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Does Insurance Cover Rehab?

Paying for treatment is one of the most common concerns about going into rehab for alcohol or drug abuse. You might avoid seeking help altogether if you worry about your if insurance covers rehab costs whether or not you can afford it. However, medical insurance might cover some or all of the costs of rehab.

Insurance Coverage Options For Drug and Alcohol Rehab

Whether private or subsidized, all insurances will usually cover some form of substance use treatment by the law, which can include long-term treatment in a rehab facility. Depending upon your insurance plan, you might get a different amount of coverage.

Overall, private medical insurance will provide you with more options for treatment; however, private insurance is usually more expensive than subsidized plans. You might purchase a more affordable medical insurance plan from the Healthcare Marketplace.

According to HealthCare.gov, “All Marketplace plans cover mental health and substance abuse services as essential health benefits.” Any plans purchased on the Marketplace must provide mental health and substance use treatment without a yearly or lifetime limit due to their status as “essential health benefits.”

Regardless of where you purchase your insurance, your insurance plan should include some type of coverage for addiction treatment services. Some plans might only cover specific treatments, limit the number of days spent in rehab, or only pay for detox services.

What Does Insurance Cover During Rehab?

When choosing a rehab facility for you or a loved one, it is best to consider what types of treatment the facility offers. Insurance providers are more likely to pay for proven and evidence-based services.

When a facility uses evidence-based practices, you can know that they are using methods that work. Aside from being more reputable in the eyes of insurance providers, you are assured that they are using effective treatment methods to help you or a loved one recover from a substance use disorder.

Evidence-based treatment methods for alcohol and substance use disorders include:

  • Medication-Assisted Treatment (MAT)
    • According to the National Institute on Drug Abuse (NIDA), methadone and buprenorphine are proven to treat opioid addiction.
    • For alcohol addiction, NIDA recommends MAT with medications like naltrexone, acamprosate, and disulfiram.
  • Behavioral therapies can help to enhance MAT and other treatment interventions. Some of these include incorporating the following into your therapy program: 
    • Cognitive Behavioral Therapy (CBT)
    • Dialectical Behavioral Therapy (DBT)
    • Motivational Interviewing (MI)
  • Family-based interventions, like family therapy, are effective at helping you get and stay sober after rehab.
  • Peer support during your stay in rehab and after treatment is effective at treating alcoholism and drug addiction. Many peer support meetings are community-based and free to attend, such as:
    • Alcoholics Anonymous (AA)
    • Narcotics Anonymous (NA)
    • SMART Recovery

When you find facilities with these practices, they are more likely to have accreditation, licensure, and other certifications that assure insurance providers that they will be worth covering for your treatment. 

Questions to Ask Insurance Providers About Covering Rehab

Insurance coverage for additional amenities or alternative treatment methods may or may not be covered by insurance. You should speak with your insurance provider about your coverage and options before entering treatment.

You can ask your insurance provider some of the following questions about rehab coverage:

  • How many days of rehab will be covered?
  • Will treatment cover alternative therapies, like holistic treatment methods and experiential therapy?
  • Does your coverage only cover detox services and not long-term residential treatment?
  • If you step down to outpatient substance use or mental health treatment, will you have coverage for continuing care after rehab?
  • If full coverage only applies to some services and not others, what can you expect to pay out of pocket?
  • Are facilities outside of your area covered by insurance if you cannot find or get into a facility nearby?
  • Does your insurance provider pay for rehab services in another state?

These questions can help you find a treatment center that suits your needs without providing the additional stress of paying unexpected costs later. 

Can I Afford Rehab Without Insurance?

If you do not have medical insurance, you might avoid going to rehab due to the costs. However, consider the costs of continuing to live with an addiction. 

You might miss out on advancing your career, deal with additional medical issues, pay higher car insurance rates if you are arrested for DUI, or pay other legal fees if you are caught using illegal drugs. Additionally, your addiction might disrupt relationships in your life, leading to an expensive divorce, child support payments, or other issues. 

If you are concerned about the costs of rehab, contact the facility directly to discuss your financial situation. They might offer payment plans or offer their services based on the income of those seeking treatment. Many medical service providers, including drug and alcohol treatment centers, might charge on a “sliding scale” relative to your income.

Rehab Services in South Florida

Your medical insurance might help you pay for some or all of your expenses while in rehab for drug or alcohol addiction. Ambrosia Treatment Center of West Palm Beach is here to help residents of South Florida overcome addiction with evidence-based practices covered by most insurance providers. Your life is waiting; we’ll help you get there.

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