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Does American Family Insurance Cover Drug Rehab?
American Family Insurance (AFI) is a national insurance provider that specializes in life insurance, auto insurance, home insurance, and similar insurance products. Currently, however, they do not offer health insurance plans. But, does American Family Insurance cover drug rehab?
Drug rehab coverage falls under health insurance, so AmFam currently doesn’t offer any insurance plans that would cover addiction treatment.
Do Most Health Insurance Plans Cover Drug Rehab?
Thanks to the Affordable Care Act (ACA), which was passed in 2010, insurance providers must cover some level of addiction treatment coverage in their insurance plans. This includes behavioral health treatments like psychotherapy and counseling, along with detox services and substance use disorder treatment.
According to the ACA guidelines, all insurance plans in the Marketplace are required to:
- Cover substance abuse treatment
- Offer coverage even in instances of pre-existing conditions
- Refrain from putting a yearly or lifetime dollar limit on coverage of substance use disorder services
Specific coverage will vary, depending on the type of health insurance policy you hold and the state in which you live.
What Addiction Treatments Does Health Insurance Cover?
There are many types of treatment, including:
- Inpatient treatment programs
- Outpatient treatment programs
- Detox programs
- Aftercare programs
- Medication-assisted treatment
In most cases, you can get a diagnosis from your doctor and a referral for the type of treatment that seems most appropriate.
Once you decide on a proper treatment plan, your provider will confirm your insurance coverage for rehab and pre-authorize your care, meaning you can relax knowing that a specific amount of your care is covered.
The Cost of Treatment With American Family Insurance
After passing the ACA, pre-existing mental and behavioral conditions were considered essential health benefits. That meant that health insurance companies were no longer allowed to impose spending limits on the coverage of those conditions, including addiction treatment.
This means your out-of-pocket costs (the cost of treatment you’re responsible for paying) for drug rehab or medical detox services should generally be the same percentage as your out-of-pocket costs for a medical procedure.
The insurance company should pay the same percentage towards a drug rehab as they pay for a medical procedure. Keep in mind, however, you are responsible for paying all deductibles, copayments, and/or coinsurance.
Unfortunately, American Family Insurance does not currently offer health insurance plans, so they don’t have any plans that cover rehab. If you don’t have health insurance, many treatment centers will work with you to keep your costs as low as possible.
They may have financial assistance programs for people with low income, or they may have a sliding fee scale, which uses your income and other financial factors to determine your costs.
Should You Seek Addiction Treatment Out of State?
Generally, only local facilities fall into an insurance provider’s network because these are programs that have contracted with the insurance company. The shared contract determines the amount they are allowed to charge people with a specific insurance carrier’s plans. If you have health insurance with addiction treatment coverage, the lowest prices will be local.
However, if your plan covers out of network providers or if you don’t have health insurance coverage, you may feel more settled placing some distance between your old life and your rehabilitation. Be sure to thoroughly verify whether or not out of state treatment is covered by your insurance and to understand what the costs will be.
What Treatment Lengths Are Covered by American Family Insurance?
American Family Insurance does not offer insurance plans that cover rehab, so no length of treatment program is covered by American Family Insurance.
Other insurance carriers’ health insurance plans, however, understand that dependence on different substances requires different lengths of treatment. The type of plan you hold and your deductible, in part, will determine the number of days your policy covers.
Standard lengths of residential (inpatient) care include:
- 28-30 Days: This generally covers both detox and a treatment phase.
- 60 Days: This typically covers treatment for an addiction that requires more care and allows for more in-depth therapy.
- 90 Days: Treatment of this length allows for involved care that delves into the underlying roots of the addiction and preparation to safely transition back home.
Will American Family Insurance Cover Luxury Drug Rehab?
No, because AmFam doesn’t offer health insurance, they don’t have coverage for luxury rehab or other addiction treatment programs.
As far as other health insurance plans, though, coverage will vary. Some rehab centers offer additional amenities that you wouldn’t normally receive at a standard inpatient program.
Most insurance plans do not cover these types of luxury addiction treatment, although it is always wise to verify your policy coverage just in case.
How Do You Verify Your Insurance to Find Out Your Rehab Coverage?
Insurance can be complicated and confusing, so it’s always important to verify and understand your coverage before you start treatment so that you know what you’ll be paying out of pocket.
There are several ways you can determine this:
- Log onto your insurance provider’s website to check your plan details.
- Each insurance provider’s site works differently, but many of them have documentation about what levels of care they cover, what percentage of the costs they’ll cover, whether you need a referral or pre-authorization, and other details.
- Contact your insurance provider directly.
- Either through an online chat tool they may offer or simply by phone, your insurance card should tell you how to contact your insurance company.
- Some people find this easiest because you can directly ask about addiction treatment coverage and you can ask about specific situations and needs.
- Get help from the treatment center of your choice.
- If there’s a particular rehab you’ve chosen or that you want to go to, they will typically have admissions staff who can also either contact your insurance company for you or coordinate with you to find out about your coverage.
How Do You Get Health Insurance That Covers Addiction Treatment?
If you don’t yet have health insurance that covers drug or alcohol rehab, there are ample options for purchasing it. First, find out whether you’re eligible for Medicare by going to Medicare.gov or whether you’re eligible for Medicaid by visiting your state’s Medicaid website.
If you’re not eligible for either Medicare or Medicaid, you can get coverage through the ACA Marketplace. Here, you’ll be able to find out which plans are available to you at various prices. Keep in mind that all of the ACA Marketplace plans are legally required to cover some amount of addiction treatment.
Once you’ve secured coverage, you can start looking for treatment centers that accept your insurance and are a good fit for your recovery needs. The Addictions.com rehab directory can help.
