Each year, the Substance Abuse and Mental Health Services Administration (SAMHSA) releases a survey, called the National Survey on Drug Use and Health. The latest information comes from 2021 and reveals that 46.3 million people aged 12 or older met the criteria for a substance use disorder.
If you or a loved one are looking for help, you likely have questions about the cost of addiction treatment. For instance, does insurance pay for rehab?
The answer is a little more complex than you might think. Treatment involves many different components and each individual is different. Keep reading to learn more about your options for alcohol and drug rehab, and how to find a treatment that’s covered.
Does Insurance Pay for Rehab?
If you have insurance, most plans will cover at least some of the treatment costs for substance use disorder. However, the amount you have to pay out of pocket varies depending on the type.
So, does insurance pay for a rehab facility?
Insurance plans may cover all or part of the cost of care, but it’s always best to check first. Speaking with your plan administrator or contacting an addiction treatment center directly is the fastest way to learn about your coverage prior to requesting admission.
Here at the Altitude Recovery Community, we work with most major insurance carriers, including Anthem, Aetna, Blue Cross Blue Shield, Cigna, and more. We also offer self-pay options to help cover the cost of treatment. Plus, if we can’t work with your insurance provider, we’ll help you find a program for treatment.
Let’s cover the different types of rehab next, so you can learn more about your plan specifics.
Types of Rehab Covered by Insurance
Major insurance carriers usually help cover the cost of addiction treatment.
The two main types of insurance coverage include private and public. You may have private insurance through an employer or you might need to buy coverage on your own, depending on your circumstances. Public insurance refers to programs like Medicare and Medicaid.
Keep in mind that not all treatment centers accept all types of insurance, and they may not be able to take Medicaid or Medicare. You must also consider whether a treatment option falls within your insurance provider’s network.
Some of the treatment options may be a better fit depending on your case and what kind of help you need. For example, you may feel inpatient care is the best choice if you need supervision.
It’s a good idea to familiarize yourself with the different treatment types available so you can create a plan. The following are common terms you should understand.
Inpatient rehabilitation refers to live-in programs where patients receive carefully planned and structured care 24/7. Individuals who enter inpatient facilities become residents and they will gain access to the treatment programs and support available there.
Patients may live alone or have roommates. Treatment involves daily therapy sessions, either one-on-one or in a group setting. Generally, the length of stay is around 30 days, though this may vary depending on the individual’s situation.
The benefits of inpatient drug and alcohol rehab include gaining access to professional support and feeling part of a community. Additionally, patients distance themselves from potential triggers or negative influences. The goal is to focus on healing and learning new habits.
Some patients can’t afford inpatient care, either because it’s too expensive or because they still have to manage responsibilities such as going to work. In these cases, outpatient care may be their best option.
Outpatient rehab allows individuals to receive the care they need while remaining at home or in a sober living environment. They meet with a behavioral counselor or attend a treatment center several times a week. Some programs even offer evening or weekend sessions, giving patients greater flexibility.
Both inpatient and outpatient treatment focuses on creating a plan to suit an individual’s needs and help them recover. As such, no two treatment plans are exactly the same.
An intensive outpatient program (IOP) is another option for those dealing with a substance abuse disorder that doesn’t require 24-hour supervision. IOPs may be used as a way to help a patient reacclimate back into their normal environment. These programs can also help prevent relapses and assist patients to maintain better support networks.
Drug or alcohol detox is a crucial part of the rehabilitation process. During this part of treatment, patients must remove all traces of the substance from their body.
To understand how detox works, it’s crucial to know how addiction affects our bodies. Our brains are made of many different parts, including neuron networks. Neurons are responsible for sending signals to other parts of the brain and throughout the body.
Neurons work by releasing a neurotransmitter into the synapse (gap) between cells. The “message” reaches the receptors on the other neuron and this results in various changes.
However, drugs and alcohol affect the way our neurons work. Certain drugs can mimic the brain’s chemicals, but because they don’t work the same way, it results in strange messages being sent through the network.
Drug use affects parts of the brain, such as the basal ganglia, which is linked to pleasurable effects and the formation of habits. In short, drugs can overstimulate this part of the brain and create a sense of euphoria. Unfortunately, repeated drug use makes it harder to find pleasure in other activities aside from taking the substance.
Over time and with repeated use, a person’s body can become used to having these substances. They may feel they need it to feel normal again or to perform daily activities. Detox removes these substances from the body, but coping with the effects on the body isn’t always easy.
Drug treatment centers help individuals deal with withdrawal symptoms and heal their bodies in a highly supervised care facility. The trained staff try to make the experience as easy and comfortable as possible.
Aftercare is another critical part of recovery. It involves helping people keep up with their recovery and take all necessary steps to prevent a relapse. Patients undergo aftercare following inpatient or outpatient care.
Generally, an aftercare program connects patients with other support groups and professionals to help them maintain sobriety.
Again, most treatment centers take all major insurance types. However, the amount of coverage you may have can vary depending on your plan.
That’s why it’s always important to speak with your insurer or contact the rehab facility directly to check your coverage. Doing so can prevent any insurance issues or delays.
Can You Get Rehab Without Insurance?
Let’s say you want to receive treatment for a substance use disorder, but you don’t have private insurance. There are still options available to you.
Medicaid eligibility varies by state, but it’s worth looking into. Medicare is also available to those 65 or older who meet all requirements. Additionally, veterans can get VA coverage.
So what if the treatment center doesn’t accept these insurance types? Thankfully, most offer other payment options.
Treatment plans are frequently offered to those who don’t have insurance. Payment plans can help spread out the cost of treatment to make it more manageable.
Other rehab centers may have sliding scale fees. This option can benefit lower-income individuals.
Finally, there are some state-funded rehab options that may not cost you anything. Depending on where you live, you may also be able to find state financial assistance.
No matter what, there is always an option for help. You never have to feel as if you can’t access proper care simply because you don’t have insurance.
Find Insurance That Covers Rehab
Perhaps it’s time to find an insurance option that covers rehab. Before you begin shopping for a plan, consider your needs. Think about the different types of treatment such as inpatient or outpatient.
If you’re unsure of what you need, feel free to contact a rehab facility with any questions or simply do some research.
Our guide can help you find a suitable insurance plan to cover your treatment.
You may be able to change your insurance after a qualifying life event. These events allow individuals to make changes to their coverage or begin a new plan without waiting for open enrollment.
Here are some examples of qualifying life events:
- Losing existing coverage
- Loss of eligibility for Medicaid, Medicare, or CHIP
- Getting married or divorced
- Loss of coverage from your parent’s plan (turning 26)
- Moving to a different zip code
- Experiencing income changes that affect coverage
Keep in mind these are only a few of the many examples. You can find the full list here.
Get the Treatment You Deserve
So, does insurance pay for rehab? In most cases, individuals covered by a major insurance carrier will be able to get all or part of their rehab treatment covered. However, make sure to do your research and consider the points that we’ve discussed here.
Let our team at Altitude Recovery Community create personalized solutions for your care. If you have any insurance questions, we’d be happy to help you out. Simply contact us or call us to find out how you can begin on the path to recovery.