This will blow your mind. Treatment is owed to you under the Affordable Care Act. Don’t call your insurance company they may try and give you the cheapest program they have. We know what they are required to give and will help you get the best care possible at little or no cost.
Here are the quick facts about the law and rehab:
- Millions of people with drug and alcohol abuse problems are now eligible for treatment through the Affordable Care Act.
- Under the Affordable Care Act, all health insurance plans are required to cover substance abuse treatment as one of 10 “essential health benefits” specified in the law. This elevates substance abuse services to the same level as pediatric care, cancer treatment and childbirth.
- Drug and alcohol abuse should now be approached as a disease with the same protocols of screening, detection and preventative care as heart disease or diabetes.
- Substance use disorders, far less severe than addiction, are now covered.
- If you buy an insurance policy though the healthcare.gov site, the plan you pick will have mental health services as a part of the coverage. This is not optional, it is a mandate for the insurance policies.
- If you qualify for Medicaid (which had been greatly expanded) you will also have mental health and substance treatment services available to you.
- Open enrollment started November 15th.
- Open enrollment (for most) closes February 15th (see sheet at bottom of article). Enrollment for Medicaid is year round.
- 7 million eligible people with substance abuse or mental illness, still do not have healthcare.
Here are the provisions, as told by the Affordable Care Act website.
- Mental and behavioral health services are essential health benefits.
- Health insurance plans available in the Marketplace must cover 10 categories of essential health benefits. One of these categories is mental health and substance abuse services. (Substance abuse is also known as substance use disorder.)
- These services include behavioral health treatment, such as psychotherapy and counseling. They also include mental and behavioral health inpatient services and substance use disorder treatment.
- Your specific behavioral health benefits will depend on the state you live in and the particular health plan you choose. You’ll see a full list of what each plan covers when you compare plans in the Marketplace.
- Mental and behavioral health and pre-existing conditions.
- Marketplace plans can’t deny you coverage or charge you more just because you have a pre-existing condition.If you are outside the open enrollment dates, please take the time to watch this short video. You may qualify for the special enrollment period. We under this qualification very well. The best option is just to call us and we can make this easy for you.
- Coverage for treatment of pre-existing conditions begins as soon as your Marketplace coverage starts.
- There’s no waiting period for coverage of these services.
- No lifetime or yearly dollar limits on mental health services.
- Marketplace plans can’t apply yearly or lifetime dollar limits on coverage of essential health benefits. This includes benefits for mental health and substance use disorder services. Parity (equal) protections for mental health services.
- Marketplace plans must provide certain “parity” protections between mental health and substance abuse benefits on the one hand, and medical and surgical benefits on the other.
- This means that in general, limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services. The kinds of limits covered by the parity protections include:
- Financial — like deductibles, co-payments, coinsurance, and out-of-pocket limits
- Treatment — like limits to the number of days or visits covered
- Care management — like being required to get authorization of treatment before getting it.
Are you convinced that The Affordable Care Act provides one of the largest expansions of mental health and substance use disorder coverage in a generation? Also required (under the law) are rehabilitative services that can help support people with behavioral health challenges. Because of the law, most health plans must now cover preventive services, like depression screening for adults and behavioral assessments for children, at no additional cost. Plans cannot deny you coverage or charge you more due to pre-existing health conditions, including mental illnesses.
If you have questions about your insurance plan, call us. Because of the Affordable Care Act, health insurers are required to provide you with an easy-to-understand summary about your benefits including mental health benefits, which should make it easier to see what your coverage is. All state Medicaid programs provide some mental health services and some offer substance use disorder services to beneficiaries. These services often include counseling, therapy, medication management, social work services, peer supports, and substance use disorder treatment.
Some important information:
- You are required to enroll in a health insurance plan or you will be fined.
- If you miss the deadline and do not have coverage, you could be hit with fines of $325 per adult or 2 percent of family income, whichever is higher.
- The fine is actually not a bill that is sent to you, it is taken from your tax refund.
- You could file taxes in a way, so that you don’t receive a refund, however, you would need to do this every year.
Why is this information unknown to people
The new healthcare law is complicated with lots of components applied different across state lines. People with substance abuse disorder just don’t know about the range of treatment options available to them. But we do! Our No Cost Rehab Site offers free and confidential help If you have elected not to get insurance or for any reason we are unable to help you get no cost rehab click here
