Residential treatment allows teenagers to undergo recovery away from the stresses and triggers of the outside world. This type of immersive programming can be highly beneficial to their long-term well-being. However, many parents worry that they will not be able to afford this type of investment. This leads them to ask the question: Will insurance cover teen residential treatment?

If you’re wondering, will insurance cover teen residential treatment?, call us at Beachside Teen Treatment Center today or visit our admission page for support and guidance.

What is Residential Treatment? 

Also referred to as inpatient rehab, residential treatment is generally considered to be the most intensive form of rehab programming. Participants live on-site, where they undergo a variety of evidence-based modalities, experiential therapies, holistic strategies, and peer support settings. This highly structured environment gives them access to 24/7 supervision and support from a team of highly educated and experienced staff members. Overall, residential treatment is an ideal way for teens to build a strong foundation for recovery as they are able to fully focus on healing their bodies and minds. 

Insurance Coverage Benefits

In the past twenty years, certain laws and policies have been put in place to make accessing mental health and substance use treatment easier and more affordable. This includes the Mental Health Parity and Addiction Equity Act (MHPAEA), which requires the majority of insurance plans to provide equal care benefits for those struggling with mental health and addiction as they would for medical treatment and surgery. Furthermore, the Affordable Care Act (ACA) was passed to increase insurance coverage to mandate that mental health and substance use treatment be classified as covered essential health benefits.

However, some plans may provide differing levels of coverage depending on the specific type of program or services an individual is seeking. Therefore, there can be certain exceptions and limitations when it comes to coverage for residential treatment or inpatient rehab. It is always best to contact your insurance provider directly to gain a better comprehension of your exact plan and the coverage available to your teenager. 

Does Insurance Cover Mental Health Residential Treatment for Teens?

For the most accurate answer to the question: will insurance cover teen residential treatment?, it is imperative that you research your specific plan and discuss your options with your insurance provider. Typically, insurance covers mental health medications prescribed by a doctor, outpatient therapy, counseling, and some portion of residential or inpatient mental health care. This may be full coverage or partial coverage with some out-of-pocket costs. Specific plans may require pre-authorization for residential treatment for teens. This means that you must get approval from your insurance provider before enrolling in treatment. Furthermore, it is important to note that certain steps may be taken when seeking mental health care to show your insurance provider an evident need for residential treatment. 

Again, the best way to get a clear-cut answer is to speak with a representative from your insurance provider. You can also speak with your desired treatment center as they have often corresponded with insurance providers and can help you navigate this process as well as make you aware of any potential expenses. 

How to Maximize Insurance Coverage for Teens

Though insurance plans have clear boundaries and processes, there are still ways that you can make the most of your coverage. These are highlighted below. 

Advocate for Your Teen

When it comes to seeking treatment, it is best to be proactive. Always stand up for your child and their needs by filing claims, keeping documents, and asking questions. You know what is best for them and your support and advocacy can make a huge impact in the direction of their life. 

Keep Detailed Records

Insurance providers may ask for proper documentation. For this reason, it is critical to keep records of any of your correspondence between your healthcare provider or insurance company. These documents are best kept in files or in a binder.

Research Your Policy

Understanding your specific policy is a key component in effectively advocating for your teen. Review your policy carefully and read it more than once to understand what mental health services are covered. Be sure to note any services that may come with additional costs.

Establish Pre-authorization

It is best to seek pre-authorization from your insurance company before looking for residential treatment. This way, you know you are covered and are aware of any limitations. This makes enrolling in treatment easier and less stressful. 

Should You Consider a New Insurance Plan?

If you’re wondering, will insurance cover teen residential treatment?, the answer depends on various factors. For those with an employer-sponsored plan, it’s important to evaluate mental health benefits during open enrollment. If coverage is insufficient, switching to a plan that better aligns with your family’s needs may be an option. First-time enrollees should thoroughly research available plans to ensure comprehensive coverage for their teenager.

It’s also important to consider your teen’s future needs—even if they do not currently require residential treatment. If your child is in outpatient care, they may need a higher level of support later. In many cases, it’s worth choosing an insurance plan that fully covers inpatient costs or has low co-pays to ensure access to the best care when needed.

Finally, many families use flexible savings accounts (FSAs) or health savings accounts (HSAs) to set aside money for mental health treatment. These accounts allow you to save pre-tax dollars for medical expenses. If your insurance plan does not offer full coverage, FSAs and HSAs can make teen residential treatment more affordable.

Find Residential Treatment for Your Teen Today! 

At Beachside Teen, we are in-network with several of the nation’s leading insurance providers. We want our comprehensive residential treatment programs to be as accessible to teenagers and their families as possible. Our insurance verification process is straightforward, and our compassionate staff is always available to answer any questions or address any concerns. Call us today to get started now!