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Veteran’s Insurance & Benefits for Rehab

Veterans dealing with drug or alcohol addiction have a variety of rehab payment options. Ranging from government funded insurance plans like the VA health coverage or Medicaid to private pay plans, veterans have several ways to make treatment affordable. Understanding how to pay for rehab will ease your mind so that you can take the next step in your recovery. If you are experiencing drug or alcohol use disorder, it’s best to move forward and seek treatment, so you can experience healing and improved well-being.

Rehab Insurance Options for Veterans

There are several insurance options to help veterans cover the cost of rehab. Many veterans already have access to insurance plans that will cover the cost, even if they’re not aware of the extent of their coverage. Some insurance plans and benefits packages are designed specifically for veterans, and others include the greater population. Regardless, the Affordable Care Act mandates that all insurance plans must provide some kind coverage for substance abuse.1 Insurance options for veterans include:

Does the VA Cover Rehab?

People who have served in the military, naval, or air service and are no longer serving are eligible for VA benefits, provided they did not receive a dishonorable discharge.2 VA benefits provide for a variety of services both for physical illnesses and mental health disorders, including substance abuse.3 When attempting to use your VA benefits for addiction treatment programs, it’s helpful to follow these steps to ensure you have an easier time gaining access:4

  • Verify your VA benefits first with the provider or by calling the number listed on your card.
  • Talk to your VA primary care physician about your substance use issue, so if a referral is needed, you can get one.
  • Work with a VA-approved substance abuse treatment center.

You may be wondering who will be paying for rehab if you have VA benefits. The VA covers most health services, including those for mental health and substance use disorders.5 Mental health services and evidence-based substance abuse treatments provided through the VA include the following:4&6

  • Medication-assisted detox, with access to clinics that provide methadone and buprenorphine.
  • Inpatient/residential care.
  • Intensive outpatient program treatment.
  • Outpatient services.
  • Aftercare programs.

Sometimes the VA is not able to provide the appropriate care for a veteran. It could be because the facility is filled to capacity. Other times, the veteran may need a specialty service not provided at a local VA facility. To meet these additional needs, the VA uses community providers to fill the gap.7 These community providers work closely with the U.S. Department of Veterans Affairs to ensure veterans receive the healthcare they need.7 The Community Care Network (CCN) consists of these providers. They work to find appropriate treatment centers for veterans.8 CCN operates in all 50 states and is separated into 6 regions, providing coast-to-coast service.8

The Affordable Care Act

In 2010, the Affordable Care Act (ACA) was passed. Its goal was to expand access to healthcare coverage, providing more opportunities for people to have medical insurance.9 In addition, the ACA assists people in controlling the cost of health services and increases the eligibility of low or no-cost healthcare for some people.9

As part of the ACA, Medicaid was expanded to include people whose income level was up to 133% of the federal poverty level.10 Consequently, about a half-million veterans who didn’t have health insurance were able to gain access to healthcare insurance in the first 2 years of the law.11

Medicaid & Medicare

Medicaid and Medicare are both government-sponsored health insurances that can assist veterans with paying for drug rehab. Each of these programs has different eligibility requirements that will determine who pays for rehab treatment. Here is a brief breakdown of each program:

Medicare: To be eligible for this program, you must be 65 or older or have a qualifying disability. Even if you are already getting VA benefits, it’s beneficial to enroll in Medicare because the two insurances will help reduce any out-of-pocket cost for rehab. Enrollment for Medicare is on a specific timeline, or you could incur late fees.12 The enrollment period usually begins 3 months before your 65th birthday includes the month of your birthday and extends 3 months after your birthday.12 If you qualify for and receive Medicare insurance, you can count on drug and alcohol use disorder treatment.13

Medicaid: You can be eligible for Medicaid if you are in a special covered group, or your income meets the eligibility requirements.14 Most veterans who are under 65 years old and whose income is at 133% of the federal poverty level would meet the eligibility requirements.14 Medicaid is similar to any other insurance and offers substance abuse service coverage under the behavioral health umbrella.15

Can I Go to Rehab Without Insurance?

If you don’t have any insurance at all and you’re sure you don’t qualify for Medicaid, you don’t have to struggle trying to detox on your own. You may be able to find free resources to assist you with treatment or explore other payment options. 

You can check with SAMHSA for resource information or look into state-funded rehab. Also, be sure to inquire with the Department of Veterans Affairs.

Can Insurance Cover Rehab Retroactively?

Sometimes you can get insurance to cover services retroactively—or after you’ve already had the treatment. Medicaid is one provider that has some leeway for retroactive services.16 If you were eligible for Medicaid 3 months prior to applying for it, you can have treatments in those 3 months covered retroactively.16

Other private insurances and VA insurances may have different rules, so be sure to check with them directly for additional information.

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