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What to do if Your Insurance Company Refuses to Pay for Rehab

If you struggle with substance abuse, it is important to know there are laws on the books that require group insurance health plans to cover addiction treatment.

Health insurance formsGroup health insurance plans must follow all state laws and provide for any and all additional coverage requested by an employer. The truth is that some insurance providers will do anything and everything they can to deny individuals coverage for drug and alcohol addiction treatment. The financial incentive to do so is simply too great for them not to fight payment—or to pay the least amount possible.

The following is a look at what you can do if your insurance company refuses payment or reimbursement for expenses associated with rehab treatment.

Check Your Employee Handbook

The first stop should always be your employee benefits handbook. Your company may have a policy in place that overrides the decision of the insurance company. While you may be hesitant to contact your employer’s human resource department regarding addiction treatment, as long as you are not currently using illegal drugs, you are protected by law. The Americans with Disabilities Act states that you cannot be fired by your employer for disability.[1]

Ask Government Agencies for Help

State offices are the ones responsible for the enforcement of addiction treatment insurance laws. If you feel that you are not getting the coverage required by law, contact the office of the state insurance department, state health department or even the attorney general’s office. The Affordable Care Act states that mental and behavioral health services are essential health benefits. All health insurance plans must cover counseling, mental health inpatient services and substance use disorder treatment.[2]

Ask the Rehab Center for Help

Drug and alcohol rehab centers will generally stand by you as you work through coverage issues with an insurance company. In addition, addiction treatment centers may be able to provide some alternatives to help offset the cost of care such as private financing through their network of lenders. Many treatment centers offer payment plans as well as other flexible options.

Only Work With the Best Addiction Treatment Centers

High-quality drug and alcohol rehab programs understand the real seriousness of addiction. These treatment centers will allow you to start treatment while you settle things with your insurance provider. Most importantly, you should never delay treatment due to a conflict with your insurance company. Breaking the cycle of addiction and obtaining professional help is the most important thing you can do for your future. It is important to know where you stand with the law and to get as much information up front as possible. All other matters will work themselves out over time. If you’d like to talk to one of our admissions counselors at Michael’s House, know we are here to help. We want to help you get sober and live a healthy life. Get the information and support you need so you can move forward.

[1] Know Your Rights.

[2] Mental Health and Substance Abuse Coverage