Does Insurance Cover Inpatient Mental Health Treatment in Florida?

There are several levels of care designed to treat mental health disorders, and they vary in terms of intensity. The goal of healthcare professionals and insurance providers is to get you the appropriate car and support you need to heal in an environment most conducive to your recovery as possible.

Some of the levels of care include:²

• Inpatient Hospitalization. Inpatient hospitalization offers acute care for those patients who are actively suicidal, experiencing a psychiatric emergency, or who are putting themselves or others in harm’s way. During this time, patients are stabilized and continually monitored for a few days to about one week. 
• Residential Treatment. Residential treatment for mental health typically requires anywhere from a 30-90 day stay in an inpatient setting, such as a treatment facility. During that time, patients participate in various therapies and receive individualized psychiatric care.
• Partial Hospitalization Programs (PHPs). A PHP is a full-day program that provides about 6-8 hours per day of treatment for several days per week. This level of care is the most intensive form of outpatient care available, however, patients return home at the end of the day.
• Intensive Outpatient Programs (IOPs). An IOP meets several times a week, and sessions are a few hours long. Often, this involves about 3 hours of therapy each day for about 3-5 days per week. Most sessions are group-focused, but individual and family counseling may be included as well.
• Outpatient care. This level of care provides up to a few hours a week of treatment, which may include both individual and group sessions. The most familiar form of outpatient care is meeting with a therapist, which can occur about once per week or possibly more if necessary. 

There is often also insurance coverage for additional mental health treatment, including co-occurring disorders, a condition where a person has both a mental health disorder and a substance use disorder occurring at the same time.³ Co-occurring disorders require specific, integrated treatment to address both issues to help the patient reach long-term recovery.³

Every insurance plan is different, therefore it is important to contact your insurance company to get the full details of your coverage prior to committing to mental health treatment. It’s also a good idea to know what your plan covers in a crisis, so you are prepared in the event an emergency occurs.

The first step in any treatment process is to get a clear diagnosis and treatment plan from your healthcare provider. If they do recommend inpatient treatment, a simple step to take is to reach out to us at American Addiction Centers (AAC). Our admissions navigators can verify your insurance coverage in just a few minutes over the phone, text, or online chat and can determine if inpatient mental health treatment covered by insurance may be an option for you. They can also answer any questions you have about different levels of care and what you can expect from treatment. The verification process is free, and all calls are confidential and of no obligation.

You can also reach out to your insurance provider who can find in-network treatment options for you based on your plan and coverage options.

Medicare Coverage for Inpatient Mental Health Treatment

There are two forms of Medicare coverage: original Medicare and Medicare Advantage plans:⁴

• Original Medicare can be used at any provider that accepts it. Part A will cover inpatient treatment, and Part B covers outpatient treatment.
• Medicare Advantage plans are more like private insurance. They have provider networks, and your specific plan determines your coverage levels. Because each plan is different, you’ll need to talk to the insurer for details.

Medicaid Coverage for Inpatient Mental Health Treatment

Medicaid is a state-based program for low-income families and adults.⁵ Services may be available without any out-of-pocket costs, but it is necessary to choose a provider that accepts the patient’s state’s Medicaid plan.⁶

Other Ways to Pay for Inpatient Mental Health Treatment

You can also pay for mental health treatment with a private insurance plan if the center accepts the coverage. However, using health insurance to pay for rehab is only one option.

There are also other options for payment. You might be able to set up a payment plan or find a program that offers a sliding scale of fees based on income and family size. Some state and locally-funded programs may be low-cost or free of charge.

You might also be able to get a personal loan to pay for treatment or borrow money from friends and family. What’s most important is that you get the care you need as soon as possible because treatment can improve your life significantly.

If you or a loved one needs help with mental health treatment, don’t hesitate. Contact us right away to talk with our admissions navigators about your situation. We can verify your insurance coverage and answer any questions you have about what to expect from our treatment programs and more.

Reaching out to us is free and confidential, and there is never any obligation. We’re here to help you on your road to recovery. Contact us today at .