FAQs About Getting Well
We help you understand the process of getting well from this disease.
1) How do I know if formal treatment is needed?
If you are concerned about addiction or any type of drug or alcohol problem, call us and visit with a recovery coach. Our trained recovery coaches can help you better understand the problem and sort through next steps. It's also important to have a dialogue with your health care provider, as he or she will have insights as to how addiction might be impacting your broader health. You can also learn more about the symptoms of addiction.
2) How can I get into treatment?
As a first step, we recommend that you meet with one of our recovery coaches and they can help you navigate the process. They’ll walk you through the different options, help make calls about an assessment, insurance coverage and bed dates.
Oftentimes, the biggest challenge to getting into treatment is financial. Under health care reform, most insurance plans are now required to cover addiction treatment. However, a recovery coach can help you determine this. In addition, the reputable treatment centers will sometimes offer financial plans for those who have limited means.
3) What kind of treatment do I need?
This is the type of thing that first boils down to resources. If you don’t have health insurance or the funds to pay for treatment, learn more about applying for state funding (see question 6 below). To determine the kind of treatment plan you need, you will likely need a chemical dependency assessment. The results of this assessment will determine your recommended level of care.
4) Will health insurance pay for my treatment?
Medical care for the disease of addiction (substance use/substance use disorder) is one of the essential benefits that health plans must provide to comply with the Affordable Care Act (ACA). Screening and counseling for addiction is considered preventative care and must be covered as well. Whether or not your policy was purchased in the Marketplace, all policies must cover addiction treatment as of January 1, 2014. Public health plans, such as Medicaid and TRICARE, and almost all large group policies meet this requirement.
Unfortunately, some non-compliant policies (issued prior to March 2010) have been grandfathered under the ACA. Call your insurance provider if you have any questions about treatment coverage. One of our recovery coaches would be happy to help you with the call if you would like. If your plan doesn’t offer addiction treatment coverage, you may be eligible to enroll in a plan through the Marketplace exchange (during open enrollment periods).
All plans offered in the exchanges are Qualified Health Plans (QHP), meaning treatment is covered. Premiums for a QHP may be higher than you are currently paying for health insurance, but you will be getting more bang for your buck in terms of coverage and out-of-pocket costs. Depending on income, you may also be eligible for tax credits.
Insurance companies cannot deny coverage due to addiction issues on your medical records. The only health screening question asked when purchasing through the Marketplace is regarding smoking and it’s a simple yes or no. The ACA does allow insurance companies to charge higher rates for tobacco use.
5) Can I qualify for state funding for treatment?
In order to qualify for state funding for treatment, you must complete a chemical dependency assessment by a licensed CD counselor. Many providers use sliding scales for fees for the assessment, so the cost of the assessment may be lowered or even waived, depending on your financial situation. Based on the recommendation for level of care and the availability of funding, you may qualify for state funding.
The best thing to do is to make an appointment with a recovery coach and we can help guide you through this process.
6) What can I do about childcare during treatment?
If the parent is in outpatient treatment, there are resources available to help with childcare. In addition, arrangements could be made with family members or friends if needed. Inpatient can be more challenging. It is usually the responsibility of parent going into treatment to secure a plan of action and a safe and secure place for their children so the parent can focus on getting well.
The Helpline center has a large childcare database of providers throughout the Sioux Empire.
7) What do I tell my (or my loved one’s) employer?
It depends on your situation. Generally speaking, if your treatment plan does not impact your employment, and you’re still able to work, there is probably no need to share that information with your employer. But that’s not true in every case. In fact, we have many Sioux Falls employers involved in our Employer Initiative that are openly supportive of employees taking steps to get well from addiction.
If someone has to go to inpatient treatment, this process is more complicated since they will need to take a leave of absence from work. This is really worked out best on a case-by-case basis. We encourage you to make an appointment with a recovery coach and we can help you determine a good course of action.
8) Can my employer fire me for suffering from addiction?
Addiction is considered a disability under the Americans with Disabilities Act and those who suffer are protected, so long as they are not currently using illegal drugs. In addition, people in recovery are protected from discrimination under the ADA as well.
If inpatient treatment is necessary, you may qualify for medical leave under FMLA.
Your employer may be part of the FITSF Employer Initiative, in which case, your employer is dedicated to wellness and building a culture of recovery in the workplace.
The key is to enter treatment and start to get well before addiction undermines your work performance. South Dakota is a right-to-work state and if your addiction is affecting your work performance and you don't take steps to treat it, your employer may have grounds to fire you.
9) Can I force my family member into treatment?
In some cases, yes. A family member or concerned adult may petition the Court for an involuntary commitment (IVC). Learn more about that process.
10) How can I prevent relapse?
The most important thing is to continue building up recovery capital to strengthen your overall health and wellbeing. We have to the tools to help you do that.
Because addiction is a chronic disease, meaning it has to be managed over a lifetime, your top priority should be ongoing disease management. We offer free recovery coaching, which provides long-term support that will benefit you and your health. The coach will work with you to develop an addiction management plan that focuses on all aspects of your wellness and recovery. Our recovery coaches will help you address any issues or barriers to wellness and provide the structure to keep you on track. We also offer a tool, our Recovery Capital Index, to help you track your wellness and see where you can improve.
It’s also important to get connected to the recovery community and build a supportive network of friends and family.
11) Are there medications available to reduce cravings?
There are some effective prescription medications available to treat addiction to opioids (including prescription painkillers) and alcohol. However, these are complex treatments and should be carefully discussed with your physician and incorporated into a broader treatment and recovery support plan.
12) Do I have to go to 12 step meetings?
There are many pathways to recovery and 12 step meetings are just one option. The most important thing is to have access to ongoing recovery and addiction wellness supports so you can successfully manage your disease. We offer free recovery coaching and telephone recovery support to anyone who needs them, for any length of time.