RehabFAQs

what can happen to your insurance if you go into rehab

by Tianna Kilback Published 2 years ago Updated 1 year ago
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As we have discussed here before, if a Senior is admitted to a hospital as a patent, has a qualifying 3 night hospital stay and is then discharged to a Nursing Home or rehab facility for rehab, then Medicare will pay up to 100 days for rehabilitative therapy.

Full Answer

Do you need health insurance to get into rehab?

Inpatient rehabilitation care. Medicare Part A (Hospital Insurance) Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. covers. medically necessary. Health care services or supplies needed to diagnose or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.

Can my employer require me to go to rehab?

Mar 22, 2022 · Fortunately, laws protect employed individuals seeking recovery. The Family and Medical Leave Act (FMLA) and the Americans with Disabilities Act (ADA) both provide protection and prevent individuals from being fired for going to rehab for a substance use disorder (SUD) or alcohol use disorder (AUD)—medical conditions defined by an ...

What happens to my health insurance if I Lose my job?

Apr 25, 2018 · Let Medicare Pay – THEN See What Happens. When your Loved One is first admitted to rehab, you learn Medicare pays for up to 100 days of care. The staff tells you that during days 1 – 20, Medicare will pay for 100%. For days 21 – 100, Medicare will only pay 80% and the remaining 20% will have to be paid by Mom.

Can you go to a drug rehab center without insurance?

The FMLA requires that your employer continue to provide you with the same level of health insurance coverage during your absence. They must also ensure that you have the same pay, benefits and other terms and conditions of employment upon your return from rehab— although they also don’t have to give you back your exact same job.

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How long after rehab can you get life insurance?

How long do you have to be sober to get life insurance? You need to be sober for three years or more before you can qualify for most life insurance policies. You'll be eligible for the best rates after 10 years of sobriety.Feb 17, 2022

Is addiction considered a pre existing condition?

Under the ACA, addiction is no longer considered a pre-existing condition for insurance purposes.

What happens when you get out of rehab?

After completing detoxification and inpatient rehabilitation, a person in recovery will return to normal life. This includes work, family, friends, and hobbies. All these circles and events can trigger cravings and temptations. Research suggests most relapses occur in the first 6 months after treatment.Dec 14, 2021

Does insurance cover alcohol intoxication?

Injuries and illnesses experienced as a result of alcohol or other substance abuse is often excluded in health and medical insurance.Dec 28, 2018

Is mental health covered by insurance?

Is mental health covered under health insurance as standard? Most health insurance providers will not cover mental health or psychiatric care in their standard policies, though some do. This means you'll have to ask your provider for a specific mental health add-on, which will cost extra.Feb 26, 2020

Is anxiety a pre-existing condition for insurance?

Not only do insurers have to offer coverage to people with common pre-existing conditions, like depression or anxiety, plans also have to cover treatment.Oct 8, 2020

What is the aftermath of addiction?

Excessive use of alcohol and drugs can lead to mental and physical health issues, some of which include anxiety, depression, diabetes, liver disease, and heart disease. Many of these conditions may improve after recovery, but some may linger and diminish the quality of life.Mar 31, 2019

Is methadone an opiod?

Methadone is a synthetic opioid agonist that eliminates withdrawal symptoms and relieves drug cravings by acting on opioid receptors in the brain—the same receptors that other opioids such as heroin, morphine, and opioid pain medications activate.

What is total abstinence?

While stimulant addicts are of course at the highest risk when using stimulants, “total abstinence” means avoiding other psychoactive substances as well.

What are the five stages of intoxication?

Different Stages of Alcohol IntoxicationWhat Is Alcohol Intoxication?The Stages of Alcohol Intoxication.Stage 1: Sobriety, or Subclinical Intoxication.Stage 2: Euphoria.Stage 3: Excitement.Stage 4: Confusion.Stage 5: Stupor.Stage 6: Coma.More items...•Apr 12, 2022

When should a drunk person go to the hospital?

If the person is unconscious, breathing less than eight times a minute or has repeated, uncontrolled vomiting, call 911 immediately. Keep in mind that even when someone is unconscious or has stopped drinking, alcohol continues to be released into the bloodstream and the level of alcohol in the body continues to rise.

What happens if you go to the hospital for drinking?

When to go to the ER Alcohol poisoning is a medical emergency. It can lead to complications such as choking, brain damage, and even death. Prompt medical treatment can help prevent these complications from occurring.Jun 10, 2019

What is free rehab?

Free Rehab Programs. Most states provide funding for rehabilitation services that can be accessed by those with no insurance or income. These centers usually require that the clients qualify by meeting certain requirements, such as a demonstrated lack of income or addiction status and/or need for intervention. ...

How long do you have to sign up for Cobra?

You will have at least 60 days to decide if you would like to continue your coverage. Once you have decided to continue your coverage, you will sign up for COBRA, and you will be responsible for paying the entirety of your premium (what was previously covered by you and your employer).

Can I go to rehab without insurance?

Can You Go to Rehab Without Insurance? You’ve finally admitted you have a problem and you need help. But money’s tight, and you don’t have the means to pay for rehab – especially since you don’t have health insurance. Not to fear – you don’t have to let recovery fall to the wayside simply because you can’t afford it.

Do rehab centers require income?

Most states provide funding for rehabilitation services that can be accessed by those with no insurance or income. These centers usually require that the clients qualify by meeting certain requirements, such as a demonstrated lack of income or addiction status and/or need for intervention.

Can I continue my health insurance after losing my job?

Maintaining your health insurance coverage during job loss can be anxiety inducing and overwhelming, but there are options available to you. Upon losing job-based coverage, your former employer may offer you COBRA continuation. COBRA (Consolidated Omnibus Budget Reconciliation Act) provides workers and their families with the opportunity to continue the group health coverage that they previously had under their employer’s group health plan—for a limited amount of time.

