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Understanding Addiction Treatment Insurance

At least 1 in 5 Canadians experiences a mental health or substance use disorder in any given year. However, only a fraction of people struggling with addiction receives potentially adequate care.

Alcohol and drug rehab can cost a lot. In Ontario, a medically guided detox, the starting point for most addiction programs, can already cost anywhere from $1000 to $1500.

While there are public rehab facilities where you can get these services for free, the long wait times, ranging from 18 to 52 days, often get in the way of recovery and put people’s lives at risk with relapse or overdose. If you are seeking urgent care, looking for a reputable rehab facility that accepts insurance is the way to go.

In this article, we discuss everything you need to know about addiction treatment insurance and how you can use it to the fullest to turn your life around. 

Addiction Treatment Insurance 

Health insurance documents with a stethoscope.

Many private insurance providers offer coverage for addiction treatment under their mental health care plans. In Canada, companies usually provide it to their employees as an additional benefit to the existing healthcare coverage given by their province, like the Ontario Health Insurance Plan (OHIP). 

Depending on the premiums and how comprehensive the plan is, addiction treatment insurance coverage can vary from one patient to another. Insurance companies may pay the partial or full amount of the substance abuse treatment with specific limitations involving:

  • Your state of residence
  • The length of stay (30 days vs 60 days)
  • Stages of treatment (Medical detox only vs complete treatment, including counselling therapy for relapse prevention)
  • Level of care (Residential treatment vs. outpatient care)
  • Maintenance medication to support ongoing sobriety
  • Affiliated addiction treatment facilities or healthcare practitioners

Having addiction treatment insurance, whether for yourself or your dependents, gives you the peace of mind that you’ll have immediate access to professional help whenever you need it without worrying about how you’re going to pay for it. 

Reaching Out to Your Insurance Company 

If you or a loved one is dealing with a substance use disorder and would like to know more about addiction treatment insurance, we encourage you to reach out to your provider immediately. 

Follow these tips for a faster and smoother transaction.

  • Make sure you have your insurance card with the member identification number and other essential details within reach. 
  • Ask for the representative’s name with who you are speaking with and write it down on paper, including the date and time of your call. 
  • Don’t hesitate to ask questions and make clarifications for anything unclear or confusing, for example, complex terminologies or processes.

Questions To Ask About Addiction Treatment Insurance

Close-up shot of a telephone and hands taking notes with pen and notebook.

While you have an authorized representative of your insurance company on the phone, grab the chance to learn everything you need to know about your insurance plan and your options to use it in paying for an addiction treatment program of your choice.

Here are some excellent examples.

  • What type of insurance plan do I have?
  • Is it possible to upgrade it?
  • Ask specific details about your addiction treatment insurance coverage, including how long you can stay in the facility, whether you are limited to in-patient or outpatient services, etc.
  • Ask for a search radius in terms of where you can use your addiction treatment insurance.
  • What are the requirements that I need to present to avail of the benefit?
  • What is the process of getting coverage for drug or alcohol rehab? 
  • How do I get pre-approved addiction treatment insurance coverage? Do I need a referral from a family physician?
  • Inquire about maximum out-of-pocket expenses for different types of addiction treatment and your available options for customizations.
  • Ask them to send their criteria for “medical necessity” for addiction treatment coverage.
  • Request for an email with their list of accepted addiction treatment facilities where you can use your insurance.

If you have already done your research and have a preferred addiction treatment facility, feel free to inquire about coverage status from your insurance provider. Chances are, they can suggest a similar in-network alternative or find ways to make it work for you. Some insurance companies have health advocates whose primary job is to help you locate the best place to maximize your addiction treatment insurance benefits. 

Can I Use My Addiction Treatment Insurance at Freedom? 

Navigating insurance can be daunting and even discouraging. Leave it to us and focus on the one thing that matters most right now: getting better. 

Freedom From Addiction is committed to making our evidence-based addiction recovery programs accessible to everyone who needs them. If you want to know which insurance providers we accept, don’t hesitate to reach out to us, and we’ll take care of it for you.

We accept both in-network and out-of-network insurance companies. We have experts who can navigate this field for you by working directly with your provider. We’ll ask for all the info to better understand your addiction treatment insurance coverage and explain it to you. 

If you need prior authorization from us to apply for this benefit, we can take care of that for you, too. We have registered medical professionals and addiction specialists who can properly assess your specific needs and arrange for the requirements needed for prior authorization, if necessary. 

For detailed information about addiction treatment insurance, give us a call. A member of our team will be more than happy to assist you. 

Contact Freedom From Addiction today!


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