No matter what your political views may be, we can all agree that money (or a lack thereof) shouldn’t be the reason someone loses their life. There are many medical issues – substance abuse and addiction included – that can lead to death if not treated. But treatment costs money. Even countries that have universal healthcare need to fund healthcare facilities, medications, equipment, doctors, etc. Our nation has been in such turmoil over healthcare in the past few years that many people don’t even know where they stand when it comes to medical insurance.
If your son or daughter is struggling with addiction, one of the worst things you can hear from a treatment facility is: “I’m sorry. We unfortunately don’t take that medical insurance.” Yet, that response is incredibly common. Unfortunately, our nation has had quite a hard time with healthcare. So, what’s the best option in these circumstances?
What’s Up with the Affordable Care Act?
The Affordable Care Act (ACA), also known as “Obamacare,” has been in the spotlight for the last few years. Here in California it affects things like Medi-Cal insurance. The ACA has helped many people receive healthcare who can’t receive benefits from other healthcare plans. That means recent college graduates, those who lost their jobs, people whose employers don’t have healthcare benefits, and many others. But the plan isn’t without its critics. The ACA, enacted during Obama’s term, is federally funded, a fact that its critics are very opposed to. Now that we have a new president, the GOP is looking to repeal the act. And those who receive their medical insurance under the ACA fear for their future treatments if that were to happen.
Just last month, the GOP failed to get the vote they needed in a motion to proceed with repealing the ACA. So, the ACA is still currently in place and people who wouldn’t otherwise have health insurance are “safe,” as it would seem. But the overall state of healthcare in the U.S. remains a huge, confusing issue for everyone.
Healthcare, the ACA, and Addiction Treatment
The ACA does help people see doctors and get treatment for many issues. So, many people, conservatives included, are taking a closer look at whether or not the GOP should continue to move to repeal the act.
The thing is, while the ACA has saved many lives, its reach doesn’t always cover substance abuse. Take Southern California for example. In SoCal, some counties do have detox and residential treatment centers for substance abuse and addiction that do accept Medi-Cal insurance. But there are other counties, like New Start’s home of Orange County, in which no detox facilities accept Medi-Cal insurance. The federal government’s medical treatment circle does not universally encompass substance abuse and addiction. So, while it’s heartbreaking for admissions staff to tell someone who’s hurting and needs help that we don’t accept their insurance, it’s essentially a national issue that private treatment facilities have little control over. However, New Start does accept private pay through a discounted cash rate for those with insurance that doesn’t cover treatment (or those who don’t have insurance at all).
What it essentially boils down to is stigma.
Substance addiction is incredibly stigmatized in our current culture. Our country is torn between seeing addiction as a real disease and casting those who suffer from it aside as weak-minded. Addiction is a disease and is even labeled so by most medical associations, including the American Medical Association. Because substances can actually change body chemistry, it can be incredibly dangerous to try to detox from certain addictions on your own or quit cold turkey. The dangers of withdrawal paired with huge addiction issues, such as the opioid crisis, are the reasons why treatment facilities are needed. Yet, the topic as a whole is so stigmatized that healthcare for these people who need help is hard to come by.
What’s the Best Option?
What is comes down to is that people struggling with addiction need help. Treatment can be the difference between your son dying of an OxyContin overdose or living to become sober, happy, and healthy. But we completely understand that the out-of-pocket cash rate for treatment facilities isn’t always doable. So, under current circumstances, the best option overall might just be to invest in a private insurance plan that covers these life-saving programs.
Buying Private Health Insurance
All this hype about the ACA and general healthcare issues in the media has basically created a thick, grey cloud around health insurance. Many people are so confused and hesitant about the topic that they don’t realize that buying private health insurance is an option. But it is. And it’s a very smart idea in many cases – addiction treatment being just one. You might not be able to afford a plan that an employer usually offers, but some health insurance is better than none and can still save someone’s life. There are just a few steps that go into investing in a private healthcare plan.
How to Navigate Healthcare:
First, you need to decide what general type of health insurance you want or need. You’ve probably heard of the two big umbrella types: HMO (health maintenance organization) and PPO (preferred provider organization). You’ll want to look at which providers fall under each type when deciding which one is best for you and your dependents. New Start, for example, accepts most out of network PPO insurances. Other types include HDHP (high-deductible health plan), CDHP (consumer-driven health plan), and POS (point of service plan). There are also short-term individual health insurance plans if you only need insurance for a short amount of time.
Next, you’ll want to think about how big of a deductible you can manage. Your deductible is the portion of treatment you’re billed for. It’s a little more involved than this, but you can essentially think of it as you pay the deductible and your insurance covers the rest. Co-insurance and other co-pays are typically involved, but those will be listed in the healthcare plan you choose.
Once you have those things figured out, you can start browsing the major health insurance companies in your area. There are even comparison sites online to help you browse. Look for plans that come close to matching the deductible you’re comfortable with. Then search through the details of those plans to see if addiction treatment is covered. It may sound daunting on the surface, but it really can be the difference between life and death for you or your loved ones who are suffering.
Private Pay Healthcare vs. Cost of Addiction
You can’t really put a price on life. Living healthy and happily is priceless. That said, we understand that the price tag on certain health insurance plans might seem steep on the surface. However, if you research the costs of individual healthcare plans, you might find that some really are manageable.
According to data collected by eHealth, the average monthly premium for unsubsidized individual health insurance is $321.
But that’s nothing compared to the cost of addiction. Depending on a person’s drug of choice, the money spent to keep using across one year could easily be enough for a new Mercedes Benz. For example, a heroin user spends anywhere from $70 and $140 per day on their drug use on average. That’s about $2,100 to $4,200 per month and about $25,000 to $50,000 per year. Compare that to the $321 average monthly cost for individual health insurance. And don’t forget to tack on the fact that health insurance can save a loved one’s life, whereas substance abuse can take it.
Call it what you will (unethical, corrupt, broken, bipartisan, rigged, or even perfectly fine), the state of our nation’s healthcare shouldn’t mean that your son, daughter, girlfriend, spouse, or yourself lose their/your life to addiction. There are other options out there that can save your life and your wallet!
If you or someone you know is struggling with addiction, New Start can help. Call us at 855-737-7363 for a free and confidential assessment.