Does Insurance Pay For Drug And Alcohol Detox?

According to the 2023 National Survey on Drug Use and Health (NSDUH), only 26% of the more than 8.5 million Americans who need treatment for substance use disorder (SUD) each year actually receive any form of professional treatment. But just because drug and alcohol addiction are chronically under-treated doesn’t mean that you should put off getting the help you need. In fact, treatment services are widely accessible in Ohio, with many different levels of care available to meet your specific needs for recovery. 

This includes medical detoxification, a service designed to help people who are dependent on drugs and alcohol as they pass through the initial withdrawal process. Medical detox can help you start your recovery journey safely and with confidence, before you transition to other healthcare services. 

But does insurance pay for detox? And what about other inpatient and outpatient treatment services? And what can you do if the cost of your care is still simply more than you can afford?

Is Medical Detox A Healthcare Service?

Yes, it is, and it is an important one. 

The effects of different drugs of abuse vary, with some, like methamphetamine and cocaine (stimulants), greatly increasing physical and mental activity, while others, like opioids, benzodiazepines, and alcohol, reduce this activity. In both cases, the longer a person uses these substances regularly, the longer their body will experience an altered internal state and the more it will make changes to adjust to this new “normal.” With time, this can lead to the development of physical dependence, as the body learns to rely on the substance to balance out its normal function and feeling. 

When a person then stops using that substance, he or she will experience uncomfortable, painful, or even dangerous physical and mental symptoms known as withdrawal, as their body’s internal chemical balance is, once again, severely disrupted. These symptoms will be different with different drugs, and can be more or less severe depending on the situation. In fact, some forms of withdrawal are considered critically life-threatening, as is the case with severe alcohol withdrawal and delirium tremens (DT). 

Even in mild cases, however, acute withdrawal is uncomfortable and often distressing, and it can involve serious complications, relapse, and mental health crises. Because of these very real risks, medical detox services are available to provide a safe, more comfortable withdrawal experience, with medical staff closely monitoring progress and providing medications as needed, as well as emotional, social, and psychological support. 

How Long Does Detox Take?

Withdrawal syndrome, or the acute withdrawal symptoms a person experiences after discontinuing drug or alcohol use, usually lasts between three and 10 days, or five days on average. 

This period can be affected by a variety of different factors, including:

• a person’s age and overall health
• the substance or substances they are dependent on
• their dosage(s) and the length of time they used the particular substance(s)

It’s also important to note that even after acute withdrawal has finished and a person has physically stabilized, he or she may still experience some mild lingering or recurring physical or psychological symptoms over the following days, weeks, or even months. 

At Ohio Recovery Center, once clients have completed detox, they can transfer seamlessly into our residential program. Here, your care team will continue monitoring you for post-acute withdrawal syndrome (PAWS) and other ongoing health issues.

What Is Withdrawal Like?

Withdrawal is often a challenging experience, but having medical support can make it much easier. Medical detox is often people’s first step toward lasting recovery. 

After being admitted and evaluated, you will be given a room where you will stay for the duration of the program. Nurses or other health professionals will monitor your progress, check your vitals, and keep you safe and more comfortable during withdrawal. You’ll have access to meals, distractions, and creature comforts.

Symptoms and complications associated with withdrawal vary by substance. Some of these can be avoided during medical detox, while others are treated as they occur. 

Common withdrawal symptoms and complications include:

• flu-like illness (fever, nausea, vomiting, diarrhea, aches and pains)
• muscle cramps, tension, or tremors
• dehydration
• changes in appetite
• problems with sleeping, including nightmares
• problems with thinking, memory, and concentration
• strong emotions like anxiety, depression, confusion, or anger
• alcohol or drug cravings and compulsions

Other serious symptoms like hallucinations and seizures may also be possible. 

During medical detox, you may receive medications and other care and support to avoid or treat these symptoms and complications, keeping you safe and more comfortable.

Is Detox Always Covered By Insurance?

Under the Affordable Care Act (ACA), all ACA-compliant health insurance plans must cover substance abuse treatment as an essential health benefit, including medical detox services.  

This was not always the case. In the past, substance abuse treatment services were considered as being separate from other healthcare services and were often left out by healthcare plans. However, with the passage of the ACA in 2010, health insurance providers were required to make certain changes related to substance abuse treatment, including:

• expanding policy holders’ “essential health benefits” to include behavioral health treatment, mental and behavioral health inpatient services, and SUD treatment
• preventing providers from charging more or denying service based on a person’s pre-existing conditions
• eliminating spending limits on covered services
• requiring “parity” between medical services and behavioral health services (equal copays, deductibles, out-of-pocket maximums, etc.)

It’s important to note that non-ACA-compliant plans, primarily short-term health insurance coverage, may not cover medical detox treatment or other SUD treatment services. Government health insurance policies like Medicare, Medicaid, and TRICARE, as well as plans sold on the HealthCare.gov marketplace and employer-sponsored health insurance plans, are reliably ACA compliant. 

Are Other Treatment Services Covered By Insurance?

The National Institute on Drug Abuse (NIDA) expressly defines addiction as “a chronic, relapsing disorder characterized by compulsive drug seeking and use despite adverse consequences.” In other words, even if a person knows that it is harmful to continue using drugs or alcohol or to go back to using them, they will anyway, because the very effects of drug and alcohol abuse train the mind and the body to do just that, especially during periods of stress or pain. 

While medical detox treatment is a critical service that can help people stop using drugs and alcohol safely and successfully, it is not enough to treat drug addiction or alcohol addiction on its own. For that, people need a personalized and comprehensive treatment program built around additional evidence-based treatment services. 

These include:

• behavioral therapies like cognitive behavioral therapy (CBT) and family therapy, which help individuals identify and change thoughts, feelings, and behaviors that contribute to their SUD
• medication-assisted treatment (MAT) using FDA-approved drugs like naltrexone, methadone, and buprenorphine, which can be used in the treatment of opioid or alcohol use disorders
• dual diagnosis treatment, which is provided by specialized rehab centers to meet the needs of clients with unmanaged co-occurring mental health disorders like depression, anxiety disorders, ADHD, OCD, and others
• peer support groups, which help people find allies in their recovery, practice social skills, and reinforce one another’s motivation and mindset for recovery
• aftercare coordination, for long-term local support of those who have completed an addiction recovery program and are re-integrating back into daily life, with all of its distractions and temptations

Detox At Ohio Recovery Center Today

So, does insurance pay for detox? 

Yes, it can. And getting your treatment covered by an ACA-compliant healthcare plan can lower the cost of your care significantly. Especially if you have already met your deductible or your out-of-pocket maximum for the year. And you can find these treatment services and others at a wide variety of addiction treatment providers in Ohio, Michigan, Indiana, and other states, including Ohio Recovery Center here in Van Wert. 

Reach out to us and we’ll help answer your questions about your insurance, the cost of your care, your treatment options, and much more.

Together, we can help you recover and live the life you deserve to live.