With all the changes to health insurance policies and what companies are required to cover as well as what coverage individuals are required to carry, there has been much confusion when it comes to covering the cost of drug rehab. Many families are struggling to get the coverage they need to pay for treatment even though there have been very specific pieces of legislation enacted to ensure that they get the care they need when they need it.
What Should Happen
In 2008, a law called the Mental Health Parity and Addiction Equity Act was approved, requiring that employer-provided health insurance plans for larger businesses offer coverage for substance abuse and related mental health issues at the same rate and level provided for other medical illnesses like cancer and other chronic disorders.
Though the law went into effect in 2010, patients have still had a hard time getting coverage for drug abuse treatment in the past couple of years. Many have been forced to cover most of the cost out of pocket or argue long and hard for a modicum of coverage for specific services.
The Added Challenge of the Affordable Care Act
In theory, the adoption of the Affordable Care Act this year was designed to ensure that even those who can’t afford health insurance have the coverage necessary to get help – especially help for substance abuse and mental health issues among Baby Boomers. According to USA Today, treatment for these two issues is on the list of essential health benefits that must be provided in all individual health insurance policies and policies for small businesses as well. The key factor is that, just as with large business-based health insurance policies, this coverage can be no more restrictive than coverage for other medical events.
Unfortunately, these well-intentioned laws are doing little to positively impact many patients’ experience when it comes to paying for treatment.
Michael Walsh is the CEO of the National Association of Addiction Treatment Professionals (NAATP). He told USA Today: “Many providers … report less days and more difficulty with reimbursement since the final rules were established.”
The problem, according to Walsh, is that many insurance providers can’t come to a consensus when it comes to “what the practical implementation of the rules should be and what should be covered.”
The Coverage Your Loved One Needs to Heal
As the country works to resolve the many issues raised by the Affordable Care Act, many families in crisis are struggling and left to fight their insurance companies while also scraping together the funds they need from other sources (e.g., personal loans, personal savings, help from friends and family, etc.).
How are you handling the business of covering the cost of treatment for your loved one? Leave a comment below and share your experience. If you need help financing rehab for your loved one, contact us at Alta Mira today.