What to do if you have a sudden illness?

Though you don’t always have advance notice with a sudden illness or injury, it’s always a good idea to talk with your healthcare team about Medicare coverage before a procedure or inpatient stay, if you can.

Where does rehabilitation take place?

Rehabilitation may take place in a special section of the hospital, in a skilled nursing facility, or in a separate rehabilitation facility. Although Medicare covers your care during rehabilitation, it’s not intended to be long-term care. You can learn more about Medicare and long-term care facilities here.

Does Medicare cover inpatient rehabilitation?

Medicare covers your treatment in an inpatient rehabilitation facility as long as you meet certain guidelines.

Does Medicare cover rehab?

Medicare Part A covers your inpatient care in a rehabilitation facility as long as your doctor deems it medically necessary. In addition, you must receive care in a facility that’s Medicare-approved. Depending on where you receive your inpatient rehab therapy, you may need to have a qualifying 3-day hospital stay before your rehab admission.

Does Medigap cover coinsurance?

Costs with Medigap. Adding Medigap (Medicare supplement) coverage could help you pay your coinsurance and deductible costs. Some Medigap plans also offer additional lifetime reserve days (up to 365 extra days). You can search for plans in your area and compare coverage using Medicare’s plan finder tool.

Does Medicare cover knee replacement surgery?

The 3-day rule does not apply for these procedures, and Medicare will cover your inpatient rehabilitation after the surgery. These procedures can be found on Medicare’s inpatient only list. In 2018, Medicare removed total knee replacements from the inpatient only list.

What is FMLA for addiction?

Both the Americans with Disabilities Act (ADA) and the Family and Medical Leave Act (FMLA) protect addicted individuals from discrimination and help them get the treatment they need without losing the jobs they need to survive. Once you enter a rehabilitation program, you’re protected by the ADA and cannot be fired for reasons related to your addiction or the treatment process, even if it causes you to miss work. If you are fired, you can file a charge of discrimination against your employer. This applies to all state and local government employers and private companies with 15 or more employees. Under the FMLA, qualified employees can take 12 weeks of medical leave for issues that include addiction disorders each year. Unfortunately, this leave is generally unpaid unless the employer chooses to provide paid leave. This may not be an option for part-time or contract employees or for those who cannot afford to go several weeks without pay.

How much does drug abuse cost the US?

After all, drug and alcohol abuse costs the US over $700 billion each year, mostly from workplace accidents, crime, healthcare, and loss of productivity.

Is there an addiction treatment center in the US?

There are many addiction treatment centers across the US and other countries, but there are a number of factors that can make accessing that treatment more complicated than it should be. One of the most common issues experienced by addicted individuals crops up when medical professionals recommend inpatient treatment to those who have jobs.

What is a medical professional?

A medical professional may be able to provide more information on state disability benefits and guide individuals through the application process. It’s also important to know that employers are required to maintain confidentiality regarding their employees’ medical issues.

How many people in the US were addicted to drugs in 2009?

According to the National Survey on Drug Use and Health, there were 23.5 million people in the US aged 12 or older who needed addiction treatment in 2009, but only 2.6 million of them received any treatment. Knowing your rights in terms of addiction treatment while employed can be the first step toward getting needed help.

Is addiction a mental illness?

However, there are laws that protect people with addiction disorders from workplace discrimination and particularly from being fired for addiction, which is considered to be a legitimate mental illness.

What is a return to work agreement?

This is a written document containing all of the employer’s expectations for employees coming back to work after completing a treatment program for an addiction disorder. This is typically used in the case that the employer approached the addicted individual for failure to meet work responsibilities or inappropriate behavior related to substance abuse. If the employee then invokes the right to attempt treatment before being fired, it’s likely that a Return-to-Work Agreement will be arranged.

What happens if you wait to apply for medicaid?

If you do wait to apply for Medicaid, until Medicare has quit paying, there may be a gap in coverage. This means that there will be a period of time when Mom may have to pay out of pocket. The goal is to have no surprises. With proper planning, it is possible to have no gaps and no surprises!

How long did Mom stay in the hospital?

After a 10 day hospital stay, Mom’s doctor told the family that she would need rehabilitative therapy (rehab) to see if she could improve enough to go back home. Mom then started her therapy in the seperate rehab unit of the hospital where she received her initial care.

Can you go home after a rehab stay?

For some folks, it is obvious that they are going home directly after a short rehab stay. For others, like the fictional Mom is our above example, it was not as obvious. However, frequent monitoring of Mom’s care, frequent communication with the staff and tracking her progress or decline should give the family a good idea as to the expected outcome of Mom’s rehab stay.

What is the ADA?

Americans with Disabilities Act (ADA) – Addiction and mental illness are disabilities that deserve certain anti-discrimination protections in a job setting, according to the ADA. Employers that employ 15 or more people are bound by the ADA’s provisions. These include job protections for those who are currently enrolled in a rehab program ...

How long is FMLA?

employees are entitled to 12 weeks of unpaid, job-protected medical leave.

Can an employer fire you for being absentee?

Because your employment is likely “at will,” meaning you are employed by your own free will, an employer can fire you if they detect absenteeism or negligence on the job. This outcome becomes more likely the longer you let a mental health problem go untreated, leaving you vulnerable to absenteeism and negligence on the job.

What happens if you go back to work?

When you go back to work, bear in mind that if your employer discriminates against you because of your condition, that is against the law. They have a legal duty to treat you like any other person with a medical condition— and are also bound by HIPAAA laws that protect your health privacy.

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