WHY TO GET HELP BEFORE THE NEW YEAR
The holidays are coming. It’s a time of family gatherings, parties, gifts, and warm good feelings. No one wants to be away from their loved ones at this time of year—especially due to an addiction to drugs or alcohol. But remember that the holidays also come with stress. You may be facing family members who harbor resentments due to your drug-related past behavior, or you may have to travel while trying to maintain your addiction to drugs or alcohol. Going to holiday parties carry its own risks: drinks flow freely. Will you be able to control and regulate your drinking around your loved ones or bosses? The mental and physical energy it takes to get through the holidays with an addiction may require stores of energy you don’t have. If you have an addiction to pain pills you may find yourself out of medication and seeking drugs in a strange town and trying to come up with excuses for your sudden disappearances from family events. Getting help may actually bring your family closer together and give you the relief you need. It’s also easier to get time off work during the holidays. Every day spent in active addiction can lead to devastating consequences, is it really worth taking the risk? A treatment center can be your safe harbor at these times. Remember, you won’t be missing the holiday, you’ll be having a “different,” possibly better one. Even drug treatment centers can create a warm holiday vibe and best of all—you’ll be safe.
Another reason to get help before the end of the year comes down to dollars and cents. Chances are, by the end of the year you’ll have met your deductible or are closer to meeting it. Your upfront costs will be a lot less because most insurance companies run on a calendar year: from January to December.
That means that all the money applied toward your deductible and maximum out of pocket reset to $0 on January first. To break it down, the deductible is the amount that you must spend before your insurance company will start paying any of your medical bills. Once you have met your deductible—which could be as high as $5000—your insurance company will pay a percentage of your billed charges up to a certain amount at which point they will pay at 100%. That certain amount is your out of pocket maximum and it’s there to keep you from being hit with an exorbitant medical bill. But in some cases it can be as high as $20,000. If your co-insurance is 50%, meaning you pay half and your insurer pays half until you reach $20,000, you could be hit with a $10,000 bill. It’s also worth noting that none of the premiums—the monthly bill you pay for insurance—go toward your deductible, but in some cases your deductible will go toward your out of pocket maximum. In other words, if you’ve met a $3000 deductible and it applies toward your $4000 out of pocket maximum, you are only responsible for a percentage of $1000 dollars. It’s becoming increasingly more common for hospitals and medical facilities to ask for some, or all, of these fees up front. By not waiting you can be saving yourself a significant amount of money.
WILL MY INSURANCE COVER TREATMENT?
Most likely your particular insurance plan will pay for treatment In 2010 President Obama signed the Affordable Care Act (ACA) into law which listed mental health and addiction treatment as an essential health benefit or EBH. All policies sold on the exchange must include mental health and substance use disorder benefits. With the opiate crisis in full swing, the government finally realizes that the cost to treat addiction—approximately $35 billion across public and private payors—is significantly less than the societal and economic costs associated with substance use disorders when factoring in disease, death, and lost taxes that could otherwise go toward health care. Know also, that substance abuse disorders can no longer be considered a pre-existing condition which precludes you from getting future coverage for this condition.
While The Affordable Care Act (ACA ) limits how high in-network out-of-pocket costs can be, the limit itself is fairly high. It’s important to take into account that all policies comes with their own set of restrictions, allowances, and small print. There are several different kinds of policies and they don’t all cover the same kind of care. You may have an HMO or EPO which requires that you go to a facility that is within their network. There also may be exclusions for certain services, e.g., detox benefits. PPO policies, those policies in which you may choose your medical provider, are the ones most commonly used for substance abuse treatment. Most commercial policies provided by employers will have coverage for substance abuse. Currently, all states, with the exception of Arizona, Georgia, Indiana, Iowa, Idaho, Oklahoma, and Wyoming, require commercial group insurers to provide coverage for substance abuse treatment.
Don’t give yourself more stress by agonizing over the decision to go into a drug treatment center during the holidays. I went into treatment on Christmas day of 2009 and ten years later I realize that it was the best time I could have chosen. It very easily could have been my last Christmas had I not gone. Instead of facing the tensions and concerns of family or feeling as though I was under a microscope .with loved ones watching my every move, I found myself with a group of people struggling with all the same issues. I was in a safe place and could relax.
The admissions team at Pax Recovery House will speak to your insurer and find out exactly what your coverage is for treatment. You won’t have to do anything.
Why not go into 2020 with the best gift you can give yourself. . . freedom and peace of mind.