Paying for Rehab with the Affordable Care Act

The Affordable Care Act, also known as “Obamacare,” offers options to help pay for addiction treatment.

What is the Affordable Care Act (ACA)?

16255177492_0cccffde96_z

The Patient Protection and Affordable Care Act (ACA) is a health care system law passed in 2010 that covers addiction treatment. If you are addicted to drugs and alcohol, the ACA may be a way to help pay for it.

Under the ACA, addiction is no longer considered a pre-existing condition for insurance purposes.

The ACA sponsors insurance plans for sale on an online platform called the Health Insurance Marketplace. These medical insurance plans offer addiction treatment coverage similar to private insurance plans.

Need-based tax credits make many ACA plans less expensive for consumers.

The ACA also expands funds and treatment options available to Americans covered by Medicare and Medicaid. The costs and requirements for Medicare and Medicaid coverage are different from Marketplace medical insurance plans.

Get started on the road to recovery.
sidebar_cta_img

What Affordable Health Care Medical Insurance Covers

Under the ACA, coverage for addiction treatment must be as complete as it is for any other medical procedure. Some of the things you can get with these insurance plans include:

  • Addiction evaluation
  • Brief intervention
  • Addiction treatment medication
  • Clinic visits
  • Alcohol and drug testing
  • Home health visits
  • Family counseling
  • Anti-craving medication

ACA health insurance plans also assist with inpatient services like medical detox programs.

Some states run their own Health Insurance Marketplace platforms separate from Healthcare.gov. Differences between state and federal medical plans are based on Medicare and Medicaid coverage in each state.

Percentage of Addiction Expenses Covered by Obamacare

Anyone shopping for medical insurance can purchase an ACA-sponsored health plan. The five types of Health Insurance Marketplace plans available include:

  • Bronze plans – 60 percent expense coverage
  • Silver plans – 70 percent expense coverage
  • Gold plans – 80 percent expense coverage
  • Platinum plans – 90 percent expense coverage
  • Catastrophic — 60 percent total average cost coverage

*Available only to those under 30 years old or those with extending circumstances

See how Jerry
overcame his
addiction.
Jerry Lawson sitting in a chair

Who is Eligible for Coverage?

Americans with incomes between the federal poverty level (FPL) and four times the federal poverty level are eligible for ACA tax credits. The FPL changes according to family size. These statistics from the Medicaid government website outline federal poverty levels in 2015:

ACA Income Eligibility
Family SizeMax. Annual Income
1$11,770
2$15,930
3$20,090
4$24,250

“Cost-sharing” support is available to Silver Plan holders living below 2.5 times the poverty level. For example, a single person making $29,425 a year or less would be eligible; a two-income household would need to make $39,825 or less. These cost-sharing measures reduce deductibles, co-payments, insurance premiums and other out-of-pocket expenses for those consumers.

Background image

Ready to get help?

Don’t waste another second. Enter your number to receive a call from a compassionate treatment expert.
Don’t waste another second. Call now to speak with a compassionate treatment expert.

    How Does the Affordable Care Act Broaden Treatment?

    The ACA reduces addiction treatment costs, increases treatment options and extends many benefits of employer-provided insurance plans to individual medical insurance plans. The ACA also allows young adults 26 and younger to remain on their parents’ health care plan.

    These expanded benefits include addiction treatment despite “pre-existing health conditions.” ACA funding opens hundreds of new inpatient and outpatient health centers every year to support this increased care. Many of these new centers also cover treatment for co-occurring mental health conditions like depression.

    Affordable Care Act Statistics

    11.7

    million

    Nearly 12 million Americans have enrolled in Health Insurance Marketplace plans since February 2015.

    87

    percent

    Over 87 percent of ACA website enrollees qualify for financial assistance.

    32

    million

    The ACA has given 32 million Americans access to substance abuse treatment.

    Who Accepts Affordable Care Act Plans?

    Many addiction treatment centers accept Health Insurance Marketplace plans.

    If you don’t already have an ACA-sponsored plan, you can apply for one online during the open registration periods. You can find a registration schedule or request a special registration form at Healthcare.gov if you miss the normal registration window.

    An addicted person can purchase one of these medical insurance plans by completing the following steps:

    • Logging on to the Website

      Visit the Health Insurance Marketplace at Healthcare.gov to begin the process.

    • Creating an Account

      Create a Health Insurance Marketplace online account.

    • Completing Your Application

      Fill out the Marketplace application and see available health plans.

    Once approved for an ACA-sponsored plan, speak with a Health Insurance Marketplace attendant to determine which health insurance package is right for you and your family. Whether you plan to enter an inpatient or outpatient program is one of many factors to consider when purchasing an ACA coverage plan.

    Questions about treatment?

    Get confidential help 24/7. Call now for:

    • Access to top treatment centers
    • Caring, supportive guidance
    • Financial assistance options
    (855) 400-5261

    Finding a Rehab Center

    Addiction recovery can be a long, difficult process. Settling on the right rehab program is crucial to getting — and staying — sober. Not every program offers the same treatment options or accepts every insurance plan. Our treatment specialists can help you determine which treatment centers accept your insurance.

    Contact now to find a treatment center that’s right for you.

    Get help today

    Don't go through the process of recovery alone. Get in touch with someone who can help.

      Get 24/7 help now. All calls free and confidential.

      (855) 400-5261

      Take control of your life

      Our treatment specialists offer 24/7 assistance.

      • Access to top treatment centers
      • Caring, supportive guidance
      • Financial assistance options

      Call now:

      (855) 400-5261

      OR

      Have us call you:

        Where do calls go?

        Callers will be routed to:

        • Delphi Behavioral Health Group
        • Amethyst Recovery
        • Beach House Recovery Center

        A treatment facility paid to have their center promoted here. To learn more about how to be featured in a paid listing, click here.