Insurance plans make treatment and healthcare more affordable and accessible, and at Cirque Lodge, we work with most insurance providers.
United States law requires that any insurance plan you can buy on the Health Insurance Marketplace covers drug and alcohol treatment. Many insurances not available through the Marketplace also cover treatment.
However, insurance plans may not cover all aspects of your stay at Cirque Lodge.
At Cirque Lodge, we want to make the admissions process as smooth and stress-free as possible. We are more than happy to work with you to determine whether total or partial coverage is possible with your insurance provider, and you may also benefit from talking to your plan administrator directly.
Cirque Lodge is a private program and is not contracted with government agencies. For a list of in-network Medicare or Medicaid treatment facilities, please contact your state and local governments.
Health Insurance Marketplace Regulations
The Affordable Care Act (ACA) lists drug and alcohol addiction services as an essential health benefit. This means that any insurance available on the Health Insurance Marketplace must cover addiction treatment.
Insurance companies on the Marketplace must also cover any pre-existing conditions – including substance use disorders – at no extra cost. You can apply for insurance at any stage of the recovery process.
While insurance plans not available on the Marketplace are not subject to these requirements, many of the plans follow the same guidelines.
The Mental Health Parity and Addiction Equity Act requires that insurance providers subject to the parity law offer the same level of care for substance use disorders and other mental health conditions as they do for physical and surgical concerns.
If your insurance provides free doctor visits for a heart condition, it must also provide free doctor visits for depression or addiction. While the parity law does not require that insurers cover mental health, most large insurance providers already covered this before the law came into effect. The law stipulates that this coverage must be equal to that of physical health.
The parity law applies to:
Insurance plans are often complicated, and it can be unclear what aspects of addiction treatment it covers. Our knowledgeable staff is available to help you understand what your plan covers, and you can call us for support at any time at 1-800-582-0709.
You can also speak directly to your insurance company or a human resources representative from your workplace. Because every plan is different, they are best placed to tell you the details of your specific plan.
Here are the most important points to clarify:
Most insurance plans fully cover in-depth assessments of addiction and preventative care. They usually also cover detox programs. Not all providers, however, completely cover residential inpatient treatment. The insurance representative can clarify the extent of their coverage.
Most providers also offer the same coverage for all cases of a certain medical condition, regardless of its cause. If a healthcare provider covers substance use disorders, it usually does not matter what the drug is; they tend to cover all kinds of substance addiction.
Detoxification and treatment programs sometimes prescribe medication to relieve withdrawal symptoms and avoid relapse. Insurance providers can be unclear about whether the plan covers prescription medications or not. It is a good idea to ask your insurance representative directly to avoid confusion.
While insurance plans may cover certain services for free, for others, they require you to pay a fixed charge for a service. You may need to pay $20 for an appointment with a general doctor or $100 for an office visit. This charge is called a ‘copay’. You can ask your insurance representative what the copay will be for various parts of the treatment process.
A deductible is the amount of money you have to pay before your insurance provider starts covering the costs, and it varies according to your specific plan. Generally, more expensive plans have lower deductibles. You can clarify the value of your deductible with your provider.
At Cirque Lodge, our treatment programs can vary from a few weeks to several months, depending on your needs. Your insurance provider may only cover a portion of this time.
