Fall is
Open Enrollment season. Between November 1, 2019 and December 15, 2019, individuals who buy their health insurance on the
federal or state health insurance marketplaces have the opportunity to change plans. Many employers also hold open enrollment in the fall, so individuals who get their insurance through their employer also have an opportunity to change their health plan.
If you or someone on your plan requires addiction treatment services, here are a few things to keep in mind.
Know Your OptionsReview your plan options carefully to determine whether you will be able to obtain the services you need. Most plans offered on the health insurance marketplaces must offer addiction treatment benefits, although which services and medications are covered varies by state and by plan. Some plans do not cover intensive outpatient, partial hospitalization and residential treatment services. Plans often exclude methadone treatment for opioid use disorder treatment.
If you or someone on your plan needs a specific service, make sure it is covered by the plan you select. Look out for any limits on the number of days or episodes of treatment that are covered and take note of out-of-pocket expenses. In general, the longer people stay in treatment, the better their chances for recovery. Inpatient or residential stays should always be followed by outpatient treatment for some period of time.
If you get your insurance through your employer, your plan may not be required to cover addiction treatment benefits. Nonetheless, most public and private plans are subject to the Parity Act, a federal law that requires plans to cover mental health and substance use disorder treatment the same way they cover treatment for other medical/surgical benefits.
