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Health Insurance Coverage for Dual Diagnosis Treatment

Many people struggle with mental health conditions, like anxiety or depression, and a substance use disorder (SUD) at the same time. When this occurs, a person is said to have a co-occurring disorder or dual diagnosis.1 Having a dual diagnosis can make treatment more complex, but the good news is that many insurers offer full or partial insurance coverage for co-occurring disorder treatment.2 Learn more about health insurance coverage for dual diagnosis treatment and how to start your recovery journey below.

Does Health Insurance Cover Dual Diagnosis Treatment?

Yes, health insurance often covers dual diagnosis treatment to some extent.2 The Affordable Care Act (ACA) protects your access to quality healthcare and insurance coverage for mental health care.3 Under this law, all Marketplace health plans must at least partially cover 10 essential health benefits, including mental health and SUD treatment.2 Keep in mind that your coverage level will vary depending on several factors, including your insurance carrier and policy.2

Types of Dual Diagnosis Treatment Covered by Insurance

Recovery looks different for everyone, which is why multiple levels of care are available to meet you where you are in your journey.4 If you are struggling with co-occurring disorders, many facilities will work with you to create a personalized treatment planthat address each condition simultaneously.5

Your treatment plan might include a comprehensive approach with various treatments (e.g., behavioral therapies) and settings (e.g., inpatient and outpatient rehab) to fit your needs. For example, some people start treatment with medical detox to help them stop using substances safely under medical supervision.4 Once they reach stabilization, they might transition to a formal treatment program, such as inpatient or outpatient rehab.4 While programs can vary by duration, intensity, and structure, many include evidence-based interventions to help you reach your recovery goals.4

Behavioral Therapy

Behavioral therapies are an effective approach to treating mental health disorders and SUD.5 These are common behavioral therapies you may experience in dual diagnosis treatment:5

  • Cognitive-behavioral therapy (CBT) is a type of talk therapy that helps people cope with challenging situations by identifying and modifying negative behaviors and thoughts.
  • Dialectical behavior therapy (DBT) emphasizes acceptance and mindfulness of your current emotional state and situation. You will develop skills to control emotions, improve relationships, and minimize harmful behaviors.
  • Assertive community treatment (ACT) is a type of community-based mental health care that emphasizes an integrated, individualized approach and community outreach.
  • Therapeutic communities (TC) are long-term residential programs that help you develop new, positive attitudes, behaviors, and values.
  • Contingency management (CM) is an approach that uses rewards and vouchers to encourage healthy behaviors.

Medications

People with co-occurring disorders may require medications to manage their symptoms and stabilize their mental status.6 Some are useful for alleviating the withdrawal symptoms and cravings resulting from quitting substances, like alcohol or opioids.5 Others may be useful for lessening mental health symptoms or treating multiple disorders.5 Depending on your unique situation, medications combined with other evidence-based approaches could provide a comprehensive treatment plan.5

Inpatient Treatment

Inpatient dual diagnosis rehab offers a highly structured living environment with 24/7 continuous care.4 These programs often vary in duration, with shorter stays of about 3 weeks to longer stays of 12 months or more.4 While programs can differ in interventions and services, many provide a comprehensive approach to co-occurring disorder treatment, including assessment, individual and group therapy, peer support groups, psychiatric care, and more.5

Outpatient Treatment

Outpatient drug and alcohol rehab programs allow you to live at home while attending dual-diagnosis treatment.4 With these programs, you can maintain daily commitments, like work and family, while fitting rehab into your schedule. People transitioning from inpatient rehab or those who don’t require constant monitoring often find outpatient treatment beneficial.4

While therapeutic interventions are similar to inpatient rehab, outpatient programs differ in treatment intensity and time commitments.4 Standard outpatient care is the lowest level, requiring the least attendance frequency.4 Intensive outpatient programs for drug and alcohol addiction are the next step up, providing about 9 hours of weekly programming.7 Partial hospitalization programs for addiction are the most in-depth, with at least 6 hours of daily care.8

Aftercare

Mental health professionals recommend remaining in addiction treatment aftercare to promote long-term recovery.4 Ongoing counseling, 12-step programs, and sober living homes are common types of aftercare.4 These approaches can keep you engaged in recovery and provide tools for relapse prevention, managing triggers, and building a solid support network.4 Depending on your policy, health insurance may cover dual diagnosis aftercare to some degree.

How Much Does Dual Diagnosis Rehab Cost?

The cost of dual diagnosis rehab can vary drastically depending on multiple elements. When browsing your options, consider the facility and the services they offer. Each level of care varies in price, with inpatient rehab typically being the most expensive.

The services a facility offers can also affect costs. For example, a luxury rehab with high-end amenities and services will typically be more expensive than a standard inpatient program.

Treatment duration is another factor to consider. Mental health professionals recommend remaining in treatment for at least 90 days for the best outcomes.4 Your treatment plan may also include multiple levels of care. Costs will likely increase the longer you spend in a facility.

The way you pay for treatment can also determine how much you spend. Many use insurance to cover the cost of addiction services to some extent. Still, other options to pay for treatment are available. Some payment methods require more out-of-pocket costs than others. Other factors include a facility’s location and your specific insurance policy.

How to Use Insurance Coverage for Dual Diagnosis Treatment

Using insurance coverage for dual diagnosis treatment is simple. It all starts with verifying your coverage level. Check your explanation of benefits (EOB) by visiting your insurance provider’s website. Or, call the number on the back of your insurance card to speak with a representative who can explain your coverage levels.

American Addiction Centers (AAC) can also help you verify your insurance when you call . Our admissions navigators can instantly confirm your coverage at no cost and help you start your journey. Call our addiction helpline to check your benefits and learn more about dual diagnosis treatment options today.

Start Your Recovery Journey

Embarking on your recovery journey can open the doors to unwavering support and potentially life-changing care. If you or a loved one is battling SUD or co-occurring disorders, several options for healing are available. Whether searching for dual diagnosis treatment covered by insurance or exploring other ways to pay for treatment, the American Addiction Centers (AAC) team can help. Call AAC at to learn more about co-occurring disorder treatment and how to get started on your recovery journey.

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