who will fall victim to opioid abuse. Whether a person acquires them legally or illegally, these drugs are to blame for the vast majority of overdose deaths in the United States. Over 115 people in the United States die daily from opioid abuse. This has turned into a national crisis affecting public health as well as social and economic welfare. The United States loses over $78.5 billion a year fighting this crisis. Unfortunately, this negative trend is showing no signs of slowing down. 

How it Started
Drug companies originally assured the medical community and government that opioids would not be addictive. This contributed to physicians prescribing these drugs more often. Eventually, this led to widespread abuse of these medications before medical professionals realized they were very addictive. In the meantime, opioid misuse and overdose rates continued to steadily climb. By 2015, over 33,000 Americans died of opioid-related overdoses. In that same year, nearly 2 million Americans suffered from opioid pain reliever substance abuse, and nearly 600,000 suffered from heroin addiction. It is important to be considerate toward addicts because it is a difficult situation to deal with, and many factors are beyond the user’s control.

Medical Coverage for Addiction
You may be wondering if medical insurance covers opioid addiction treatment. Generally speaking, yes. The Mental Health Parity and Addiction Equity Act, which was passed in 2008, mandates that insurance companies provide coverage for opioid addiction that is comparable to regular medical and surgical care. The types of drugs that are covered and other specifics will vary based on your insurer and plan type. Prior to the Affordable Care Act, many people did not have health care insurance, and their addiction problems went untreated. Today, nearly 85 percent of adults have medical insurance coverage.

The United States has over 14,500 facilities that specialize in drug addiction. It is important to remember that your insurance plan may not cover every facility. Most insurance plans also cover maintenance programs for people who are recovering from addiction. These programs are designed for individuals who had severe addictions and are unable to survive without drugs even after rehabilitation. Typically, maintenance programs will prescribe medications to help these people live a drug-free life. In most cases, these drugs are very expensive, so medical coverage is essential.
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Opioid addiction is a very serious problem in the United States that costs billions of dollars each year to confront. The problem started with a misunderstanding of the addictive potential of the drugs. On the bright side, the majority of people in the United States do have medical insurance to treat addiction and improve their lifestyle.

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Does Insurance Cover Treatment Centers?

10/16/2018

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If you are dealing with addiction problems, then you know how difficult an addiction can be to beat. When a person does not find the correct resources to help with his addiction, he can find himself in a constant cycle of addiction and pain. Unfortunately, there is a stigma attached to addiction and addiction recovery, so some people may want to try to quit on their own without telling anyone about their struggle. Although there have been individuals who have been able to get clean on their own, most people do need to go to some type of treatment center. Many leading doctors agree, “coupling medication with psychotherapy and support creates a solid foundation and results in a longer lasting recovery." Treatment centers can offer a person relief from the lifestyle that is keeping them in the prison of addiction.

Do Insurance Companies Cover Treatment Centers?

Since the majority of people who suffer from addiction will need some type of help from a treatment center, you may wonder how it is possible to cover the cost. These recovery experts explain, “there are many approaches to successful treatment such as: behavioral therapy, 12 step programs, motivational interviewing, contingency management, medication treatments, and even alternative methods.” Treatment centers can keep a person for weeks or even months. These centers have to be able to fund the professional staff that works at the center and the facility itself. For that reason, the cost of staying at a treatment center can be high. Instead of worrying about payment, you'd do well to get in contact with your insurance company.

The good news is that most insurance companies will cover treatment centers; there may be some stipulations on the coverage. It is possible that the insurance company will want you to only go to a treatment center that is in their network, or they won't cover the expenses. On the other hand, the insurance company may only cover you for a certain amount of days, or for a percentage of the total cost. There are still some insurances that will ask you to pay a certain amount towards the deductible and copay before they offer coverage.

Don’t Hesitate To Get Help

Regardless of the issues that may come up with insurance, the most important thing is that you get the help that you need in order to stop the addiction rollercoaster. This government agency reinforces, “You suffering is real, and it is possible to overcome it. Don’t give up on hope. It may not be simple or easy, but it will be worth it.”

It is worth the time and effort that you may have to spend when working with your insurance company to find the right treatment center. There is no price on your happiness and your livelihood, so do the initial work so that you can live a better life. Various treatment centers can give you the tools that you need to break the cycle of addiction.
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If you find yourself in need of insurance, whether it be health insurance or some other kind, keep George Beach Insurance in mind! We want our clients to be happy, healthy, and safe. Get in contact with us for a free quote!
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Will Your Health Insurance Cover Addiction Treatment?

10/10/2018

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​There are many advocacy groups for addiction recovery that are claiming some addictions are diseases. Therefore, they believe that it's critical for insurance coverage to be available. However, if addiction isn't understood as a disease, these insurers will not make payments for treatments. These groups are insisting that we continue making the case that addiction is a disease and that insurance companies cover the fees for treatments.

Insurers are Already Making Payments
Many insurance companies are already making payments for many conditions they don't consider diseases. For example, pregnancies and broken bones receive coverage, and they don't fall under the category of diseases or disorders. Therefore, it's vital that those who have an insurance policy to review the details regarding the inclusions and exclusions of their coverage.

