Covering The Cost Of Rehab

For many people, the single-biggest barrier to entering treatment is the cost. Often, the stress of how to pay for treatment can feel just as burdensome as the challenge of living with an addiction.

The cost of attending rehab can be a real barrier for those who need treatment, but it doesn’t need to be.

The cost of rehab varies widely depending on the level of care you need. Residential treatment programs offer the highest level of care, often including medical detox services with 24-hour medical care by specialized medical professionals. These services are usually the most recommended level of care and often the most expensive as a result.

Outpatient treatment programs, such as partial hospitalization programs (PHP) and intensive outpatient programming (IO), will often cost less than traditional residential treatment, but may not provide enough support for sustained recovery for those in active addiction or who require more accountability in early recovery. For more information on the different types of treatment programs and what they do, ask a treatment provider today.

Treatment comes in many forms, and there are various strategies to take when it comes to covering the costs. When it comes to finding ways to secure payment for treatment services, many people turn to their health insurance for help.

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Paying For Rehab With Insurance

Most private insurance plans will cover at least a portion of substance abuse treatment, while some cover it entirely. To learn about an insurance carrier’s benefit coverage for residential treatment, call them or visit their website to find out what’s covered.

Many treatment centers will assist with this task to help alleviate barriers that potential patients or caregivers may experience along the way. They can find out if the treatment center is in network and how many days and what services are covered under your specific plan. It’s important to note that all information given at this stage is not final, as there are many moving parts to the admissions process. Once the full admissions process has been completed, a more detailed plan can be created that will better describe how long treatment may be covered by an insurance plan.

In the United States, United Healthcare, Cigna, Blue Cross and Blue Shield, and Aetna are the four major health insurance companies that cover addiction treatment. Read more about these major insurance providers and the addiction treatment services they cover below.

united health addiction treatment coverageMany people’s policies under United Healthcare cover at least a portion of addiction treatment services, including detoxification and inpatient rehab. The amount of coverage depends on your chosen plan level and your residential location.To better support individuals searching for ways to overcome their addiction, United Healthcare created a United Behavioral Health division. The division provides confidential substance abuse and mental health services to ensure the highest potential for recovery possible. Explore additional ways United Healthcare can help you or a loved one heal from the effects of drug and alcohol abuse.

cigna addiction treatment coverageCigna prides itself on providing affordable, quality healthcare coverage to more than 190 million global customers. Depending on your chosen plan, Cigna will cover many of the addiction treatment expenses you’ll be responsible for when you choose an inpatient or outpatient facility.People looking to treat their addiction will be served by Cigna’s Behavioral Health division, which is dedicated to providing educational tools and resources for overcoming their substance abuse. Treatment coverage and costs greatly depend on your specific plan and where you’re located. Find out more about Cigna’s plans and levels of coverage for substance abuse treatment services.

Aetna insurance for addiction.While many insurance policies set a limit on the level of addiction treatment a person may receive, Aetna takes a more individualized approach. The company will work with an individual’s needs to determine how much coverage is needed for a successful recovery. They’ll also help people find therapeutic and aftercare support services in their community.Those with Aetna insurance may be covered for partial hospitalization, detox, inpatient rehab and continuing care, but it’s important to contact your provider to check what’s covered under your individual plan. Discover what other addiction treatment services could be covered under your Aetna insurance plan.

blue cross blue shield addiction treatment coverageNearly one in three people nationwide are covered by a Blue Cross and Blue Shield insurance plan, which is why the company is committed to providing excellent care to all of its customers. People wishing to heal from their toxic abuse patterns can be covered for detox services, inpatient rehab, or partial hospitalization – depending on the plan they’ve chosen. In addition, those who suffer from addiction have access to around-the-clock support and educational tools thanks to the company’s OneHealth mobile platform. Read more about the wide array of coverage options under a Blue Cross Blue Shield insurance plan.

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The Affordable Health Care Act (ACA, Or Obamacare)

Under the Affordable Health Care Act, an insurance applicant is no longer penalized for a pre-existing condition, allowing someone who is already battling an addiction to apply for a healthcare policy. Drug and alcohol disorders are included in the ten essential health benefits central to the ACA, which means that these policies must treat addiction and mental health disorders with the same level of importance as any other medical condition.

…Part of the promise of the Affordable Care Act has been the requirement that insurance companies provide coverage for diseases like alcoholism. Historically, private insurance companies either limited or denied access to treatment…we can [now] identify and intervene with individuals who are still in the abuse stage of the disease and not the addiction and dependent stage of the disease.

