Finding Health Insurance That Covers Medication Assisted Treatment

Covers Medication Assisted Treatment

If you're on MAT or have family in treatment, you know the high cost of care and the dangers of skipping doses. But unfortunately, there are many times that patients come up short on paying their daily treatment cost. With the passage of the Affordable Care Act (ACA), the problem of paying for treatment may no longer be an issue for some.

Whitehuouse.gov states that "The ACA includes substance use disorders as one of the ten elements of essential health benefits. This means that all health insurance sold on Health Insurance Exchanges or provided by Medicaid to certain newly eligible adults starting in 2014 must include services for substance use disorders." Although not all health insurance providers cover the same treatment options, it is expected that they now cover some medications for opiate treatment and programs to treat substance abuse.

Depending on the insurance company, either a combination of Suboxone, Subutex or Methadone or all three will typically be covered under a health insurance plan in a post ACA world. Not only are the medications covered by the plans, but many of the consumers purchasing the plans will qualify for tax credits to help pay the plans monthly premiums and co-insurance deductions to help pay plan deductibles and prescription copays. The tax credits are available to those whose incomes are below 400 percent of the federal poverty line and the co-insurance deductions are available to consumers who have incomes under 250 percent of the federal poverty line. So as an example, an individual with an income in 2015 of less than $46,680 would qualify for a tax credit and an income of less than $29,175 would qualify for a co-insurance deduction.

Customers can apply for these plans at healthcare.gov, by working with a health insurance agent or by calling insurance companies directly that participate in the federal exchange. One source for those looking to work with an agent to find insurance that covers their MAT is saveonmethadone.com. The site (and sites like it) look to match consumers with insurers that cover their medications and treatment providers. No matter what channel you use to obtain your ACA insurance coverage the monthly premium cost should be the same. This is because each plan that a carrier offers must have the plan cost approved by the individual states Department Of Insurance. This allows consumers that would like to use the services of a licenced health insurance agent to have peace of mind in knowing that they will not be charged any additional fees for seeking the advice of an agent.

Larry Medcalf is a licensed insurance agent. His main focus is on serving the life, health, medicare and long-term care insurance needs of small businesses and middle-income families and individuals.