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Tips for Getting Addiction Treatment Covered by Insurance

CHICAGO, March 26, 2015

Chicago-based Gateway Alcohol & Drug Treatment urges Illinois residents—even if denied health benefits for alcohol or drug rehab in the past—to check their current healthcare plan to determine if substance abuse treatment is covered by insurance. Now that federal parity laws, Illinois Parity, and The Patient Protection and Affordable Care Act have all taken effect, many health plans include the same coverage benefits for treatment of mental health/substance use disorders (MH/SUD) as they do for general medical and surgical treatment.

"There are thousands of Illinois residents who need care for addiction issues and now more than ever they have access to treatment through their health insurance. Our goal is to help people understand their treatment options and their insurance benefits" says Michael Darcy, President & CEO, Gateway Alcohol & Drug Treatment.

Here are the top five tips Gateway provides to those seeking coverage for drug or alcohol rehab their health plans:

1. Know Your Illinois Parity Rights
In the state of Illinois, unless an insurance plan is exempt, large employer plans are required in each calendar year to cover the following for substance use disorders:

2. Understand What Health Insurance Plans Must Follow Federal Parity Laws:

  • Health plans sponsored by private and public sector employers with 51 or more employees, including self-insured and fully insured arrangements
  • All insurance plans sold inside and outside the state exchanges, which are available to individuals and smaller companies with 50 or fewer employees
  • Some state and local government health plans

3. Understand What Health Insurance Plans Do Not Have to Follow Federal Parity Laws:

  • Medicare
  • Individual plans not purchased through the health insurance marketplaces
  • Group plans with 50 or fewer employees
  • Plans who received an exemption based on increase of costs related to parity

4. Look for a Reputable Treatment Center
Substance Abuse Treatment is a specialty service and it's important your Financial Counselor is an accomplished expert who can work on your behalf to gain the most from your insurance coverage.

5. Don't Take No for an Initial Denial
If your health plan meets the criteria of state and federal parity, it's important to realize an initial denial does not always mean no coverage is available. Knowledgeable Financial counselors may be able to obtain insurance coverage for treatment by exploring different avenues with your insurance company.

"Substance use is a treatable healthcare disorder - and people should know it is covered by insurance, similar to diabetes, hypertension and cancer." says Michael Darcy.

To learn more about treatment options or insurance coverage for treatment related to alcohol or drug abuse, call Gateway at 877-505-HOPE (4673).

About Gateway Alcohol & Drug Treatment

Since 1968 our goal has been straightforward: to help clients get their life back on track and achieve a life of sobriety, free from drug use and symptoms of mental illness, that is productive, socially responsible, and healthy. As the largest, non-profit treatment provider in the country, we currently operate drug and alcohol treatment programs for men, women, adolescents, and clients diagnosed with co-occurring mental health disorders.

Gateway's Community Division has treatment centers located throughout Illinois, including Carbondale, Chicago, Lake County, Fox Valley, Springfield, and the St. Louis Metro East area. These centers offer residential and outpatient treatment services for adults, teens, and adolescents accessed through insurance, state funding, and self-pay.

Gateway's professional clinicians help thousands of individuals successfully complete treatment by developing a personalized plan that treats the underlying causes of substance abuse—not just addiction to drugs or alcohol.

Learn more about insurance coverage, treatment options, or Gateway's confidential consultation at RecoverGateway.org or call 877-505-HOPE (4673).

Reporters and Editors, for more information, please call Leslie Colman, Marketing Director, at 630-776-5725.