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 / Addiction Information / Insurance / Affordable Care Act

Does The Affordable Care Act Cover Drug and Alcohol Rehab Costs?

The Affordable Care Act (ACA), often known as Obamacare, is a law that aims to make health insurance more accessible to Americans.

 

A conversation regarding the Affordable Care Act (ACA) appears to be happening in every corner of the country these days. As a highly charged topic, many are curious about its impact on their lives. Even after being in place for roughly a decade now, those thinking about entering a drug or alcohol rehabilitation program are still concerned about the effects of the ACA on their health insurance. One common misunderstanding is that Obamacare may only cover a small subset of physical problems and won't pay for treating mental health conditions. This is far from reality.

What To Know About Your Healthcare Insurance

Our Admissions Experts Will Help You Navigate This Difficult Information. 

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Co-Insurance

Deductibles

Co-Payment

Typically, co-insurance percentage range from 20% to 40%, and the insurance company clears the rest.

The amount you pay out-of-pocket for treatment before the health plan starts helping with payments.

Co-pay is a fixed amount you must clear (usually when you receive treatment) for covered treatment services.

What is the Affordable Care Act?

The Affordable Care Act was signed into law by Obama in March 2010 to ensure that all Americans have access to medical insurance.

To achieve this goal, this law:

 

  • Prevents health insurers from discriminating against patients with preexisting SUDs during the coverage.

  • Bars insurance companies from denying customers coverage due to age, health, or other criteria.

  • Helps low-income households afford insurance by providing discounts and subsidies.

 

The ACA also boosted healthcare quality by mandating that all insurance policies include a set of minimum medical services called EHBs (essential health benefits).

Who Qualifies for ACA Coverage

You are generally eligible for ACA coverage if you:

 

  • Reside inside the United States.

  • Have U.S. citizenship or a valid U.S. permanent resident card, or are a foreigner but live in the United States legally.

  • Are not now detained in a penal institution.

  • Cannot be paid for by Medicare.

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Anytime, day or night, you may call us at Rolling Hills Recovery Center at 855-559-8550. We'll work with you to find the best treatment plan.

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Affordable Care Act Subsidies for Alcohol and Drug Addiction Treatment

Subsidies, often called tax credits, are available under Obamacare and are based on a person's income. Premium payments are capped at a specific proportion of your annual wage.

 

While the Affordable Care Act allows anybody to obtain health insurance, people with earnings of between 100% and 400% of the FPL (federal poverty level) may be eligible for financial help that lowers premiums and other out-of-pocket payments when seeking care.

 

With an income between $26,500 and $106,000 (based on 2021 FPLs), a family of four qualifies to receive financial assistance to pay for alcohol and drug addiction treatment. In addition, if a (single) person's annual income is between $12,880 and $51,520, they may be eligible for these tax credits.

Here is what you need to know if you're wondering whether you qualify for a subsidy under Obamacare:

 

  • The earnings you declare in the year your health plan covers you will determine your eligibility for credits, not your income from the previous tax year. This implies that you must provide an estimated amount of your earnings when applying for ACA subsidies.

 

  • You may be obliged to pay back part or all of the subsidy money spent on your behalf for your insurance premiums if you earn more than anticipated during the year.

 

  • If you make less money than anticipated during the year, you may qualify for further subsidy support, which may be allocated when you submit your year-end taxes. If this is the case, you must keep careful records to ensure you get this funding.

 

  • A website, healthcare.gov, "the Health Insurance Marketplace," is set up to sell insurance policies that the ACA backs.

 

  • ACA subsidies are available via your state's government-run health insurance Marketplace, qualified licensed agents, and private online Marketplaces that work with the government Marketplace.

Why Recover With RHRC?

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There are affordable options for addiction treatment

Rolling Hills Recovery Center works with a variety of healthcare providers.

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Rolling Hills Recovery Center is dedicated to your success. We provide evidence-based treatments backed by science and holistic therapies that heal the mind, body, and spirit.

  • We are fully accredited

  • Mater level clinicians

  • We treat you as an individual

  • Respectful and peaceful setting

  • Insurance is accepted

Medically Reviewed:

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Expert Contributor

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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How Should One Go About Applying for the ACA?

One may apply for health insurance by going to the HealthCare.gov website, even if they reside in a state that doesn't have its health insurance Marketplace established.


In addition to Healthcare.gov, several states operate their own Health Insurance Marketplace websites. Medicare, CHIP, and Medicaid coverage in a given state are the primary factors that distinguish state healthcare systems from their federal counterparts. The Federal Marketplace website in your state will probably have links to the various state exchanges.

What Kinds of Drug Addiction Treatment Are Covered by the ACA?

Addiction is now considered a pre-existing disease under the Affordable Care Act. Also, addiction treatment must have the same comprehensive coverage as other medical procedures under the ACA. These insurance policies provide a variety of benefits, including:

Medical Detoxification

Medical detox may ease the discomfort and ensure the safety of the withdrawal process. This aids in a smoother transition to long-term care for addiction, whether inpatient or outpatient therapy.

Inpatient Programs

Patients may obtain treatment for addiction in a residential environment at an inpatient rehab center. Most inpatient treatment centers provide various therapeutic activities, including group and individual sessions and holistic therapy programs.

Outpatient Programs

Patients in an outpatient program can continue living at home while receiving care.

Intensive Outpatient Programs (IOP)

Intensive outpatient programs (IOPs) are outpatient programs that include more prolonged, more frequent appointments.

 

Partial Hospitalization Programs (PHP)

Compared to inpatient programs, PHPs provide the same level of care while enabling patients to remain at home. Patients in such a program often participate in therapy for four to six-hour sessions on five or more days per week.

Aftercare

Aftercare programs assist patients in maintaining their sobriety and identifying ways to prevent falling back into old habits.

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How Much Will ACA Pay for Substance Abuse Treatment?

The Affordable Care Act ensures that everyone in the market for health coverage may buy a policy. All ACA-related insurance plans will fall into one of four main categories, each of which has a unique payment breakdown structure:

 

  • Plans in the bronze category provide 60% cost coverage.

  • Silver plans pay 70% of rehab costs.

  • A gold plan will cover 80% of your rehab costs.

  • Platinum plans provide 90% coverage of rehab costs.

Call Rolling Hills Recovery Center to Verify Your Health Insurance Eligibility Under The Affordable Care Act

Obamacare, commonly known as the Affordable Care Act or ACA, provides health insurance to millions of previously uninsured Americans. In addition, the American Rescue Plan Act of 2021 made the ACA's coverage year of 2022 the most cost-effective in its history. Thanks to the newly available subsidies, 80% of households may pick a monthly plan costing them $10 or less.

 

If you are a citizen or legal resident of the United States who is not currently jailed or receiving Medicare, you may enroll in an Affordable Care Act insurance plan. In addition, if your work does not provide health insurance, you may be eligible for an ACA health plan within your budget. Get in touch for more information on how the ACA can help you pay for alcohol or drug rehab services.

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Affordable Care Act Subsidies for Alcohol and Drug Addiction Treatment
How Should One Go About Applying for the ACA?
What Kinds of Drug Addiction Treatment Are Covered by the ACA?
How Much Will ACA Pay for Substance Abuse Treatment?
Call Rolling Hills Recovery Center to Verify Your Health Insurance Eligibility Under The Affordable Care Act

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