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What Rehab Insurance Options are Available for Low-Income Patients

What Rehab Insurance Options are Available for Low-Income Patients

Health insurance can help pay for addiction treatment to drugs like clonazepam, and low-income patients have several options for assistance

Addiction often takes people by surprise. Recreational drug users typically know it is a risk, but an addiction can also develop from legitimate pharmaceutical use. Klonopin, a trade name for clonazepam, is an example of a medication with unexpected addiction potential. The benzodiazepine-class sedative can help treat anxiety disorders, panic attacks, seizures, muscle spasms and epilepsy, but Current Opinion in Psychiatry noted in 2005 that benzodiazepines are intended for short-term use lasting only two to four weeks. Extended use can result in physical dependence, and chemical changes in the brain reward system can lead to addiction.

Nevertheless whether the addiction stems from medical or recreational use, professional rehabilitation is the most effective form of treatment to address substance use disorders. For low-income individuals, however, this may present certain financial challenges. Addiction to drugs like clonazepam clearly affects finances, but treatment also involves expense. Fortunately there are rehab insurance options that can assist low-income patients.

The Financial Effects of Addiction

Before evaluating the cost of rehab and insurance, it is important to recognize the cost of an untreated substance use disorder. Produced by the Substance Abuse and Mental Health Services Administration (SAMHSA), a (TEDS) report looked at employment status among all rehab admissions in 2006. According to the study only 31% of the patients had a full-time or part-time job at the time they started treatment. This statistic highlights the financial reality for many addicts when they finally enter rehab. Addiction can affect finances in numerous ways including the following:

  • Addictive behavior and intoxication can lead to job loss.
  • An addiction makes it more difficult to secure new employment.
  • Many employers require drug testing that an addict cannot pass.
  • Purchasing drugs can be expensive especially through illicit sources.
  • Addiction involves legal risks with potential financial consequences.
  • Substance abuse increases the risk of accidents to the user and others.

Forbes noted in 2012 that addicts often spend money on drugs or alcohol that would otherwise go toward paying bills or debt. This directly affects finances as the addict becomes responsible for late fees and penalties, and accumulating debt involves increasingly higher interest payments. Likewise prescription drug addicts who do not have health insurance usually acquire the medication in illicit ways. In some cases drugs like clonazepam may be stolen or provided by a person with a legitimate prescription, but these sources can often dry up at a moment’s notice. If this occurs the addict may quickly experience strong withdrawal symptoms, and for benzodiazepine dependence, an immediate stop in use can result in long-lasting symptoms and potentially fatal seizures.

Insurance Options for Low-Income Individuals

Many people who enter rehab use some form of health insurance or government assistance to help with the expense. Published by SAMSHA in 2014, the 2012 National Survey of Substance Abuse Treatment Services (N-SSATS) report found that 65% of rehab centers accept private insurance, 58% accept Medicaid, 40% accept state-financed health insurance and 33% accept Medicare. Likewise 62% of the treatment centers offered sliding scale fees based on the patient’s ability to pay though there may be limits on the number of patients they accept at one time.

When it comes to insurance options, low-income patients benefit significantly from the Affordable Care Act (ACA) and its marketplace plans and subsidies. For the year 2014, a family of six may qualify for lower premiums on an ACA plan if they make less than $126,360, while an individual may qualify if he or she makes less than $45,960. The reduction in premium is based on a sliding scale, which means policyholders with lower income generally have lower premiums. Furthermore ACA plans include new treatment standards that help addicts in several significant ways including the following:

  • Addiction treatment is one of the ten required benefits of all marketplace plans.
  • Preexisting conditions like addiction are no longer grounds for denying benefits.
  • ACA policies cannot have lifetime and annual dollar limits on treatment cost.
  • Treatment benefits are typically available during all stages of a substance use disorder.
  • Coverage is available for lawful permanent residents and other immigration statuses.

The ACA also expanded Medicaid benefits for low-income individuals though some states opted out of the expansion preventing its residents from accessing lower premiums. Nevertheless ACA marketplace plans are usually still preferred because current addicts can enroll and immediately seek benefits without treatment services being denied because it is a preexisting issue. If benefits are denied for any reason, the Parity Implementation Coalition produced a Parity Toolkit that provides guidance for insurance appeals.

If looking at non-ACA plans, avoid catastrophic health insurance as it only cover emergencies and not addiction services for drugs like clonazepam. Policies also need to be evaluated by weighing premiums against deductibles, limits, out-of-pocket maximums and the policyholder’s share of medical expenses.

Free Help for Low-Income Addicts

If finances appear to be a barrier to getting addiction help fro drugs like clonazepam, our admissions coordinators are available 24 hours a day to help. We can discuss insurance coverage, check policies for benefits and explain other financing options and resources. Dealing with addiction is essential for a person’s physical, mental and financial health, so please call our toll-free helpline now.