If you’re starting to feel like your drinking, opioid use, or other substance use is getting out of control, you’re not alone—and it’s okay to feel unsure about what to do next. Figuring out what kind of help is available and whether you qualify for treatment can feel overwhelming. You may be asking yourself two important questions: “Do I qualify for treatment?” and “Will my insurance cover it?”
The good news is that many health plans, including popular private and public insurance options, may help cover hospital or outpatient services related to Opioid Use Disorder (OUD), Alcohol Use Disorder (AUD), or other types of Substance Use Disorders (SUDs) when a healthcare provider confirms a diagnosis.
Even if you’re not physically dependent or worried about withdrawal, you might still feel like you’re out of control or that something needs to change. At Waypoint Recovery Center, we help people across South Carolina—whether they need residential care in Cameron or outpatient support in North Charleston. The path forward starts by asking for help.
How Do I Qualify for Coverage to Enter Treatment?
Getting evaluated by a professional can help clear up any doubts and get you started on the right track. And even if you don’t meet all the criteria for coverage, your pain and concerns still matter. If insurance is the route you need to take, coverage can be tedious and challenging to navigate, but stay hopeful. Many standard health plans will cover at least some part of SUD treatment if you’ve received an official diagnosis.
Fortunately, if you have health insurance, you may receive partial or complete coverage for a number of treatments, but the exact benefits and out-of-pocket costs depend on your specific policy and where you receive care.
Inpatient and Outpatient Services
Many plans cover some or most inpatient care and intensive outpatient programs (IOPs) with services that range from therapy and support groups to medical appointments. Just keep in mind that copays and deductibles may still apply.
Alternative Approved Treatment Programs
Services from licensed or in-network providers, especially those that specialize in substance use treatment, could have a greater chance of coverage. These may include equine therapy, tactical recovery, or even recreational therapy.
Medication-Assisted Treatment (MAT)
If your plan offers coverage for prescriptions, you may qualify for medications like buprenorphine, naltrexone, or naloxone, which doctors often prescribe for individuals with opioid or alcohol use disorders.
To find out what your plan covers, talk with your healthcare provider or call the number on the back of your insurance card. Additionally, our Waypoint Recovery Center team can help you explore your options, gather documents, and walk through the next steps. We’re here to make the process quicker and less overwhelming.
Other Clues That You May Need to Enter Recovery
Plenty of people seek care even when they’re unsure whether their use qualifies as a disorder.
Here are a few signs that could mean it’s time to look into treatment independent of a medical diagnosis:
- Family and friends express concern. When the people closest to you bring up your substance use, it may be a sign that the situation is more serious than you can see.
- You’ve experienced accidents or dangerous situations due to your substance use. Maybe it was a car accident, a fall, or you simply had something scary happen while using. These moments often signal it’s time for change.
- Your academic or professional work is suffering. If you feel yourself slipping, whether it’s missing deadlines, calling out frequently, or struggling to focus, substance use could be the issue.
- You’re struggling with anxiety or depression. Substance issues often pair up with mental health challenges. If your mood is low or you’re constantly on edge, your substance use could be coming into play.
- You’re showing patterns of dependence. If you use more than you intend to, try to cut back but fail, or spend considerable time recovering from drinking or using, you may be experiencing symptoms of SUD.
If you’re experiencing any of these signs, you may want to attempt to gradually eliminate your substance use. Gradual is the key word, as going “cold turkey” without medical supervision, especially when using opioids or alcohol, can lead to serious complications. Even if withdrawal doesn’t seem serious at first, the risk of overdose goes up significantly if you return to using afterward.
Get Help For Substance Use Disorder in South Carolina
If your insurance doesn’t cover everything, don’t give up. Waypoint Recovery Center has resources, insights, and people who can help you figure out what comes next. Whether you’re looking for treatment in North Charleston or Cameron, we’re here to support your journey. Contact us today to learn more and take that first step toward healing.
