Will My Insurance Cover Rehab for Addiction?

If you’ve decided that it’s time to get treatment for the addiction you’re struggling with, one of the first things that comes to mind is trying to figure out how you can pay for treatment. Will you need to pay out of pocket, or will your insurance cover rehab for addiction? It’s an important question, and one that impacts your care in a huge way. In most cases, insurance companies will cover rehab for addiction in some way. However, the exact coverage for rehab can vary from plan to plan. It’s important to understand what is covered by insurance companies to ensure you’re able to get the care you need so you can take the first steps in your journey towards recovery.

What Types of Insurance are Accepted for Drug Rehab?

Several different types of insurance may help cover the cost of rehab for addiction, including:

  • Public Health Insurance – Public health insurance plans, such as Medicaid and plans purchased through the national healthcare marketplace (including subsidized plans) are required to offer coverage for rehab under the Affordable Care Act. While some type of coverage will be available to you, the exact coverage available can vary depending on your plan and the company your policy is with.
  • Private Health Insurance – If you have private health insurance, you probably have a plan that offers more comprehensive coverage. Most private health insurance plans give you more options when it comes to the drug rehab centers you can choose from, and private plans will usually pay a large portion of your treatment costs so you don’t have to pay a lot out-of-pocket to receive the rehab treatment you need.
  • Group Health Insurance – Most group health insurance policies today have provisions for rehab, and the Mental Health Parity and Addiction Equity Act of 2008 has mandated that companies with over 50 employees offer health plans that have a balance of drug and alcohol treatment if the plans have psychological health benefits.

Does My Plan Require Me to Go to a Specific Facility?

Whether you’re required to go to a specific facility or now is going to depend on the specific type of health insurance plan you have. If you have a preferred provider organization (PPO) plan, then you’ll need to choose from a provider that is covered. However, your insurance will pay more of your rehab costs if you go to a provider that is “in-network” instead of an “out-of-network” provider. For managed care plans, you’ll have to go to a provider that is your network to receive coverage.

Is My Rehab Stay Fully Covered by Insurance?

Even though your health insurance may offer coverage for addiction rehab, it doesn’t mean that your stay is fully covered by your insurance. You may have to use facilities that are in your network to make sure you are covered. Some plans may not cover detox, while others may cover detox but not rehab post-detox. Your insurance may only cover so many days of inpatient or outpatient treatment, and the coverage available may change based upon the type of treatment you choose. Keep in mind, while your insurance may cover rehab, you will be responsible for paying any deductibles, co-pays, or coinsurance amounts. The amount you’ll be required to pay will depend on the plan you have.

Do I Have Options if My Insurance Won’t Cover Drug Rehab?

Even if your insurance does not cover drug rehab or if you’re uninsured, you do have some options that can help you afford the addiction treatment you need. One option is to talk to your employer about the problem. Even if your insurance doesn’t cover it, your employer may cover some of your rehab if you ask. Your employer may also be willing to give you some extended time off work to deal with the treatment you need. Talk to your Human Resources department to find out what options may be available to you.

It’s also a good idea to talk to the treatment centers you’re considering. Many treatment centers want to make sure patients can afford their care, and they are happy to offer affordable payment plans that allow you to get started as quickly as possible. Treatment centers may know of other resources available that can help you deal with the cost of rehabilitation, such as grants.

How Much Does Rehab Cost?

The cost of addiction rehab can vary greatly based on many different factors, such as whether it’s an outpatient or inpatient program, the type of treatment center, and the length of your rehabilitation. Certain options may be free or low cost if you get into a program with a nonprofit center. On the other hand, luxury rehabilitation centers for high end clients like celebrities can cost $80,000 or more for a month of treatment. In most cases, a standard drug rehab program will cost somewhere between $2,000 and $25,000 per month. Keep in mind, your cost will vary depending on the length of stay, amenities included, and the location.

Should I Consider Inpatient or Outpatient Rehab?

Inpatient rehab programs require you to stay at the facility during your treatment, and most programs last between 28 and 90 days, depending on your preferences and unique needs. At the beginning of the program, you’ll probably undergo detoxification before you start the addiction treatment. Most inpatient programs have a very structured detox program and then they go on to focus on developing skills to help you avoid relapse, including education, therapy, and counseling.

Outpatient programs allow you to receive addiction treatment while you continue to live at home when you’re not engaged in treatment. This can allow you to continue going to school or working, taking care of your responsibilities while you get treatment. Outpatient programs will require you to attend individual and/or group therapy sessions weekly, and you may need to meet with a psychiatrist regularly to deal with any mental health issues or medication management. Contingency management, motivational interviewing, multidimensional family therapy, and cognitive behavioral therapy are all types of therapies that may be used in outpatient programs.

Both programs have their own unique pros and cons, but many patients find inpatient rehab to be more effective. In many cases, removing yourself from your environment while you focus on detoxing and then recovering can help you break the habit and lower your risk of relapse in the future. However, for individuals who have other obligations they cannot leave behind, outpatient programs may make more sense.

Drug-Specific Rehab Insurance Costs

The cost of addiction rehab can vary depending on the specific substances an individual is addicted to. For example, with drugs that don’t cause dangerous withdrawals, detoxification may not be needed. However, for individuals who use heroin or alcohol, intense withdrawals are very common and patients often require medications and medical monitoring while going through the detox process. When detoxification is needed and medications are used to help with the process, the cost of rehab goes up significantly. The length of withdrawal period and the length of rehab required for each type of drug can also affect the cost of treatment.

Financing addiction rehab is an important consideration, but don’t allow the cost of care to keep you from getting the help you need. Many drug rehab insurance plans will cover at least some of your rehab, making it easier to afford the care you need. Even if your insurance won’t cover or you are uninsured, you still have low cost options available to ensure you get the treatment you need to beat addiction.

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