Differences Between Private and Public Insurance For Addiction Treatment

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Differences Between Private and Public Insurance For Addiction Treatment

Purchasing insurance for drug rehab can seem like a grueling task, especially because there are plenty of insurance firms out there offering different types of plans, plus the insurance lingo does nothing to make it easy to understand any of the processes. Essentially, there are several types of traditional health insurance plans available. They are standard group health plans that offer medical coverage, have a monthly premium, and include a network of providers such as doctors, hospitals and others who provide healthcare services.

Private health insurance plans are run by private insurance companies, and once you purchase a plan, you can either pay for all or some of your coverage. These types of plans have open enrollment periods, and coverage starts the on the first of the following month where you are required to make premium payments including a certain percentage in co-pays and coinsurance.

Private insurance for drug rehab simply costs more in premiums, especially for individuals who have little to no recurring health issues. It also costs more in medical care because oftentimes healthy people don’t use their plans and never meet their deductibles while at it. The biggest advantage with private insurance plans such as HMOs, PPOs, POS, fee for service (indemnity), or health savings account (HSA) is that they feature a network of doctors, specialists, and hospitals and offer a range of health benefits, including preventive care. Additionally, each year a person meets their predetermined deductible and co-insurance payment until they reach a maximum amount, their insurance company pays the entire bill.

Individuals who take out private health insurance for drug rehab do it for a number of reasons, mainly for the peace of mind that comes with avoiding public hospital waiting lists. They also do so to avoid the Medicare levy surcharge, claim rebate, choose their doctor, or even stay in a private hospital room upon availability.

Public health insurance plans such as Medicare, Medicaid, and children’s health insurance program or CHIP are all federal and state health insurance programs for those above the age of 65, for low-income families or individuals and children below the age of 18 respectively. Applications for public insurance for drug rehab are accepted at any time during the year and coverage begins the first of the month that the application was received. Qualified applicants may be required to pay an enrollment fee and a copay otherwise, public health insurance offers low-cost coverage plans for its members.

In addition to providing an affordable alternative to private insurance, eligible members can also get a combination of Medicare plans to achieve a more comprehensive plan including help with other out-of-pocket expenses.

Regardless of the insurance a person opts for today, the Affordable Care Act, also known as Obamacare has made covering mental health, substance use disorder services including rehabilitative and habilitative services a requirement for all health insurance plans available to individuals who are looking to obtain health insurance for drug rehab.


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