Treatment Options

The cost of rehabilitation, detox, and MAT can vary based on the level of care needed. There are a range of options to pay for treatment—including self-pay, private insurance or state insurance coverage, or financing through the rehab center.

Connecticut has many insurers who offer individual and group health insurance plans. It is important to know who your provider is; if you are not insured, it is recommended that you get coverage in case of a health emergency. For a list of available health insurance companies in Connecticut, visit the Connecticut Office of the Health Care Advocate's website: https://www.ct.gov/oha.

If you don't have insurance, the state offers affordable health care options for you or your loved one to consider.

HUSKY: This state insurance program includes federal Medicaid and offers a program for adults. “Husky D” provides insurance for low-income adults without children and covers a range of behavioral health services. There are programs offered for families, those with disabilities, and those with children as well. For more information or to see if you qualify, visit the HUSKY website.

To apply for HUSKY healthcare, visit Access Health CT and apply online, dial 1 (855) 805-4325 to apply over the phone, or visit your local DSS field office to apply in person.

If you don't qualify for HUSKY, there are alternative plans available to you. You can purchase an individual healthcare plan through Access Health CT.

If you have insurance, it is important to know what your plan covers in case you need addiction treatment services. HUSKY provides comprehensive coverage which includes Behavioral Health Services. Behavioral Health Services include coverage of, but not limited to:

• Detoxification
• Residential rehabilitation (HUSKY D only)
• Partial Hospitalization
• Day Treatment
• Outpatient Services
• Prescription Coverage (through the CT Medical Assistance Program – CMAP)
• Methadone Clinics and related lab fees for testing
• All outpatient substance use clinic services (diagnosis doesn't matter), including medications

To find out what other services are covered under your HUSKY plan, dial 1 (855) 805-4325 or visit Access Health CT.

If you have a private insurance plan such as Aetna, Cigna, Anthem, Connecticare, or others, you may want to talk to your employer or call your provider to see what services are covered under your plan. The Mental Health Parity and Addiction Equity Act of 2008 requires insurance companies to make mental health benefits comparable to general medical coverage (this ensures that copays, treatment limitations, out-of-pocket expenses, etc. are all treated similar to other physical conditions). As of 2017, Connecticut passed a law requiring insurers to cover medically necessary inpatient detox services.

It would be helpful for you or your loved one to call your insurance company to determine your coverage. If you are unsure what questions to ask, see Suggested Questions to Ask below.

Coverage depends on your health insurance plan and its offerings. However, Connecticut law mandates that all individual and group policies provide benefits for the diagnosis and treatment of substance use disorders. The Connecticut Insurance Department works to ensure that insurance policies in the state cover necessary services to help with an addiction.

The state mandates the following services:

• Residential Treatment
• Chemical Maintenance Treatment/MAT

The state considers the following as “essential health benefits” in any plan:

• Office Visits
• Acute Inpatient Services
• Partial Hospitalization
• Intensive/Routine Outpatient
• Substance Abuse Detoxification
• Emergency Room & Urgent Care

When surveyed by the CT Insurance Department, most insurance providers covered all of the above. Each plan's coverage may vary, so it is important for you or your loved one to get in touch with your insurance provider to learn about what benefits you have, how long you will have them, and if you are responsible for any additional costs.

To determine what kind of insurance you have and to learn more about your treatment options, you should call the Member Services department of your insurance company. Be sure to have your insurance card and member ID number handy. It would also be helpful to have a pen and paper nearby to take some notes.

• What type of plan do I have? (i.e. EPO, HMO, POS, PPO, etc.)
• What levels of care are covered? Inpatient services? Outpatient services? Medication Assisted Treatment/Chemical Maintenance Treatment?
• If so, what is my deductible cost? What is the cost of each copay?
• If I desire inpatient treatment, is there a limit for my stay? If so, how many days?
• Will my coverage vary based on my stage of treatment? (Detox vs. continuing care)
• Can you provide me with a list of in-network providers? (providers covered by the insurance plan)
• Do I need to be pre-approved or be referred by a doctor to get coverage for treatment?
• Ask them to send you a document that lays out what determines “medical necessity”

Health insurance can be a bit difficult to understand sometimes. Thankfully, the Connecticut Office of the Healthcare Advocate is available to answer your questions about your insurance plan and advocate for you to ensure you get the treatment you need! To contact the OHA, visit their website or call 1 (866) 466-4446.