Yes, all insurance providers are mandated by the US federal government to provide coverage for rehab treatment for any drug use disorder including that from Gabapentin.
This drug is a habit-forming substance used for numerous medical conditions, most particularly for controlling seizures caused by epilepsy. Its powerful therapeutic effects include relief from nerve pain, restless leg syndrome, and fibromyalgia. It also has the potential to calm down anxiety and improve poor sleep.
Known as the sixth most prescribed drug in the country, Gabapentin poses health risks, specifically addiction, when taken in doses higher than what is prescribed or abused in conjunction with other substances such as opioids. To prevent addiction from causing you any grave harm in the future, you should seek professional help right away.
Most individuals feel apprehensive about getting treated because rehab can be expensive. However, it is important to note that private and state-funded health insurance programs can now be used to pay for its cost. In case you don’t qualify for any insurance, you can also apply for scholarship grants offered by public health and private institutions.
What Is Included in the Insurance Coverage For Rehab Treatment
This depends on the type of policy that you own. Fortunately, substance addiction is no longer considered a pre-existing ailment, an argument that most health insurance providers use as a cause to deny a patient a policy coverage for rehab treatment.
As stipulated in the Affordable Care Act (ACA) of 2010, mental health problems and substance addiction are now recognized as no different from any physical illness that requires medical care. The ACA ensures patients suffering from substance addiction that can enjoy a complete medical treatment from diagnosis to aftercare intervention.
Specifically, the following medical procedure must be shouldered by insurance policies about rehab care:
- Evaluation and intervention
- Prescribed medications
- Clinic and home health visits
- Family Counseling
- Maintenance drugs
Whether you are recommended to go for an inpatient or outpatient program, these are the basic standards that must be paid for by any insurance policy. While some policies can accommodate the full cost of the treatment, some may require the patient to pay out of pocket.
Every policy contains limitations, which means some can only cover the least partial benefit and pay for the remaining amount. While some policies aid in the cost of detox programs, others do not. For inpatient treatment, you could personally pay for the cost of accommodation and meal services since they are not part of the basic standards.
To avoid excess costs or to give you some time to prepare a certain amount for the potential out-of-pocket cost for your rehab treatment, it is best to reach your health insurance provider and know more about the specific benefits of the health insurance policy you own.
Does Insurance Cover Dual Diagnosis During Rehab Treatment
Yes, although they are not required to cover the full cost. With Gabapentin as a common option to strengthen the potency of other substances, it can be likely for a patient to suffer from two substance use disorders. On another note, addiction can also be either a cause or a result of a mental health problem such as depression or an anxiety disorder.
When two health problems exist at once, this is identified as a dual diagnosis or comorbidities, and it is not likely to receive treatment only in one condition. Rehab treatment must also be specialized in such a way that it treats both conditions. Insurance can still provide coverage for this type of case, although not the full cost.
The following are the types of insurance policies that can significantly affect the benefits you can enjoy whether you are taking rehab treatment for comorbidities or not. In considering which of the following types suits you, you can weigh which matters more to you: the monthly cost of the policy or the flexibility of your healthcare network.
Health Maintenance Organization (HMO)
HMOs allow patients to enjoy affordable healthcare policies by only paying low monthly premiums. If you are not particular about the healthcare provider who can assist you with your needs, then this can be suitable for you.
In HMO, you can only enjoy your insurance policy if your healthcare provider is a member of the network that your insurance company recommends. If you choose an outside network, then you will not be able to use your insurance policy for this case.
Preferred Provider Organization (PPO)
PPO allows patients to enjoy their healthcare policy with the freedom of choosing the healthcare provider they prefer, regardless if they belong to the network recommended by the insurance company or not.
To avail of this benefit, you need to pay high monthly premiums with annual deductibles, unlike the HMO. This can be an advantage for those who have complex conditions and would require a specific specialist to attend to their needs.
How To Pay For Rehab Treatment Without Insurance
If you do not have any insurance policy, you can consider the following options to finance your rehab treatment.
Medicaid
Medicaid is a federal and state-funded health insurance provider offered to low-income citizens or residents of the country. You can visit your state’s health home to see if you qualify and if you do, turn in the requirements to start your application.
State Grant
This is a state-funded rehab treatment that can only be availed in the state’s public health, and not in any private rehab center. You cannot expect high-end treatment facilities under this type of care, but rest assured that the healthcare staff is guaranteed competent.
Scholarship Grant
Some private rehab institutions offer a scholarship grant for qualified applicants. You can check out the nearest rehab center in your area and inquire at their front desk if they offer such a program.
Payment Plan
Some private rehab institutions also offer a payment plan. This allows you to divide the full cost of your treatment into a certain number of terms and make a monthly payment. This way, the cost becomes lighter since you only pay a minimal amount every month.
Fundraising
If the rest of the previously mentioned options do not work for you, you can try fundraising. Your family, friends, and connections can help you sustain the financial cost of your treatment. Although it can be difficult to ask, it can also be a great means to get treated.