Does Insurance Cover Rehab For Alcohol Addiction
Private or public insurance may be able to help you cover some or all of the cost of addiction treatment. The Affordable Care Act , requires long-term private and public insurance plans to cover 10 essential health benefits including treatment for mental and behavioral health disorders.3 This includes treatment for substance use disorder. The exact amount of coverage will depend on your specific insurance plan, and you may be responsible for costs like your deductible, copayment, or coinsurance.4
The two main types of insurance are private and public. Private insurance includes coverage you get through an employer and coverage you buy on your own .1 Public health insurance consists of Medicare, a federal plan for older and disabled Americans, and Medicaid, which is state-based coverage for lower-income Americans.2 Both private and public insurance are bound by the provisions of the ACA, meaning both can help provide coverage for medically-necessary substance use disorder treatment.3
One important factor is choosing a treatment program thats within your insurance providers network. Many health insurance plans dont offer any coverage for non-emergency care outside of the network, and if there is coverage it will be much more expensive.5
How To Find Alcohol Rehabs That Accept My Insurance
Finding a rehab near you that works with your insurance doesnt need to be a difficult process. A good starting step would be to contact your doctor or medical professional and talk to them about your substance use concerns. They can determine what treatment you need and connect you to in-network rehab centers. The SAMHSA treatment locator is another way to find rehabs that are near you.
Another option is to contact an addiction helpline. These helplines can answer questions you have about the rehab process and how to use your insurance to cover some or all of the costs. For example, you can contact American Addiction Centers at any time by calling .
AAC operates a variety of treatment centers around the country and is proud to be in-network for many insurance plans. If youre ready to start on the path to a happier, healthier life, we can help. Contact us today.
- Resources about addiction and recovery
- Information about our treatment process
Talk To The Treatment Center
If the initial cost sounds daunting, dont let it stop you. Many recovery centers offer payment plans so you can pay in smaller increments each month. This will let you start your treatment as soon as possible. When youre clean and able to hold down a reliable job again, youll be able to pay it off.
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What Services Does Drug Rehab Insurance Cover
Every insurance plan is different. Depending on the insurance plan, drug rehab insurance may cover all or part of your addiction treatment. This includes any of the following treatment programs and clinical interventions:
Detox is a process of ridding the body of drugs and alcohol. It is often the first step in addiction treatment and can be done in an outpatient or inpatient setting.
Inpatient rehab is a type of drug treatment where people live at the facility while they receive care. This allows them to be away from triggers and get around-the-clock care. During an inpatient program, you will take part in individual and group therapy, as well as other activities that help you recover.
Outpatient rehab is a type of drug treatment where people do not live at the facility but come for treatments during the day. This option is often less expensive than inpatient care, but may not be as effective for those with severe addiction. You will typically go to the facility for a few hours each day to participate in therapy and other activities.
Intensive outpatient programs, otherwise known as IOPs, are a type of drug treatment that is similar to outpatient care but with more hours required each week. IOPs typically require 9-12 hours per week and are a good option for those who cannot commit to full-time inpatient care.
What Isnt Covered By Insurance For Addiction Treatment
There are many health insurance regulations now in place to ensure that people receive the treatment they need without discrimination against their need for that treatment. In other words, a person with a chronic illness, such as diabetes, will not receive a higher level of coverage than a person with the chronic illness of addiction.
However, as with treatment for other conditions, guidelines for addiction treatment are specific, both according to the plan and the provider. In addition to figuring out what precertification requirements a person must meet prior to entering treatment, its also important to know exactly which treatment programs, types, and medications are covered.
Some questions to ask an insurance provider before entering addiction treatment include:
- Does my plan cover inpatient addiction treatment? Outpatient treatment?
- Will my plan pay for medication during withdrawal? Medication management?
- Will my plan only cover 12-step-based programs, without medication?
- Does my plan have coverage for any forms of aftercare, such as outpatient programs?
- What is my daily copay for an inpatient treatment stay?
- Will my plan only cover a certain length of inpatient program, such as 30 days?
- Does my plan require that I enter treatment for a minimum length of time, such as 90 days?
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How Does Coverage Work With A Private Or Employer
Full coverage isnt necessarily guaranteed with private or employer-subsidized plans. There is never a simple, yes or no answer when it comes to what insurance companies in the U.S. will or will not cover. Its crucial to investigate the insurance plan to find out what is and is not included in a particular policy. There may be certain stipulations for coverage, such as:
- Detox may not be a part of the coverage
- Patients may be required only to use in-network doctors and facilities
- Coverage may change based on the length of treatment
- Coverage may vary based on the type of treatment
- Coverage may be denied based on a patient attending rehab before
- The type of addiction may not be covered
Many rehab facilities have professionals on staff whose job is to find out what a patients insurance policy will or will not cover. Its important that patients or trusted family members contact the rehab facility they wish to attend and find out what treatment options are covered under their particular insurance plan.