Because treatment plans aren’t cheap, it’s vital that you contact your insurance provider if you have any questions regarding your insurance coverage.
This medical website also advises, “if your insurance company denies your claim, you have the right to appeal (challenge) the decision. Ask your doctor for his or her opinion. If your doctor thinks it’s right to make an appeal, he or she may be able to help you through the process.”

Understand Your Options
There are a significant amount of insurance companies recognizing the fact that addiction is a condition that's treatable. This treatment center explains, “medically supervised drug and alcohol detox eases symptoms of withdrawal for individuals recovering from drug abuse and addiction.” The assistance these centers can provide should be recognized. Thankfully, many drug and alcohol dependencies are seen as medical conditions that could be covered under a public, private, or group insurance plan. If you have a private or public insurance plan, they'll frequently compensate a portion of the inpatient or outpatient treatment expenses for just about every kind of addiction treatment program.

Recognition of Mental Disorders
These mental health experts defines it as, “addiction is a complex condition, a brain disease that is manifested by compulsive substance use despite harmful consequence. People with a substance use disorder have distorted thinking, behavior and body functions. Changes in the brain’s wiring are what cause people to have intense cravings for the drug and make it hard to stop using the drug.” Because our culture as a whole has begun to recognize it, insurance companies are also recognizing addiction more and more as a mental condition.

As such, they're providing the same coverage as they would for health and behavioral conditions. These insurance companies understand that substance abuse can lead to physical or psychiatric consequences in the future. They also recognize that other health conditions including diabetes and heart disease could be the result of addiction. Therefore, it's favorable for those who are insured to receive coverage.

What Coverages Can I Expect?
Coverages will depend on the insurance provider with which you're doing business and your plan. Look for plan coverage that will include detoxification. This drug abuse hotline explains, “in many cases, private insurance will cover some or all of your addiction treatment. Payment options like financing, loans, and sliding scales often help to offset the remaining cost.” So no matter what situation people may find themselves in, there’s always hope.

Medically supervised drug and alcohol detox is a serious situation and, when patients are undergoing this treatment program, insurance companies understand that withdrawal symptoms could be fatal. Therefore, many insurance companies understand that it's critical for coverage to be in place for the health and safety of the patient. When patients are surrounded by experienced healthcare professionals, they have a better chance of experiencing a positive outcome that involves less potential for risk or fatalities.


If you’re looking for health insurance and need some additional support, spend some time examining our Health Insurance options! ​
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A Guide To Financing Addiction Treatment

6/14/2018

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Getting help for an addiction illness is an important consideration. Among the things one has to consider is what type of treatment to get and where to get that treatment. Unfortunately, addiction treatment has a price tag. Thanks to the Affordable Care Act of 2009, healthcare insurance plans are required to cover addiction treatment costs much the same as they would any other illness. But what about people who don't have insurance?

Types of Treatment
First and foremost, the depth of the addict's addiction will often dictate which type of treatment is needed. In a financial pinch, outpatient treatment might be the best option, due to its superior affordability. Still, inpatient treatment is usually preferred because this option offers a more thorough solution. Of course, other treatment options might be necessary, including Suboxone, dual diagnosis treatment, or family therapy. Before selecting the appropriate treatment option, a prospective patient should consult with their healthcare insurance provider to determine what's covered and to what extent.

Financing Addiction Treatment Costs
When health care insurance is not available, patients might need to consider other financing options. Here are some alternative ways to finance your addiction treatment costs.

Health Savings Account
An HSA is a newer concept in finance, but it is quickly becoming the preferred method for financing out-of-pocket healthcare costs. HSAs are basically savings accounts, but they can only be used for healthcare expenses. The advantage of an HSA is that your contributions to the account go in pre-tax, which effectively means that Uncle Sam is matching approximately 20% of your contribution. HSAs are especially helpful when combined with high-deductible health insurance plans, which typically have far lower premium rates and out-of-pocket maximums.

Personal Savings
However, if you're already looking for tips on how to pay for treatment, chances are you need a more immediate source of funds. The thought of using your savings account might sound unappealing because you might feel like you are sacrificing a portion of your future. But frankly, you might not have much of a future without immediate treatment. Sacrificing savings might put a dent in your plans, but you'll get through treatment without incurring new debt, and you can always recover your savings by saving more aggressively in the future.

Personal Loan
If you have something of value to offer as collateral, you should be able to get a personal loan to cover some or all of your addiction treatment costs. You'll want to shop for the best possible rates. It's new debt, but it could be life-saving debt, and will probably come at lower rates than credit card debt or provider financing.

Rehab Facility Financing
Provider financing could be an excellent alternative because an addiction treatment facility is more likely to understand how debt might interrupt recovery. For this reason, they can usually create a custom financing package that's manageable for each patient.

Let me say this very clearly: if you’re struggling with addiction, please get help now. However you pay for it, your well being, your future, and your very life are in jeopardy until you get clean. Don’t delay. Contact a mental health professional or a doctor and get a referral to a treatment center or program near you and start to reclaim your life. It’s worth it.
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References:
https://www.addictioncenter.com/rehab-questions/cost-of-drug-and-alcohol-treatment/
https://www.nerdwallet.com/blog/health/what-is-an-hsa/
https://rightpathaddictioncenters.com/suboxone-film-right-for-you/
https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction

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George Beach Insurance Services LLC​
Modesto, CA 95355
(209) 353-2330​
Click Here to Email Us
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