Insurance For Mental Health & Dual Diagnosis Treatment

Can I Use Insurance for Mental Health Treatment and Dual Diagnosis Treatment?

Yes, you can. By law, private medical insurance in the U.S. covers treatment for substance abuse This wasn’t always the case. The Affordable Care Act (ACA) passed in 2010 brought substantial changes to the healthcare industry that make it much easier to use insurance for mental health needs. This law transformed access to treatment services for addiction as well.

The ACA made it a requirement for health insurance providers to offer coverage for substance use disorder (SUD) treatment. This means using insurance for mental health and dual diagnosis care for addiction is easier than ever before. The 2010 Affordable Care Act (ACA) also extended the 2008 Mental Health Parity and Addiction Equity Act which requires insurance for mental health to cover substance abuse needs equally (that’s the “equity” part).

No matter what private health care plan you have, you can use your insurance for mental health treatment. There is also coverage for substance use disorders (including alcohol). Ideally, if you have a substance use disorder, you will want to choose a dual diagnosis program. That way you can use your insurance for mental health and addiction at the same program potentially and get the care you need to thrive in recovery.

What Does Insurance for Mental Health or Addiction Cover?

Exactly what is covered and for how long will depend on your specific plan as well as your (or the patient’s) needs, which will be communicated to your insurance company by the treatment provider (The Sylvia Brafman Mental Health Center, in this case) who is treating and evaluating you.

In other words, when you use insurance for mental health or addiction treatment, the amount of coverage varies. Insurance companies do not typically “green light” an entire 30, 60, or 90 days of treatment right up front. What happens is, you get approval from a facility to admit you for treatment based on your clinical interview and medical records, where applicable.

Once you are in treatment, your care provider (SBMHC, if you admit here) works with your insurance company, letting them know how you are progressing and getting approval for each successive period of treatment. You don’t have to worry about any of this while you’re in treatment though. That’s our job. Your job is to focus on getting better.

How Do I Have My Insurance Checked?

The simplest way for most people is to call our admissions department directly at (877) 958-9212

Our staff can gather your information and have our insurance department contact your provider to get coverage details for you. While you wait, you can find out more about what The Sylvia Brafman Mental Health Center can do for you or your loved one and ask any questions you may have about our services or accommodations. We can also begin your intake screening at this time (if we are speaking to the prospective patient on this call).

Insurance Benefits Verification

The process to check your insurance at The Sylvia Brafman Mental Health Center is easy and usually takes less than an hour. An insurance benefits check does not obligate you to treatment at SBMHC. It simply gives us permission to verify what your plan offers and then explain to you how you can use your insurance for mental health treatment or dual diagnosis care for a substance use disorder.

All you need for insurance verification is:

• A health/medical insurance card
• Your (or the patient’s) full legal name, DOB, and social security number (or last 4 digits)
• A telephone (or computer) to submit the information to us.

What about Self-Pay or Medicare or Medicaid?

The Sylvia Brafman Mental Health Center works with all major private medical insurance networks. If you don’t have medical insurance coverage or elect not to use it, we have reasonable self-pay rates and options worth exploring. We regret that we cannot work with state or federal (Medicaid or Medicare) insurance for mental health treatment at SBMHC. If self-pay is not an option for you, we will help you find appropriate care that meets your needs and means using your Medicare or Medicaid coverage.