Health insurance typically covers the cost of drug and alcohol rehab as well as other mental health and behavioral health services. However, the extent of treatment coverage varies between insurance providers and plans. Some insurance plans may cover the full cost of substance abuse treatment while others may provide partial coverage. Learn how to pay for rehab with insurance and without.
In this article:
- Does Your Health Insurance Cover Addiction Treatment?
- What Insurance Providers Cover Rehab?
- What Types of Substance Abuse Treatment Does Insurance Cover?
- Can You Have More Than One Insurance Provider?
- Find Rehab Centers That Accept Insurance
- Buying Health Insurance on the Marketplace
- Getting Addiction Treatment Without Insurance
Does Your Health Insurance Cover Addiction Treatment?
If you have health insurance, your plan most likely provides at least partial coverage for addiction treatment as well as mental health disorders like depression or posttraumatic stress disorder (PTSD). Your specific provider and plan will determine how much of your rehab program is covered as well as what you will be required to pay out of pocket or in copays.
The best way to determine if your health insurance covers drug and alcohol rehab is to contact your provider directly. Call the number on the back of your insurance card to speak to a representative who can walk you through the details of your health insurance plan and what types of addiction treatment are covered by it. Your insurance provider can also provide you with a list of in-network rehab programs that accept your health insurance plan.
That list can serve as a great starting-off point when searching for the right drug rehab for you or a dependent on your health insurance plan.
The Affordable Care Act (Obamacare)
The Affordable Care Act (ACA), which was enacted in 2010, is a health care reform law that increased access to health insurance and made it more affordable. It stated that no one could be denied health insurance coverage, even if they have a preexisting condition, such as a drug or alcohol addiction (also known as a substance use disorder).
Under the ACA, substance use disorder is listed as one of the 10 essential health benefits that all health insurance providers must cover, meaning providers are required to cover addiction treatment services.
What Insurance Providers Cover Rehab?
Many different insurance providers cover the cost of addiction rehab, including:
- Private insurance: Private insurance offered by your employer or purchased off the Health Insurance Marketplace typically provide partial or full coverage of addiction treatment services.
- Medicare: Medicare parts A and B provide coverage for drug and alcohol rehab. Plus, part D covers medications for alcohol addiction treatment. Make sure to find a rehab that accepts Medicare as a form of payment.
- Medicaid: Medicaid typically covers addiction treatment services like inpatient and outpatient rehab. Much like Medicare, it’s important to find a treatment facility that accepts Medicaid.
Countless health insurance companies provide addiction treatment coverage, such as:
- Blue Cross Blue Shield
- United Healthcare
However, the list is not limited to these providers—if you have insurance, chances are your provider offers substance abuse treatment coverage to some extent.
What Types of Substance Abuse Treatment Does Insurance Cover?
Every insurance plan and provider covers different substance abuse treatment and recovery services, but some types of treatment you can expect to be covered by insurance include:
- Inpatient rehab
- Outpatient addiction treatment
- Medication-assisted treatment
- Medical detox
- Dual diagnosis rehab (co-occurring disorders)
- Ongoing therapy and counseling
- Medication maintenance (e.g. methadone or Suboxone)
Before choosing a treatment program, you’ll want to check with your insurance provider about what your plan covers and does not cover. Knowing the services and levels of care your plan covers will help narrow down your search for the right addiction treatment program.
Can You Have More Than One Insurance Provider?
Yes, you can have coverage from several insurance providers. When you have coverage through more than one insurance provider, this is called coordination of benefits. Certain people may qualify for coverage through two or more providers. Eligible people include:
- Those who are under 26 and are covered by guardian insurance and their own
- Those who are under 26 and are covered by each of their divorced parent’s plans
- Those who are married and covered by their own insurance and their partner’s
- Those who are over 65 and have coverage through Medicare and an employer
If you are covered by more than one health insurance plan, one plan will be designated as your primary plan and the other will provide secondary coverage. Your primary plan covers your addiction treatment first. And if they don’t provide full coverage then your secondary insurance will kick in and pay the remaining treatment costs.
Find Rehab Centers That Accept Insurance
If you are searching for the right rehab program for you or a loved one, you can use our treatment directory to browse facilities. You can narrow down your search by state and city, and then once you click on individual rehab programs, you will be able to learn what types of insurance they accept.
Buying Health Insurance on the Marketplace
If you don’t have health insurance offered by your employer or the government, you can shop for health insurance plans on the Health Insurance Marketplace. These insurance plans are those made available under the Affordable Care Act, also known as “Obamacare.”
Every plan sold through the Marketplace includes the same essential benefits, including prescriptions, hospitalization, preventative care, and more. You can compare plans that fit your budget and needs. The only requirements to be eligible for health insurance through the Marketplace are that you live in the United States, are a citizen (or be lawfully present), and are not incarcerated.
During the Open Enrollment Period, you can apply for a Health Insurance Marketplace plan in a number of ways, such as:
- By phone
- With a paper application
- With the help of a trained assistant in the community
You can visit the Marketplace site to learn more about how to apply for coverage.
Getting Addiction Treatment Without Insurance
Although health insurance can provide financial assistance in paying for addiction treatment, there are still ways to receive substance abuse treatment without insurance. Here are some financing options for rehab:
- State-funded low-cost rehab: Some rehabs receive government funding and are able to offer low-cost or even free rehab for those who qualify.
- Sliding scale fees: Many treatment programs offer sliding scale fees, which means they charge what you can reasonably afford based on your financial situation.
- Payment plan: Some rehab facilities allow you to break up the cost of rehab into smaller, monthly payments.
- Rehab scholarships: You can find rehab scholarships through individual treatment centers as well as non-profits like 10,000 beds, which matches you with treatment facilities that have vacancies.
- Substance abuse treatment loans: You can apply for loans that are specifically created for addiction treatment.
- Fundraising: Create a campaign on a crowdfunding site like GoFundMe to raise money for your rehab stay.
- Health care credit card: You can apply for a health care credit card that’s designated for paying medical bills.
If you are looking for a drug or alcohol rehab that accepts your insurance, call our confidential, toll-free helpline at 800-662-4357 to speak to a treatment support specialist. The right treatment program for you is out there.