While insurance can be very helpful in offsetting the cost, it rarely covers the entire expense of treatment. Every plan is different, even different plans within the same insurance company. So one patient may see 50% of their treatment covered from Plan A by Company 1, while another patient has only 20% of their treatment covered from Plan B by Company 1. Because of this, it is important to run through all insurance options prior to deciding on a school. This can be timely and very frustrating with schools requiring a lot of paperwork and commitments to be made prior to verifying your coverage.
Sometimes You Can’t Know What To Expect From Insurance Until After Your Teen Is Enrolled In A Program
Insurance will generally cover costs based on the diagnosis of your teen. In the case of depression, anxiety and suicidal tendencies, most insurance plans will have at least partial coverage. However, these conditions must be diagnosed prior to billing and even verifying if your insurance will cover them. This can result in not know your insurance allowance until after your teen is enrolled and committed to a program.
Some plans will provide coverage for substance abuse diagnoses. Sadly, most behavioral or personality disorders – such as Oppositional Defiance Disorder (ODD) – will not be covered by insurance mental health plans.
Programs Can Help You Estimate Your Insurance and Out Of Pocket Costs
Insurance very rarely covers 100% of treatment. It is not uncommon for a program to give false hope about insurance coverage without running the proper verifications first. This leaves parents with wildly misguided financial expectations. So, if you have been told by an institution that treatment will be covered completely by insurance, use caution. This doesn’t often occur, and parents should be prepared to pay for at least part of the program. On average, families who have insurance coverage will pay at least $3,000 out of pocket for a residential treatment center, or boarding school program.
Insurance Can Only Pay For Treatment A Program Is Licensed To Provide
Each state regulates therapeutic boarding school regulations and licensing. Some states allow these types of programs to be licensed for more forms of treatment than others. Typically, when a school is licensed for more treatment, they’re able to utilize patient insurance better to reduce the out of pocket expense for the family.
Help Your Teen Now Can Help You Navigate This Confusing Process
Partial hospitalization programs, or intensive therapy without boarding or hospitalization, may be covered more thoroughly, and cost less to the parents. But they may not be the best choice for your child, who could need the structure of a boarding school environment.
At Help Your Teen Now, we have decades of experience with different programs, their licensing, their ability to bill insurance, and the average costs that parents can expect. We can help you, free of charge, to determine not only a good program fit for your teen, but we can also help you find the best financial option with the most realistic expectations for insurance and out of pocket coverage.