- Dr. Michael S. Shafer, Professor at Arizona State University and director of the Center for Applied Behavioral Health Policy

Depending on the plan you select, ACA-sponsored policies cover between 60 to 90% of the cost of rehab services incurred in a drug treatment center.

Health Insurance Marketplace Plan Types
Bronze plans 60 percent expense coverage
Silver plans 70 percent expense coverage
Gold plans 80 percent expense coverage
Platinum plans 90 percent expense coverage
Catastrophic 60 percent total average cost coverage*

*Available only to those under 30 years old or those with extending circumstances

Medicare And Medicaid

Federal and state-sponsored health benefits are available for rehab costs for specific segments of the population. These insurance programs can provide payment options for alcohol addiction treatment and each program has different requirements for eligibility.

To be eligible for Medicaid, you must be one of the following:

  • Over the age of 65
  • Under the age of 19
  • Pregnant or a parent
  • Within a specific income range

To be eligible for Medicare, you must be one of the following:

  • Over the age of 65
  • Disabled

Private Funding And Financing

Because the cost of rehab can be expensive, depending on the facility and length of stay, it may be necessary to secure private financing for treatment if you are uninsured and cannot qualify for federal or state assistance. Some addiction treatment centers may offer scholarships, so it’s a good idea to talk to the admissions office as soon as you decide on a treatment center.

If private funding is out of the question, or if you are unable to cover the cost of treatment upfront, some treatment facilities may offer financing plans that allow you to make payments after discharge. This arrangement is sometimes offered through a third-party lender that can create a loan package. Be sure to discuss financing options with any treatment center being considered.

If you have a savings account, an IRA, or a 401(k) plan, it may be necessary to take out some of those funds to cover a portion of the treatment program. Some people find their home has equity and can obtain an equity loan to use toward rehab services. This can be an important discussion to have with family members or stakeholders who are connected to these funds.

Fundraising Or Crowdfunding

Family members are often the biggest supporters when deciding to seek treatment. They may be willing to help manage the cost of attending so recovery can be the most important focus. For family members, it’s suggested that they make payments directly to the facility so there will be no question that the funds are being used as intended.

Some people find additional funds within material items the family may be comfortable with selling such as unused vehicles, computer items, and other items that are agreed upon.
Friends may also be able to help raise money for rehab costs using Crowdfunding sites like GoFundMe.

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State And Local Government Programs

Federally-funded, state-run drug and alcohol addiction rehabs can provide public assistance to those in need. Depending on the state, these programs may be a separate agency, or they may be included under a larger health or behavioral health department. They can offer both outpatient and inpatient care, as well as aftercare support services.

These public programs will have specific requirements to qualify for assistance, including proof of citizenship; proof of residence in that state; documentation of your addiction (either by a doctor, psychiatrist, or licensed counselor); and a demonstrated inability to afford other treatment options based on income and other factors. There is usually a waiting list to get into these programs, but most will offer some kind of support during the wait for an opening.

SAMHSA Grants

One source of federal funding for state addiction treatment programs is one of the block grants provided through SAMHSA. Specifically, the Substance Abuse Prevention and Treatment Block Grant (SABG) offers drug and alcohol prevention and treatment programs for specific segments of the population. A few examples of individuals who qualify for this type of grant are pregnant and postpartum women or intravenous drug users.

Explore These Featured Treatment Centers

Non-Profit Treatment Centers

There are non-profit addiction treatment programs available at little or no cost in most states. Many of these programs are “faith-based” in nature, meaning they focus more on using religious elements to help those struggling with addiction. Many of these programs often last between 6-12 months.

The Salvation Army has a faith-based program that requires no payment, but the participant must be willing to work a 40-hour week to pay for their room and board. The work usually involves physical labor within their warehouses sorting donated items or helping with administrative duties. This program has been described as helpful for many, however, not all faith-based programs engage in traditional treatment approaches that are commonly found in treatment centers. It is encouraged to reach out and contact them for specific information on how their program treats addiction.

Teen Challenge is a nonprofit that offers addiction treatment for teens and adults at a nominal cost. The facility’s cost differs from location to location, so check each local program to determine the cost of rehab through Teen Challenge.

Getting Started In Treatment

Ultimately, paying for an addiction treatment program is entirely possible. Once you’re ready to enter treatment, it is just a matter of gathering information and determining how to finance a life-changing road to recovery. Contact a treatment provider to discuss available rehab and financing options.

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Author

Travis Pantiel, LMHC, MCAP

Photo of Travis Pantiel, LMHC, MCAP
  • Travis Pantiel is a Licensed Mental Health Counselor and a National Board-Certified Counselor with specialized expertise in the co-occurring disorder treatment field.

  • More from Travis Pantiel, LMHC, MCAP

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