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Is It Possible to Get Insurance Coverage If I’m Already in Recovery?

Is It Possible to Get Insurance Coverage If I’m Already in Recovery?

Changes in the law guarantee that a person can get insurance coverage even if treated for a past addiction

Health insurers are no longer allowed to deny coverage based on a pre-existing condition such as past addiction treatment to drugs like clonazepam. This important change in law gives people who relapse or need additional treatments greater access to care.

Health Insurers and Addiction Treatment

The Affordable Care Act (ACA) along with the Mental Health Parity and Addiction Equity Act (MHPAEA) work together to provide more complete health care coverage for people who suffer with addiction and mental health problems. While a small number of plans are exempt from certain provisions of the law, most small employer and individual plans are now required to offer additional benefits while large employers already offered the additional benefits. The ACA, or Obamacare, requires insurers offer substance use disorder and mental health benefits as part of 10 essential benefits. The law also prevents all insurers from denying coverage based on a person’s pre-existing condition, even a past substance use disorder diagnosis. Together with the MHPAEA, insured Americans should pay comparable copays and other costs for mental health treatments as they do for medical/surgical treatments.

Coverage for individual treatment varies by insurer and state. While law mandates addiction treatment, it’s important to understand ahead of time what will be covered. The sweeping changes brought by the ACA and mental health parity laws still leave room for debate. Insurers will require a medical diagnosis and prior authorization is generally required for all mental health services. On the whole most insurers must offer treatments such as psychotherapy and counseling.

When a person needs treatment for addiction and mental health, it’s important to be honest about symptoms at the very beginning. There are many steps to recovery and a relapse is often part of the learning process that helps a person understand the best way to create lasting change.

Finding Treatment After a Relapse

Addiction is a chronic, recurring disease, notes the National Institute on Drug Abuse (NIDA). A person who develops an addiction is likely to need ongoing care especially if the addiction is severe or the person has multiple addictions. Relapse rates for addiction are similar to other chronic diseases. For example, 40% to 60% of people diagnosed with an addiction experience relapse compared with 30% to 50% of people with type 1 diabetes, 50% to 70% of people with hypertension (high blood pressure) and 50% to 70% of people with asthma.

When a person experiences an addiction relapse to drugs like clonazepam, it is a signal he or she needs more treatment according to the NIDA. A relapse may occur at any point—a person may relapse during treatment or after being sober for many years. One of the best ways to lower the chance of relapse is to find an individualized treatment plan that focuses on the reasons behind an addiction, which include biological and behavioral factors. Finding a long-term balance of sobriety and healthy functioning takes time. Many people need multiple treatments to achieve long-term recovery.

Since many people also suffer with a co-occurring condition, such as a mental health condition or addiction to another behavior, it’s important to find treatment that addresses all conditions at the same time according to the Substance Abuse and Mental Health Services Administration (SAMHSA). It’s also crucial for a person to be actively involved in the plan for recovery and find treatment that offers needed supports.

Research on people who successfully live in recovery shows sobriety is more a process than a cure according to an article in Psychiatric Rehabilitation Journal. The process is highly individual with each person evaluating how well he is performing using his own standards. It also requires personal responsibility and the decision to remain sober. People who achieve recovery find ways to develop personal meaning in their lives, through work or social interactions or charitable or spiritual works. They also develop a belief that the future can be better, and there is hope for change.

Need Help Finding Addiction Treatment?

Addiction is a serious disease, but decades of scientific research shows people who go through treatment do get better. Going without treatment, however, opens a person up to greater pain because addictions destroy lives and lead to disabilities or even death if untreated. If you or a loved one is struggling with an addiction to drugs like clonazepam, we can help.

A person who experiences a relapse may feel demotivated, but the slip is just part of the overall journey to long-term sobriety. Individuals who recognize the need for help are ready to take the next step. Our admission coordinators are available 24 hours a day, seven days a week at our toll-free helpline to provide options. Don’t wait to find the help you need. Call us today, and get started on a more fulfilling, productive life.