How to Talk to Insurance Companies About Treatment

You are finally ready to get treatment for your addiction. Chances are, you have hit many roadblocks along the way of getting here. Not being ready, waiting for the right time, persistence from friends or family, or denial can keep people from getting the help they need. Another roadblock on the way to finally walking in the door to a recovery center can be the cost. Don’t let this be what stops you – learn how to talk to insurance companies about treatment and what to do if they do not cover your care.

Know What Questions to Ask

Calling up your insurance company to ask about addiction treatment isn’t as cut-and-dry as it seems. It is important you know what questions to ask to make sure all aspects of your care are covered or not so that you know what bills may or may not be involved.

Make sure you ask about:

  • Detox, rehab, and aftercare. Addiction treatment often involves these three elements. When talking to insurance companies about treatment, make sure to ask if all three of these are covered and by how much.
  • Copay and deductible. These are both out-of-pocket costs to you. Your copay is what you may pay when you arrive, and your deductible is how much you may need to pay before your insurance “kicks in” and begins covering the rest.
  • Length of treatment. Treatment for addiction depends on the needs of the person. You may be recommended to stay anywhere from one month up to three months. Check with your insurance to see how long they will cover your treatment for and what those specific options are.
  • In and out of network providers. Some insurance companies do not cover out-of-network providers, and some do. Ask your insurance company about the specific treatment centers you are considering to see if they are in-network, out of network, and what that coverage is like.
  • Medication coverage. There can be many medications involved when it comes to addiction treatment, especially medication-assisted detox for all substances and medication-assisted treatment for opioids. Ask your insurance company what your medication coverage is not only for your stay, but any relapse-preventing medication you may need in aftercare.

Let Us Handle It

There are many circumstances in which negotiating with your insurance company is unrealistic. This could be if you are in a hurry to get to a treatment center, do not have the cognitive wherewithal to speak to insurance companies due to your addiction, if your loved ones are choosing your treatment center and care options for you, or if you are the loved one of an individual suffering from addiction and do not have the proper information.

No matter the case, there are other options for talking to insurance companies about treatment than doing it yourself. At Pinelands Recovery Center, we employ a 24-hour admissions staff who can confidentially help you work out all of the logistics of paying for treatment, whether it is covered by insurance or not.

What to Do If Insurance Won’t Cover Treatment

There could be many reasons why insurance companies won’t cover some or all of your treatment, depending on what insurance company you have, what your insurance plan is like, or whether you have insurance at all. In this case, it is important to know your options if your insurance company won’t cover some or all of your addiction treatment.

  • Ask about other payment options. Many treatment centers offer payment plans and other payment options. Ask our admissions specialists what could be worked out for your care to make it as easy as possible.
  • Ask your employer. It is important to know your rights with your employer as far as taking time off work for your treatment, but in addition, your employer may help cover some of the costs of your treatment. This is especially true if you are in an important or specialized position and are an important asset to the company.
  • Consider the cost of your addiction. For every dollar spent on addiction recovery and prevention, seven dollars are returned. Think about what the financial toll would be on you and your family if you were to continue on with your addiction and compare it with the cost of treatment. The cost is a saving in the long run.

About Pinelands Recovery Center

Figuring out the logistics of paying for treatment can be just as difficult as coming to terms with addiction in the first place. Luckily, there are many options for paying, including knowing how to talk to insurance companies about treatment. If you are unsure of these options, give us a call so that we can help guide you.

Pinelands Recovery Center of Medford is widely known as one of New Jersey’s finest, most respected addiction treatment facilities. With comfortable 30-bed accommodations and 24-hour professional staff, we can offer clients a serene, relaxing environment amid the lush piney woods. This stress-free setting with its sense of warmth and welcoming enables you to feel comfortable and confident about your clean and sober life ahead.

We will establish clear goals, both general in nature and specific to your needs. We continue to monitor those goals, to make sure that our clients are progressing and buying into their recovery plan. We thrive on assisting clients in feeling connected to the recovery community, share and demonstrate effective coping techniques, help clients to modify attitudes and patterns of behavior and everything else you will need to be happy and productive living a sober, healthy life.

We ensure that clients complete their planned concrete tasks, encourage hope, optimism and healthy living. Our recovery program is not a revolving door treatment program; it is a recovery model designed to help clients go on to lead productive, happy lives. For more information, visit