Navigating the Healthcare System When Facing Addiction

Find the resources you need to overcome substance abuse disorder.

Navigating the Healthcare System When Facing Addiction

Navigating the healthcare system can be a confusing and daunting task. Therefore, understanding how to properly access prevention, treatment and recovery services is crucial to an individual suffering from substance use disorders. Insurance coverage for mental health services, including substance use disorders, has been expanded due to The Mental Health Parity and Addiction Equity Act of 2008 and the substance use parity rule. These require private health insurance plans to offer substance use disorder and mental health services, with equal coverage for mental health treatment compared to treatment for other health conditions. These laws were made to ensure equality, but will require time, effort and collaboration to make it a reality for all Americans.

Understanding your insurance plan and coverage is important for seeking healthcare. Call your insurance provider before receiving treatment in order to understand which providers and services are covered on your insurance plan. Depending on your plan, in-network providers may be a more reasonable price, as they are required to use the pre-determined rate approved by your insurance provider. Some insurance plans cover out-of-network providers; if yours doesn’t, ask your insurance provider prior to receiving care about filing an appeal to have this service covered.

Your healthcare provider may be able to recommend a treatment facility for you, but it’s important to research treatment facilities in your area and be ready to discuss options with your healthcare provider.

Use these tools to search facilities in your region:

Support groups may provide useful tools for navigating the system based on others’ experiences.

If you or someone you love is in a crisis, please call 911 or a 24-hour emergency helpline:

Mental Health America Crisis Line: 1-800-273-TALK
Narcotics Anonymous
Alcoholics Anonymous

Medically reviewed in January 2019. Updated in August 2019.

More On Substance Abuse and Addiction

How to Choose an Addiction Treatment Center

article

How to Choose an Addiction Treatment Center
If drugs were easy to stop abusing, there would be no need for 12-step programs, rehab facilities, methadone and a host of other treatment options. Bu...
How Important Is Family in Drug Addiction Recovery?

video

How Important Is Family in Drug Addiction Recovery?
Addiction is a complex disease on many levels; the family dynamic is disrupted, and loved ones besides the addict are impacted. Watch addiction specia...
How Is Addiction Treated?

video

How Is Addiction Treated?
Addiction is treated in many different ways, based on the severity of the disease, a patient's individual history and any medical complications. Watch...
How Can I Help Someone Who Is Addicted to Drugs?

video

How Can I Help Someone Who Is Addicted to Drugs?
If you suspect someone is using drugs, gently confront the person with others who care (not alone); ask them what's going on and clearly state there i...