How Do I Get Treatment In California Without Insurance Or An Insurance Policy With Poor Coverage
There are several options for individuals with no or poor insurance coverage:
- Centers that offer fees based on the income of the patient these centers provide individualized care by asking for payment for only what the patients can afford
- State-funded programs, although patients have to meet certain requirements to be admitted
- NGOs that specialize in drug rehabilitation can redirect addicts to clinics that admit patients without insurance or without the means to pay medical bills.
- The SAMHSA offers grants to low-income people, helping them fund their drug treatment.
ObamaCare and Mental Health Treatment Policies
ObamaCare allows states to expand Medicaid to increase coverage for low-income people under 65, many who had not been eligible for coverage. The act came into effect starting January 1st, 2014 and established a new income limit of 138% of the federal poverty line. According to a 2016 report, more than 4.7 million people in the State of California were covered by Medi-Cal since the ACA was introduced.
The California Department of Health Care Services offers a comprehensive list of all the programs and services people can benefit from as a result of the ACA
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Your Not Alone: Navigating Insurance Policies Can Be Challenging
If you have put off addiction treatment due to worry over your insurance verification status, then youre not alone in that regard. Financial costs also prevent many other people from considering entering treatment. However, you can get addiction treatment insurance verification fairly quickly with Northern Illinois Recovery Center. You could also have access to coverage options you were completely unaware of. Of course, theres only one way to find out!
Coverage Is Not For Quality Addiction Treatment Programs
Often, the medical care offered for addiction treatment through an insurance plan doesnt provide the attentive and comprehensive care needed to fully recover and rehabilitate. Traditional insurance plans frequently only give access to one size fits all treatment programs for addiction. Everyone has different things that cause and trigger addiction, so while a specific type of program and treatment could be beneficial for some, it doesnt take into account the wide variety of issues that are causing the addiction. Other underlying factors to addiction could be:
- Extreme amounts of stress in someones daily life
These underlying issues can only be discovered and thoroughly worked through in a comprehensive therapy and treatment program.
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Does Insurance Cover Emergency Same
If you have health insurance, emergency rehab centers and same-day detox may be covered under your insurance plan. Keep in mind that there may be some out-of-pocket costs in the form of co-pays and deductibles. Talk to your insurance provider to determine your coverage and any out-of-pocket costs you may be responsible for. The treatment facility may need to verify your insurance benefits prior to admission.
The Affordable Care Act , passed in 2010, mandates that all Medicaid insurance, as well as health insurance sold on the Health Insurance Exchanges, must include coverage for substance use disorders and behavioral health services7 Mental health and substance abuse services are considered essential services under the ACA. You can visit the following health insurance provider websites to verify services:
How To Find Insurance Plans Accepted By Rehabs
First, check the policy. Call the insurance company and ask about the types of addiction treatment the policy covers. While these private insurance plans often have the most comprehensive coverage, the plans tend to cost more. In other words, if a particular plan has extensive rehab coverage, it is likely that those benefits include high premiums, paid for by the policyholder. Common insurance companies that may be able to cover at least some of the cost of rehab include: Blue Cross Blue Shield, Aetna, Anthem, Cigna, Humana, United Healthcare, and more. For Veterans, TRICARE may also cover rehab depending on your plan as well.
Similarly, employer-provided group insurance plans can be expensive and may be subject to restrictions.
For self-employed individuals, people not insured through work, and those who dont otherwise have insurance, the Affordable Care Act Marketplace or state exchange plans provide options for getting coverage for addiction treatment.
If the policyholder is seeking alcohol addiction treatment for the first time, for instance, the insurance plan may cover rehab.
However, if the person relapses and needs to return to treatmentwhich is often part of the recovery process1insurance plans may exclude additional treatments.
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Outpatient Care Costs And Coverage
This all sounds very expensive remember that for the majority of the countrys 20 million patients struggling with substance abuse, treatment doesnt require inpatient treatment. In one study of Californian claims for substance abuse treatments, for example, 27% of insured patients only needed between $1-100 worth of services, while 20% needed $1000-2,500 worth of care.
Rehabilitative care can overlap with detoxification most policies include the 20-visit-per-year provision, as well as requiring copayments. Rehabilitative care encompasses counseling but does not usually include home residential care. Outpatient care will usually include a blend of prescribed treatment medications that will help addicts reestablish and maintain their brain chemistry and function as well as ongoing behavioral therapy sessions.
Obviously, treatment approaches and their costs vary as widely as the range of substance abuse issues they target. Depending on a patients abuse habits and their medical histories, treatment periods can be as short as three months or can be considered lifelong commitments. Usually, patients require an individualized blend of treatments that include medication and behavioral therapy to cope with the major stages of recovery from withdrawal to maintaining sobriety once its achieved.
Find A Treatment Facility That Accepts Cigna Today
Addiction affects millions of families in the United States. Without treatment, addiction can be deadly, and in the meantime, can cause severe harm to health and hurt relationships.
