Addiction Helpline and Resource Center

Will Insurance Pay for Aftercare?

Will Insurance Pay for Aftercare?

Aftercare is reimbursable under most insurance plans

Completing rehab signals the start of a new life and recovering addicts can feel proud of their accomplishments. At the same time, it is important to remember that getting through treatment is not the same as getting “cured” from prescription drug abuse. Addiction never disappears completely, and must be managed like any other chronic disease.

According to the American Society of Addiction Medicine, addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. So just like recovery from hypertension or diabetes, staying sober from prescription drugs means paying attention and monitoring signs that could point to a coming relapse. Ignoring these signs increases the risk of reverting to addictive, self-destructive patterns. In fact, according to statistics from Alcohol and Alcoholism, up to 46 percent of alcoholics relapse six months after receiving inpatient treatment and up to 48 percent relapse within six months after rehabilitating in an outpatient program.

Aftercare, a resource that kicks into gear during the recovery maintenance phase, is one solution to this problem. While rehab lays groundwork for healthy living, aftercare begins the building process in which new principles and strategies are put into play. To learn about why seeking this support is important even after you’ve left rehab and to understand what part insurance plays in paying for it, read on.

Aftercare 101

Whether your treatment experience exceeded expectations or is a chapter you would rather forget, staying motivated after discharge is critical. Although preventing relapse is a topic frequently discussed during treatment, aftercare programs focus on this key recovery component more intensely. Attending aftercare is one of the most formidable defenses you can build against threats to your sobriety from prescription drugs.

The goal of aftercare is to maintain treatment gains, prevent backsliding, and get an individual’s life back on track. Each stage of recovery brings new challenges, and what worked well in rehab may not prove effective once a person is back on the job or living with family. In aftercare, individuals get help evaluating changing recovery needs with the assistance of a team comprised of peers and professionals who serve as cheerleaders, coaches and teammates.

Traditionally held on a daily basis in the evenings and offered to rehab graduates, aftercare programs usually include the following elements:

  • Ongoing counseling
  • Crisis intervention
  • Relapse prevention
  • Support group meetings
  • Service opportunities
  • Community
  • Accountability to a sponsor, sobriety coach or therapist

Sessions are overseen by counselors and case managers who help with important life tasks such as looking for safe living arrangements, career planning, job placement and strengthening relationships. Education is an integral part of most aftercare programs. Group sessions frequently center on examining environmental, social and psychological factors to learn what triggers substance abuse—and why. Clients are encouraged to consider recovery issues that include the following:

  • Identifying stressors
  • Coping with cravings
  • Thinking through the outcomes of a relapse
  • Replacing substance abuse with healthy habits such as exercise

The structure and accountability of attending regular sessions with a counselor are extremely beneficial in the following ways:

  • Enhance identity and self-worth
  • Improve coping skills
  • Develop problem-solving and stress-management skills

Many people who attend say they learn valuable ways not only to continue growing in sobriety but also to deepen relationships they made in treatment. Leaving the highly structured environment that protected you while you were in rehab can feel like taking a terrifying leap. Think of aftercare as a stepping-stone to keep you on your feet.

Insurance Coverage for Rehab and Aftercare Treatment

Studies show that it takes four to five years of recovery to stabilize sufficiently. Only at that point does the risk of future lifetime relapse drop below 15 percent, say experts at the National Institute on Drug Abuse (NIDA). That is why many treatment centers provide aftercare free of charge for people who have attended inpatient treatment. It is also why aftercare is reimbursable under most insurance plans. Details regarding this coverage are usually included within the “outpatient” section of your insurance manual’s psychiatric health section.

Insurance policies can be extremely difficult for non-professionals to understand. For this reason, many facilities offer assistance to navigate its ins and outs. Professionals working at treatment call centers will contact insurance companies to discover exactly what policy holders are entitled to– and what is required to qualify for coverage. In the event that an insurance company denies aftercare that a physician believes is essential, treatment center staff can help to locate other sources of financial assistance. Funding options include the following:

  • State-funded aftercare programs
  • Charities
  • Loans or gifts donated by friends and family members
  • Payment plans

The bottom line is that you should never let financial concerns keep you from getting addiction services that you need to stay clean. Every investment you make in your long-term sobriety is money well spent.

Help for Prescription Drug Abuse

If you or someone you love abuses painkillers, help is available. Admissions coordinators at our toll-free, 24 hour helpline can guide you to wellness. You never have to go back to a life of addiction. Please call.

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