Does Insurance Cover Rehab?

Substance abuse is not exactly in the life plan when someone maps out their future, so when they have spiraled into substance abuse and are determined to find their way out, figuring out how to pay for it can be overwhelming. Thankfully, it can be made easier, since many drug and alcohol rehab centers take a variety of insurances. Life is hard and can cause stress. Finding ways to feel the happiness of the carefree life you had before major responsibilities consumed your thoughts can go any number of ways, from meditation to drug use.

Those who have subconsciously chosen an unhealthier path that includes drugs or alcohol to ease the stressors of everyday life can either gradually or suddenly become dependent on them. A variety of drug and/or alcohol rehab programs customize their care according to the needs of each person walking through their doors. With over 14,500 treatment centers spanning the country, everyone from female veterans addicted to Xanax to teen males shooting up heroin will find a place that gives them the best chance at recovery, and the coverage provided by health insurance can truly save their lives.

How expensive is the average drug and alcohol rehab program?

Every program is different. One may offer the basics of detox, rehab, aftercare, and maintenance with meals and standard activities while another offers tennis courts, swimming pools, acupuncture, and massages. Out-of-pocket costs are not something that many people can afford; however, the majority of health insurances cover much of the amount. What kinds of costs are we looking at on average?

• Detox costs
  • Outpatient detox can range from $1,000 to $1,500, but it is included in most inpatient treatment programs.
• Inpatient rehab costs
  • 30-day rehab averages approximately $6,000, but facilities with more amenities can cost upwards of $20,000 for 30 days. 60 and 90-day programs may set someone back between $12,000 and $60,000.
• Outpatient rehab costs
  • 90 days of treatment may cost about $5,000, while more renowned ones can cost $10,000. The cost is adjusted to how often and how long the visits are made.
• Medications used during treatment
  • Depending on the addition being treated, some people don’t require medication, but it can cost several thousand a year (e.g., methadone for one year can cost a previous opioid addict an average of $4,700.

What coverage does health insurance provide for drug and alcohol rehab?

Health insurance is one of the most popular ways to pay to help someone who needs to get their substance abuse under control. The cost of rehab can be daunting, so relying on the insurance that you have paid into for years can ease the stress of choosing a facility that is suitable to your situation. As of 2 years ago, 90.9% of Americans had health insurance. If you're asking yourself, "does insurance cover rehab?", the coverage depends solely on the insurance company’s policies. Insurance generally covers the following:

• Medication-assisted detox
• Dual diagnosis (co-occurring mental health disorder)
• Inpatient care (in approved facilities)
• Outpatient care (with approved facilities)
• Aftercare counseling
• Maintenance medication

What is HMO vs PPO insurance?

The two most common health insurances are HMOs and PPOs and knowing the difference can help weed through the best options.

• HMOs (Health Maintenance Organization) allow patients to pick their PCP (primary care physician) and visit them for most of their medical issues. If they require a specialist, the PCP refers them.
  •  HMOs typically have no deductible and have lower premiums but also have lower coverage than a PPO.
• PPOs (Preferred Provider Organization) generally have higher premiums and deductibles but also allow patients to see specialists and other healthcare providers outside the network without referral.

Some common insurances that cover drug and alcohol rehab include:

• Medicaid
• Medicare
• ACA (Affordable Care Act) or Obamacare, no longer penalizes a user as having a pre-existing condition when seeking treatment for their substance abuse. Plans vary as to how long they cover treatment and what type.
• Private insurance
• Military insurance

What are my options if health insurance doesn’t cover the entire rehab program?

It’s devastating to find out that insurance is covering only a portion of the program that has been chosen to help get you back on your feet. It can be hard to feel hope when you have been let down so much in life, and fighting your way back from the loneliness and isolation that accompanies substance abuse is even harder when the path to rehab has not been as easy as planned. So, what can you do to make up the difference?

• Grants
  • SAMSHA (substance abuse and mental health services administration) provides funding for a journey to recovery. Some facilities also offer scholarship and grant opportunities of their own.
• Sliding scale plans and subsidized coverage
  • Most centers offer payments according to income level and debt to income ratio.
• Monthly payment plans
• Savings
  • Using savings may seem daunting, but there is no future without investing in it. Some people can dip into their IRA or 401k plans. A home’s equity can be borrowed against.
• Fundraising or crowdsourcing
  • Sites such as GoFundMe allow people in the community, friends, and family to help pay for rehab. People donating can also make payments directly to the facility so there is no question as to where their money is going. Fundraising events can also grow funding — like spaghetti dinners, running and dancing marathons, or food drives allow people to purchase items with the idea that they are doing so for a good cause.

Adults typically start using drugs because they are stressed and cannot seem to handle all that life is throwing at them, so when they have lost all control with a drug or alcohol addiction, it can be even more overwhelming to call around for the necessary help. Starting with an insurance company is a great first step, since it can help narrow down their search in a facility that will match their situation. Substance abuse is considered a chronic condition in today’s society with over 2.1 million people fighting its clutches. relying on the medical and insurance professionals to help with coverage on evidence-based physical and psychological assistance can be the perfect solution that saves someone’s life and helps them regain the happiness for which they have strived for so long.