At FreeRehabCenters.net, we can help by offering insurance verification, explaining your treatment options, and aiding you in finding a rehab center that accepts your insurance.
If youre ready to find a treatment program for yourself or a loved one thats covered by Cigna insurance, call our helpline for more information today.
Written by the Free Rehab Centers Editorial Staff
Free Rehab Centers aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- Cigna Mental Health Insurance & Substance Use Benefits https://www.cigna.com/individuals-families/shop-plans/plans-through-employer/mental-health-insurance-and-substance-use-benefits
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What If I Cannot Get Drug And Alcohol Rehab Insurance
Depending on your income and other financial obligations, you may not be able to afford the monthly premiums or deductibles of a commercial insurance plan, even one obtained through the ACA Marketplace. Some individuals also have other barriers to obtaining insurance, such as not having a current state or federal ID.
You still have resources that can help you to receive treatment for a drug or alcohol use disorder if you do not currently have the option to enroll in insurance, including: 7,8
- Some states offer treatment funded by block grants from the Substance Abuse and Mental Health Services Administration . Call SAMHSA at 1-800-662-4357 for help locating a center that offers grant-funded treatment.
- At FindTreatment.gov, you can search for treatment centers that offer free care or a sliding-fee scale. You can also search for facilities that accept Medicaid or Medicare.
- Certain treatment centers offer scholarships from affiliations with foundations or private sponsorships.
- Some treatment centers offer payment plans or discounted rates for cash-pay clients.
For more information about addiction treatment, call to speak with a rehab specialist today.
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Can I Go To Rehab Without Insurance
If you dont have insurance, various state-funded health programs can help with the cost of rehab. These programs include Medicare and Medicaid. In addition, most treatment facilities accept payment options such as payment plans, loans, and public assistance. If the cost of rehab is deterring you or someone you love from finding treatment, call us today at
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Ready For Rehab Take Our Alcohol Addiction Assessment
Take our free, 5-minute Am I an Alcoholic? self-assessment below if you think you or someone you love might be struggling with an alcohol use disorder . The evaluation consists of 11 yes or no questions that are intended to be used as an informational tool to assess the severity and probability of an AUD. The test is free, confidential, and no personal information is needed to receive the result.
Does Blue Cross Blue Shield Insurance Cover Mental Health Care
The Affordable Care Act requires that all insurance plans provide coverage for behavioral health services, including mental health and substance abuse issues.1 This means that there must be some type of insurance coverage, whether you are looking for a heroin drug rehab facility or a treatment program that addresses a co-occurring disorder, which means that someone has mental health and substance issues that occur simultaneously.1 Treatment that addresses both mental health and substance use disorders are not only beneficial, but are necessary for those who wish to address both the mental health issue and substance abuse issue simultaneously. This integrated treatment has been shown to help people stay sober, reduce hospitalizations, help people live independently, and provide stable employment for those who receive treatment for both issues.1
Many BCBS insurance plans cover individual therapy and other services for people with co-occurring disorders. Even with BCBS insurance plan mental health coverage, you or a loved one may have to pay some costs such as a copayment or the remaining balance of the plans deductible.
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How To Find Substance Abuse Treatment Near Me
You may be thinking, where can I find the best rehab centers near me? or how can I find drug and alcohol rehab programs that are covered by insurance? American Addiction Centers is here to help. You can contact our admissions navigators 24/7 for free at to help you find the right addiction recovery program and learn about ways to cover the cost. You can also check your insurance coverage online now to determine whether your insurance provider will cover rehabilitation treatment.
Health insurance coverage can be a confusing maze to navigate, especially when it comes to treatment. Alcohol and drug rehab coverage can make the high cost of treatment manageable and affordable, allowing more people to access care for addictions. Federal laws ensure that insurance companies offer similar benefits for mental health care as they do for physical health conditions.
A range of treatment types is offered for substance use disorders and the majority of public and private health insurance plans provide some coverage for addiction treatment. However, checking your benefits before seeking care to ensure that your drug or alcohol rehab insurance is accepted at the facility you choose to attend is a good start on the road to recovery.
Finding A Rehab Center
Addiction recovery can be a long, difficult process. Settling on the right rehab program is crucial to getting and staying sober. Not every program offers the same treatment options or accepts every insurance plan. Our treatment providers can help you determine which treatment centers accept your insurance.
- Beronio K, Po R Skopec L, Glied S . Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans. Retrieved on June 11, 2015
- Healthcare.gov . Mental Health and Substance Abuse Coverage. Retrieved June 11, 2015
- Vimont C . Affordable Care Act to Provide Substance Abuse Treatment to Millions of New Patients. Retrieved on June 11, 2015
- Healthcare.gov . How to Choose Marketplace Insurance. Retrieved on June 11, 2015
Reviewed by Certified Addiction Professional: January 14, 2019
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