Challenges in Finding Affordable Care
Financial need should not prevent us from getting help. There are treatment and care options around mental health and addiction for every price point, including some that are free. Researching multiple options before committing can provide perspective on the range of options available and lessen the chance of being misled. Opportunities for affordable care exist, but navigating the process and understanding costs even when insurance is involved requires effort.
If you search the Internet, you may feel overwhelmed by the choices and options available. Many are unclear when it comes to the actual cost to the patient. Opportunities for profit in the recovery industry have created an environment where unethical organizations and individuals have misled families.
Along with the ethical challenges previously shared, there have been cases where online resources or call centers don’t provide fully accurate information on all costs and fees associated with their programs, or engage in other fraudulent practices. This applies to programs covered by private insurance as well. There may be additional fees, or limitations attached to the coverage offered by insurers. Intentional or otherwise, staff members from providers that stand to make profits via patient care might neglect to mention all fees, promise that fees will be waived, or overestimate the coverage of insurance.
OneStep is passionate about helping individuals and families find providers that put patient well-being at the forefront of their work, be it a non-profit, for-profit, or public provider.
Payment Models for Recovery Services
At OneStep, we like to group providers into three different categories:
- Providers of treatment, either inpatient / residential or outpatient, that accept out-of-pocket pay or private insurance. These typically are the most expensive, but may also have the most amenities. They are also the most likely to be for-profit companies, although some may be non-profits. Because of the payment method in this category, there may be greater potential for ethical challenges due to financial incentives.
- Providers of residential / inpatient or outpatient care that offer either free services or services paid for by government grants or public health insurance. Many of these providers are non-profit organizations or government-run organizations, but some may also be private companies. Falling into this category does not guarantee ethical or quality care, but it may indicate less potential for obvious financial conflicts of interest.
- Providers of a range of additional services that support treatment, but do not actually include clinical care. This broader category includes sober living homes and facilities, additional counseling services or centers (not already included in a treatment plan or program), experimental therapy providers, or otherwise. Payment methodologies vary broadly for those providing services under this category.
5 Tips for Finding Help that Doesn’t Break the Bank
What can you do to find cost effective resources around mental health or addiction?
- Remember that free resources exist. The vast majority of support groups are free. Many communities have clinics offering various forms of treatment and support for free or via government funding. Check out our Connection Resources for listings of free or government-funded resources.
- Talk to a trusted resource not financially benefitting from your decision. A medical professional such as a doctor or counselor, or a trusted friend or mentor, may have ideas on providers that fit your budget.
- Reach out to insurers / EAPs directly, if possible. If you have insurance, contact your insurer or your company’s Employee Assistance Program to better understand your coverage.
- Read the fine print. Be cautious around treatment centers that promise to take care of additional costs or fees, such as travel expenses. Many of these additional benefits or forms of support may violate ethical or legal rules around marketing of the medical services provided. There have been cases of misrepresentation of fees and insurance coverage that has left families in major debt.
- Be persistent. Some providers may not have initial openings, but space may open sooner than expected. There are different forms of care and support – e.g., counselors, support groups, and more — that can help if capacity is not immediately.