Will my health insurance cover online addiction counseling?

Will my health insurance cover online addiction counseling?

Did you know that private insurance plans legally have to cover drug addiction treatment?

The Mental Health and Parity Act, passed in 1996, requires insurance to cover addiction treatment counseling, just like any other mental health treatment.

After 2017, implementation standards were changed, and task forces were developed to make sure that insurance companies were complying, and that people knew this about their coverage.

But even those who know their insurance has to cover addiction counseling and treatment still have questions about which options are covered.

 

One big question is: does that coverage include online addiction treatment?

Telehealth addiction counseling is remote counseling aided by technology, using either a phone or the internet to speak to your health professionals.

While aspects of the treatment differ from program to program, online treatment options are flexible, usually cheaper than traditional inpatient programs, and allow for the best care because doctors can be selected from anywhere in the country, not just the doctors who happen to live and work nearby.

But online treatment is accessible for more reasons than just convenience and quality.


 

Online video counseling is a necessity in rural areas and for people facing other barriers to treatment

People with children, people without driver’s licenses or reliable transportation, people with disabilities which make travel difficult, and people who just live too far away from their town’s healthcare offices NEED services like online counseling.

Brick and mortar doctor’s offices might take months to reschedule an appointment that was missed due to any of those barriers, and some places will even charge the patient a “missed appointment” or “failure to cancel” fee.

Then the travel itself can even be an added financial burden, between gas prices, bus fare, or hiring a ride from a taxi or ride-sharing service like Uber. None of these things are cheap, even in the best of circumstances.

Some states, 38 of them to be exact, have taken these factors into account, and are making sure that the coverage required for addiction counseling will apply to online counseling services.

Other states are in the process of creating similar “parity” laws, with one of the most common hold-ups being a struggle over the definition of telehealth.

Make sure to keep an eye on the news for updates on whether or not your state legislature is trying to pass a parity law.

The states where telehealth is already covered by insurance are listed below:
 

  • Maine

  • Oregon

  • California

  • Colorado

  • Georgia

  • Hawaii

  • Kentucky  

  • Louisiana

  • Texas

  • Oklahoma

  • Virginia

  • New Hampshire

  • Maryland

  • Michigan

  • Missouri  

  • Arizona  

  • Mississippi

  • Montana

  • New Mexico

  • Vermont

  • District of Columbia

  • Tennessee

  • New York

  • Arkansas

  • Indiana

  • Minnesota

  • Nevada

  • Connecticut

  • Delaware

  • Washington State

  • Florida

  • Alabama (State's largest insurance provider agreed to reimburse for telehealth for rural areas)  

  • Rhode Island

  • Nebraska

 

Unfortunately, these laws only apply to private insurers.

Medicaid will only offer coverage for telehealth recovery counselors if the recipient lives in a rural area, under other specific circumstances.

With Medicaid, sometimes a patient will still have go to a health professional’s office and teleconference with an addiction counselor from there. However, in many states, such as Florida, this is only a requirement for the first visit. After the initial visit, Medicaid recipients may receive online treatment for up to 3 months before having to see a professional in-person again.

All of this may change in the future though, depending on further evaluation of the Mental Health and Parity Act’s implementation.


 

Which parts of addiction treatment are actually covered by my insurance?

For traditional, in-person addiction treatment, insurance could cover a wide range of treatment aspects, such as:

  • Inpatient care at an approved facility

  • Outpatient procedures through an approved provider

  • Medical detox, usually including medications

  • Co-occurring mental health conditions

  • Follow-up counseling and services

  • Maintenance medication

The depth and breadth of services covered depend somewhat on the particular terms of your health insurance plan.

For telehealth, this still holds true, though there are minor differences from state to state, due to the language of each state’s parity laws, and their definitions of telehealth.

In some states, patients may still be required to go see a doctor in person for a medical evaluation before they can begin telehealth counseling and then be counseled at home after they are evaluated in the doctor’s office.

According to the Affordable Care Act, insurance plans are required to provide a one-page summary of benefits and therapy services, and their corresponding fees, per the U.S. Department of Health and Human Services.

Requesting this from your insurance can be a good place to start when figuring out which parts of addiction treatment are included in your plan.

If you’re close to re-enrollment, make sure to see which plan or tier your insurance company offers has the most mental health and addiction treatment options.

You might also see if some of the extraneous costs like medication can be paid for with a Health Savings Account (HSA).


 

What can I do if I my insurance WON’T cover online counseling, or if I don’t have insurance at all?

There are several different options for those who need to pay all or part of their addiction counseling out of pocket, or those who need additional addiction counseling services after they have already gotten all the services their insurance will cover.

Some services are sliding scale, meaning they are based on your income. Some people receive scholarships or grants to attend a specific treatment program. Some people even crowdfund their costs through websites like GoFundMe.

Or, if your credit is acceptable, you can use credit or look for financing options.

Recover At Home provides financing for Good Credit (FICO 700+), Okay Credit (FICO 600 - 700), and sometimes to Less Than Perfect (FICO less than 600).

At Recover At Home, we pride ourself on our affordability, as well as our quality services. For questions about pricing, insurance, and financing, do not hesitate to reach out us.

If financing is still not an option, Recover At Home has a limited number of scholarships, which you can apply for here: https://www.recoverathome.org/scholarship/

Whether the inquiry is for yourself or a loved one, a caring ear is waiting on the other end of the line, hoping to get access to care for those struggling with addiction.

Phone number: +1-800-559-2032

E-mail: info@recoverathome.org