Does My Insurance Cover Opiate Detox?

Few addictions can turn someone’s life upside down the way opioid addiction can. And this, by the way, applies to prescription-based opioids and their street-level counterparts, namely heroin.

Now, to appreciate what makes opioids so addictive and destructive, we have to understand what these powerful drugs do when someone takes them. When someone takes morphine, heroin, codeine, oxycodone, hydrocodone, fentanyl, or another opioid, the drug makes its way into their bloodstream. From there, it attaches to opioid receptors in the brain, which, in turn, tamps down pain and triggers feelings of euphoria.

Except for heroin, most people begin taking opioids to cope with severe pain, but eventually, they stop taking these drugs as directed by their physician and ultimately develop an addiction. Most who have a problem with opioids usually turn to heroin when they can no longer get a prescription from a licensed physician.

The Truth About Why Opioids Are So Addictive

According to a study published by the National Institutes of Health (NIH), an astounding 3 million people in the U.S. either had or currently have an opioid use disorder (OUD). This news is not entirely surprising in light of the addictive nature of opioids. When someone repeatedly takes these powerful drugs explicitly for their euphoric effects, they eventually build up a tolerance that leads to them having to take more and more of it. Sadly, the price they pay for doing so is an addiction.

For a large percentage of users, their love affair with opioids is the thing that brings their life to an early end. According to a study published by the Centers for Disease Control and Prevention (CDC), opioids were responsible for approximately 80,000 overdose-related deaths in 2021. As unsettling as this is, there is some good news. More and more people are starting to recognize the havoc opioids are wreaking on their lives, and they are getting the help they need to break the cycle of addiction.

Overcoming Opioid Addiction: A Closer Look at the Journey Toward Sobriety

Something to note when it comes to opioids is quitting them requires detox, the body’s natural way of ridding itself of not only drugs but also other harmful contaminants. Because opioid detox can trigger numerous unpleasant symptoms, such as muscle aches, nausea, and vomiting, physicians in most rehabs in the U.S. recommend medication-assisted detox.

In short, medication-assisted detox involves round-the-clock monitoring by physicians and taking FDA-approved drugs to combat symptoms associated with detoxing from opioids. But this aspect of addiction recovery is not cheap. According to the National Center for Drug Abuse Statistics, the cost of addiction recovery that includes methadone to combat withdrawal symptoms typical of quitting opioids is between $5,897 and $18,468.

Will Insurance Cover the Cost of Opioid Detox?

For those who are concerned about being unable to pay for medication-assisted detox to quit opioids, you needn’t be. And this is especially so if you have health insurance. Thanks to government mandates, all health insurance providers must provide addiction recovery in their policies, which includes coverage for the monitoring and medication necessary to help individuals get through opioid detox.

This mandate is courtesy of the Mental Health Parity and Addiction Equity Act of 2008. Although you will likely still be on the hook for some out-of-pocket expenses, you can rest easy knowing your insurance coverage will absorb at least some of the costs associated with helping you to quit opioids. The Affordable Care Act (ACA) also helps in this regard.

The Mental Health Parity and Addiction Equity Act

This government mandate requires health insurance providers to set the annual or lifetime dollar limit on mental health benefits at an amount comparable to the limits established for medical and surgical benefits. The long and short of it is insurers cannot offer fewer benefits or higher copay requirements for counseling, behavioral therapy, or any other treatment related to the psychological aspects of addiction recovery.

The Affordable Care Act

This mandate prevents health insurance providers from denying coverage to individuals with a pre-existing substance use disorder. It also prevents those providers from imposing yearly or lifetime limits on coverage.

In summary, by law, health insurance providers must provide coverage for all aspects of addiction recovery, not only for opioids but also for other drugs. In the context of addiction recovery, that means coverage to help pay for medication-assisted detox, addiction counseling, and much more. To learn more about using health insurance to help pay for your addiction recovery, consider speaking with one of our friendly, compassionate, and knowledgeable associates today at 844-639-8371.

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