How Your California Insurance Can Cover Addiction Treatment Costs

A common concern of those struggling with drug addiction is health insurance and cost of treatment.

There are a few types of California insurance including HMO’s, Health insurance policies, Self-insured plans, Medi-Cal, and CA Marketplace.

How much treatment will insurance cover?

The coverage requirements and limitations depend on the type of policy a patient has. There may be some limitations concerning what kind of care is covered by the plan. For instance, insurance companies may pay for the detox process and the drugs needed during this stage (as most patients require medication during the rehabilitation process,) but they might not or only partially cover the subsequent rehab therapies a patient needs.

How to verify your insurance coverage?

There are several secure ways a person can check what their insurance covers. Consulting the summary of coverage and benefits by logging into the account provided by the insurance company is one way. This compendium holds a listing of all the services the insurance plan covers.
Call or email an insurance company representative to ask them about the coverage. They will also provide information on what drugs the insurance covers or for what clinics or treatment plans they qualify.
Or contact a reputable treatment facility and ask for a verification of benefits with the facility’s program.

Out of State Care

People tend to avoid seeking out-of-state care as they fear their insurance will not cover it. That restricts a patient’s access to the best care since they base their decision within the bounds of their state. In truth, there is no rule stating that California-issued insurances can only apply within the borders of the state, but some companies might impose this practice themselves. Patients should check with their insurers before making a decision.

What about health insurance I receive from my employer? Am I at risk of losing employment?

According to the Family and Medical Leave Act, those who wish to enter a rehabilitation treatment facility can benefit from up to 12-weeks unpaid leave from work annually. As such, if the patient wants to follow a 24/7 inpatient treatment program, they can do so without having to quit their job. The act applies to all public institutions, schools, as well as businesses with over 50 workers.

Watch the entire Windward Way Explainer Series about addiction, insurance, detox, treatment, & more on our Youtube page.

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