Substance Use: Care and Coverage

Services for substance use problems are delivered in a variety of settings, including hospitals, clinics, homes, and other community locations.

Treatment is effective. Recovery is possible.

The Department of Health Services supervises Wisconsin's public substance use services system. Wisconsin's 72 counties are responsible for delivering services and providing for the well-being, treatment, and care of individuals living with substance use concerns. This often is done in partnership with community-based agencies and organizations.

Private practice professionals licensed by the state also provide care and treatment to people living with substance use concerns.

Pregnant women are given priority in substance use treatment admissions.

Three steps to accessing care

  1. Contact your health insurer. Ask about your coverage and whether they have a network of preferred providers for you to use. Get more information on paying for health care in Wisconsin.
  2. Review the websites of the providers and see if they have the five signs of quality treatment detailed below.
  3. Call for an appointment. If they can't see you or your family member within 48 hours, find another provider. One indicator of quality is the ability to get an appointment quickly. Many programs offer walk-in services. Look for programs that can get you or a family member into treatment quickly.
Help is available, if you have:
  • Been denied insurance coverage.
  • Reached a limit on your plan (for example, copayments, deductibles, yearly visits).
  • Have an overly large copay or deductible.

You may be protected by federal and state laws.

 

Five signs of quality treatment

Use these questions to help decide about the quality of a treatment provider and the types of services offered. Quality programs should offer a full range of services accepted as effective in treatment and recovery from substance use disorders and should be matched to a person’s needs.

  1. Accreditation: Has the program been licensed or certified by the state? Is the program currently in good standing in the state? Are the staff qualified? Good quality programs will have a good inspection record and both the program and the staff should have received training in treatment of substance use disorders and be licensed or registered in the state. Does the program conduct satisfaction surveys? Can they show you how people using their services have rated them?
  2. Medication: Does the program offer Food and Drug Administration-approved medication for recovery from alcohol and opioid use disorders? At this point in time, there are no Food and Drug Administration-approved medications to help to prevent relapse from other problem substances. 
  3. Evidence-Based Practices: Does the program offer treatments that have been proven to be effective in treating substance use disorders including medication management therapies, such as motivational therapy, cognitive behavioral therapy, drug and alcohol counseling, education about risks of drug and alcohol use, and peer support? Does the program either provide or help to obtain medical care for physical health issues?
  4. Families: Does the program include family members in the treatment process? Family members have an important role in understanding the impact of a mental health condition on families and providing support.
  5. Supports: Does the program provide ongoing treatment and supports beyond just treating the substance issues? For many people addiction is a chronic condition and requires ongoing medication and supports. Quality programs provide treatment for the long term which may include ongoing counseling or recovery coaching and support, and helps in meeting other basic needs like sober housing, employment supports, and continued family involvement.

Find help

If this is an emergency and you need help now, call 911 or go to the nearest emergency room.

Wisconsin Addiction Recovery Helpline

Call 211 or 833-944-4673 to learn about local treatment services for an addiction to alcohol or other drugs. Pregnant women are given priority in treatment admissions. 

Know your rights

There are rules to ensure your privacy and dignity are protected. Learn more about Wisconsin's client rights law

 

 

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Last Revised: October 22, 2018