Yes. By law, all private health insurance in the United States must cover some substance use disorder treatment. Most plans pay a significant part of IOP substance use disorder treatment costs.
Know Your Rights: Laws Require Coverage for Addiction Care
Federal law protects your right to treatment. The Mental Health Parity and Addiction Equity Act requires insurance plans to treat mental health and substance use care at the same level as medical and surgical care. The Affordable Care Act lists these services as essential health benefits, which means most plans must include them.
How Private Health Insurance Covers IOP Treatment
Private health insurance most often covers IOP treatment for addiction or mental health. Most insurers view IOP as a step that supports recovery and may follow higher level treatment like partial hospitalization programs (PHP) or IOP treatment may be standalone.
If your insurance is accepted, your plan pays a percentage of the cost of IOP. You will be responsible for any remaining deductible for the year. You may have a co-pay, or co-insurance as well but IOP is generally quite affordable compared to most addiction treatment.
Does My Insurance Cover IOP for Substance Use Disorder at The Living Room?
Contacting The Living Room and requesting a verification of benefits is the easiest way to find out if your insurance will cover IOP and other treatment here. You are welcome to call us, or submit your insurance through our secure form here.
We will be happy to explain your benefits after we complete verification so you can make an informed decision about your addiction treatment.
Deductible and Co-Insurance Explained
Your deductible is the amount you pay before your plan begins to cover the cost of IOP treatment. Some plans have a separate deductible for mental health care, so it helps to confirm which rule applies to your plan.
Co-insurance is the part of the cost you pay after you meet your deductible. For example, if your plan lists a twenty percent co-insurance rate, you pay twenty percent of each approved session and the insurer pays the rest.
Using Insurance for IOP Substance Use Disorder Care
The first step in using your insurance to attend IOP at The Living Room at Princeton is to contact us and request a confidential insurance verification. While we check your benefits to see what’s covered, we have a gentle conversation.
This over-the-phone admission screening helps us better understand your needs. That way we can ensure our IOP is a good fit. During the call we will ask some questions about your medical history, past attempts at addiction treatment and any co-occurring mental health conditions, like depression or anxiety.
Once your insurance verification is complete, we’ll explain what your plan covers here at The Living Room. We work with most insurance providers. IOP treatment for addiction is highly cost-effective and relatively easy for most people to fit into their schedules. This makes it the most popular form of treatment for substance use disorders.
Insurance Providers We Work With
Our center works with all major insurance providers, including Aetna, Blue Cross Blue Shield, Cigna, and UnitedHealthcare. Each plan sets its own coverage rules, so benefits differ from person to person. For now, focus on explaining your challenges and needs as clearly and thoroughly to us as you can. Our admissions staff can verify the details for you so you do not feel alone with the process. This step helps you understand your benefits before you begin care.
Take a Step Towards Recovery with The Living Room IOP
The Living Room at Princeton offers holistic, evidence-based addiction care for adults and adolescents in parallel programs. We offer medical detox placement, partial hospitalization program (PHP), Intensive Outpatient (IOP) and weekly outpatient counseling. We welcome the opportunity to play a part in your recovery. Please reach out to us anytime with questions about IOP or treatment for addiction and mental health anytime at (732) 327-1066
SOURCES:
Mental Health Parity and Addiction Equity Act – CMS
Affordable Care Act – CMS