does insurance cover rehab

Does Insurance Cover Rehab? Here’s What You Need to Know

Of the over 22 million Americans who required treatment for a substance use problem in 2013, only 2.5 million ever received that treatment.

These numbers reveal a very large treatment gap. Perhaps one of the most important deterrents to seeking treatment is the cost of a rehabilitation program.

Which begs the question: does insurance cover rehab?

The simple answer to that question is ‘yes’, but there’s far more you need to know about how insurance for rehab works.  And even in the case you’re not covered, there are still options for getting the help you need.

Keep reading to learn more about the cost of rehab, insurance programs, and what those options are.

How Much Does Rehab Cost?

Rehabilitation programs have a wide variation in costs. The costs vary depending on where the facility is located, how long the program is, what’s included in the program, amenities, and other factors. 

While a luxury rehab center with amenities tailored to celebrities and other high-profile people can cost tens of thousands of dollars every month, there are also non-profit health centers, which offer treatment for free. But most rehab centers fall somewhere in the middle of the two. 

When thinking about what costs insurance might cover, there are a few items you need to consider. And while some insurance companies will cover all of these pieces, not all will.

Detox

Detox is an important aspect of recovery. It gives you a chance to rid your body of whatever substances you’ve been using. And for many substances, that detox needs to be medically supervised to ensure your health and safety.

Inpatient program generally includes the cost of detox in the total cost of the program. But an outpatient detox usually costs $1,400 on average

Inpatient vs. Outpatient Treatment

Probably the biggest factor influencing overall costs is whether you choose inpatient or outpatient treatment.

Inpatient treatment is a residential program. Meaning that you live at the facility, usually for durations of 30, 60, or 90 days. This allows you to focus all of your attention on recovery while getting the therapy, medications, and coping tools you’ll need to live sober outside of rehab. The average cost for an inpatient program varies from as low as $7,500 per month to as high as $10,000 or $20,000.

An outpatient treatment program costs a lot less than inpatient treatment because you don’t live at the facility. Instead, you visit the center for recovery classes, counseling, and medications. This way, you can continue working, going to school, and attending to your daily responsibilities.

The average cost of an outpatient program is $1,400 per month. But that cost will fluctuate based on how often you visit the facility and for how long.

Medication

Another big factor affecting costs is the medication you need. Medications may be prescribed during detox and throughout your program to help you stave away symptoms of withdrawal and cravings. These types of medications are sometimes covered under pharmacotherapy and can cost 1000’s of dollars every year.

Does Insurance Cover Rehab?

Addiction is a medical disease. As such, many insurance plans help cover the costs of treatment, like they would any other disease. But that wasn’t always the case.

In the past, insurance companies could deny coverage for mental health, substance abuse, and behavioral health. But thanks to two recent laws, that’s changed.

The Mental Health Parity and Addiction Equity Act mandates that insurance companies treat mental health and substance abuse like any other medical condition. While they don’t have to include mental health in their plans, they have to cover them the same as any other treatment if there is mental health coverage. Expanding on that, the Affordable Care Act requires most health insurance plans to have some degree of mental health coverage. 

With that said, what you’re covered for depends largely on your particular insurance plan. But most insurance companies will help cover a portion of your treatment.

To answer the question “does insurance cover rehab?”, you must speak to your provider. Ask them what treatments and services are covered, for how long, and how much you’ll have to pay out of your own pocket.

Getting to Rehab Without Insurance

At least 44 million Americans have no health insurance. If you’re one of those Americans, and you or someone you love needs treatment for an addiction, there are other options.

The first thing you should do is consult your employee handbook. This should tell you whether or not your employer offers coverage for drug treatment. 

If there’s no information in the handbook, contact your Human Resources department. They’ll be able to tell you what’s available and whether the company would be willing to help. At the very least, they may offer to grant you an extended leave to get the help you need and still have a job when you’re finished.

You can also ask the treatment center you’re interested in if they offer scholarship programs. Sometimes, donors will offer financial help to people who can’t afford it on their own. Alternatively, many treatment centers offer financial assistance programs where you pay in increments over an extended period of time.

There are also resources and program made available for people belonging to specific populations. If you fall under one of these categories, you may be able to get treatment faster and at a discounted cost. These include:

  • people under the age of 18
  • people older than age 65
  • pregnant women
  • those who are homeless
  • those with severe medical problems

Not having insurance doesn’t mean you don’t have access to treatment services. If you really want the help, there are solutions out there.

Looking for Immediate Help?

When asking “does insurance cover rehab” there are a number of factors to consider. These include the type of insurance plan, the many costs involved in rehab, and what kind of treatment is needed. Most insurance companies will help cover a portion of the costs, but you should contact your provider to find out for sure.

And if you’re looking for immediate help, contact us and we’ll help you find the treatment center that’s right for you. 

About the Reviewer: Chris Barnes

Chris BarnesChristopher Barnes has worked in health care for over thirty years. He is a graduate of Alabama State University where he earned a double Bachelor of Science Degree in Social Work and Psychology in 1982. Christopher Barnes is currently the Director of Clinical services at The Discovery House where he has been employed for the past five years. Because of his extensive experience in health care & substance abuse he has an excellent rapport with constituents, clients, and other professional organizations in the counseling/social service community.