The Affordable Care Act does require all insurance policies to offer addiction treatment coverage. But it allows policies to set conditions on treatment if they choose.
Some policies require a person to go through outpatient treatment before they will cover in-patient treatment.
This can be really challenging – I know, because what it basically means is that your loved one has to fail out-patient treatment before they will be offered in-patient treatment, and that “failure” could have devastating consequences.
Other policies might require pre-approval before your loved one can be admitted to a treatment program. Again, by the time you get a doctor’s pre-approval, your loved one could change their mind.
There are three things you can do:
First, do your research about your insurance and available treatment options right away.
If your loved one will need pre-approval, it might be worth your while to contact your primary care physician, or another willing physician well ahead of time, explain your situation to them, and see if, when your loved one is ready, they would agree to get your loved one in on a last-minute basis so you can get the pre-approval with minimal delay.
Finally, I suggest you contact your congressperson and ask them to support updating the addiction treatment mandates in the Affordable Care Act.
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