Is It Worth Paying Out-of-Pocket Costs for Rehab?

Is It Worth Paying Out-of-Pocket Costs for Rehab?

Getting the best care may cost more in the short-term

Research studies often determine more effective ways to treat addiction. While the latest research offers treatments that produce better outcomes and longer-term sobriety rates from drugs like Xanax, health insurance policies don’t always cover the newest treatments.

Health Insurance Plans and Out-of-Pocket Costs

Many health insurers offer products that allow patients to choose in-network and out-of-network providers. Popular insurance plans, such as preferred provider organizations (PPOs) offer this benefit, while some more heavily managed products, such as health maintenance organizations (HMOs) may not.  While copays and coinsurance for in-network providers may be at one level, for example, a $30 physician copay, costs for out-of-network providers will be substantially more. Patients may be required to pay a certain percentage of out-of-network provider costs as well.

The Affordable Care Act (ACA) requires all federally qualified plans to offer addiction and mental health benefits, but the total amount of coverage will vary based on the insurer and benefit level. Health insurers negotiate with providers such as physicians and hospitals to get the best rates on medical services. When an insurer does not have a contract with a provider, the costs are higher and passed on to the member.

Still when a person has health insurance, they are protected by an annual out-of-pocket maximum that caps their total healthcare spending at a certain level. The Affordable Care Act (ACA) limits total out-of-pocket spending in 2014 to $6,350 for an individual and $12,700 for a family. While pharmacy costs may be considered separate from this total in 2014, by 2015 all health care spending must be included into one total according to Kaiser Health News.

Evidence-Based Addiction Treatments

Studies on the effectiveness of addiction treatments provide important information about achieving the best outcomes. In the past some insurance companies set coverage policies based on outdated information. One example of a well-researched treatment protocol with little recognition by insurance policies is residential treatment.

A 30-day stay at a treatment facility is considered standard; however, studies show that a 90-day stay or even longer offers much better outcomes and helps patients achieve sobriety from drugs like Xanax with fewer chances of relapse according to the National Institute on Drug Abuse (NIDA). Offering a person the best possible type of treatment at the beginning reduces the chances of multiple treatment episodes and, therefore, reduces overall costs.

Another example of an effective treatment is coordinated care that treats a person’s addiction along with any mental health disorders at the same time. Federal agencies like the Substance Abuse and Mental Health Services Administration (SAMHSA) promote coordinated care, known as Dual Diagnosis treatment as the most effective long-term strategy for treating substance use disorders.

Although experts recommend offering a coordinated treatment program, most addiction treatments do not meet this standard. Experts also recommend screening all individuals admitted for substance use disorders for any co-occurring mental conditions, but too often funding challenges or staffing limitations prevent any mental health evaluation.

Behavioral Therapies

Another important element of addiction treatment for drugs like Xanax is the ability to learn new strategies for living a sober life along with the confidence to avoid temptations and cravings. There are several evidence-based forms of talk therapy that teach these important strategies including Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) according to SAMHSA. These protocols may or may not be offered at in-network treatment facilities. In addition these sessions are commonly offered on an outpatient basis, and an insurance company may only cover a certain number of sessions.

While addiction treatments cost money, there are also financial costs associated with skipping treatment. Individuals suffering from addiction may engage in behaviors that prevent them from having a stable job or ruin family relationships. Overcoming addiction can help people be more creative and find better jobs as well as improve interactions with family and friends.

Need Help Finding Addiction Treatment?

Addiction treatment is crucial for the well being of an individual and his family and friends. While health insurance may not cover every treatment cost, it does lower total out-of-pocket costs and give a person the ability to get discounts on services.

If you or a loved one needs help finding an effective treatment program for addiction to drugs like Xanax, please call our toll-free helpline. Our treatment philosophy is based on helping the whole person, mind, body and soul. We specialize in treating co-occurring disorders such as substance addictions that occur along with mental health conditions.

A successful recovery means lifestyle changes that help a person avoid temptations and bad habits. Our admissions coordinators are trained to find the best treatment program for each individual person. Our toll-free helpline is available 24 hours a day, seven days a week. Don’t wait to find help. Call today.

Are you ready to seek treatment?

If you are ready to beat a Xanax addiction and start a new life in recovery then we can help. We have admission counselors standing by 24 hours a day to take your email, live chat request, or phone call to get you in the addiction treatment center that best fits your unique & specific needs.