How to Pay for Addiction Treatment Programs
Addiction treatment programs can be expensive, but many insurance health plans include drug rehab coverage. This can help to offset the cost of addiction treatment services. This page will help you understand more about:
- Types of addiction treatment that are covered by healthcare benefits.
- Information on insurance mental health coverage.
- Does insurance cover drug rehab?
- How to check your insurance benefits.
Substance use disorders (SUDs) can have negative consequences on a person’s health, leading to physical and psychological health issues and causing long-term changes in the brain.1,2 However, insurance providers are recognizing that treating SUDs can lead to reduced costs in the long run, so addiction treatment coverage is becoming more prevalent.3 Federal laws mandate that insurance plans offer equal coverage for physical and mental health disorders.4
What Types of Addiction Treatment are Covered by Insurance?
In 2018, 91.5% of Americans had some form of healthcare coverage.5 Different plans may offer varying levels of coverage. Treatment types that may be covered include the following:
- Medical detox, where medical staff is available around-the-clock to provide monitoring and medications to ease the process of getting rid of any drugs in the body.1, 2, 6 Withdrawal can be very uncomfortable or even dangerous, and medications can make detox safer and more comfortable.7 Detox isn’t a substitute for treatment. For best results, detox should be followed by additional services, such as inpatient or outpatient treatment.2, 6
- Inpatient treatment, which involves staying at a facility for the duration of treatment. Staff will provide therapy and support to help people understand their SUD, address the root causes, and develop the skills they need to live in recovery.2, 7, 8 Staff is available around-the-clock for monitoring and support and medical care is provided if needed.7
- Outpatient treatment, which is offered in a clinic setting that allows people to attend to their daily responsibilities while receiving treatment. A continuum of services is designed to meet each person's needs as they progress in recovery.2, 7 Many of these services take place in a group setting, providing a similar benefit as inpatient care but on a less intensive level.2
- Integrated treatment, which is necessary to treat people with co-occurring psychiatric disorders and SUDs.1 In some cases, treating mental health disorders with medications can help support recovery.7, 8
- Behavioral counseling, which can take place in various settings, including individual, group, and family sessions.2 These sessions help people learn how to prevent relapse, develop the skills required to stay sober, manage triggers, communicate effectively, solve problems, and function without returning to substance use.2, 7, 8
Verify your Insurance
Insurance Coverage for Drug and Alcohol Addiction Treatment Programs
Rehabilitation insurance coverage can vary widely depending on which plan you have. However, federal laws have been enacted to expand access to treatment insurance coverage.4, 8, 9 The Affordable Care Act (ACA) requires plans to offer alcohol and drug rehab insurance coverage.4 The ACA and mental health parity laws also require that drug and alcohol rehab insurance coverage is equivalent to coverage for physical health disorders.4, 8, 9 SUD treatment is viewed as an essential health benefit, which must be covered under all Medicaid and marketplace insurance plans.4, 9 Inpatient and outpatient rehab insurance coverage is included under this benefit.9 Medicare also covers SUD treatment that is medically necessary.10
Treatment should be tailored to the needs of each person. The length of treatment is dependent on several factors, including the severity of the SUD and other needs.2 Studies show that spending at least 90 days in treatment leads to better recovery results.2 Inpatient treatment ideally lasts between 3 and 6 weeks.2 The amount of treatment that insurance will cover can also vary, depending on your policy. Most policies will cover treatment that is shown to be medically necessary, although you may need to obtain authorization. The best way to find out if your treatment will be covered is to contact your insurance company by calling the number on the back of your card to discuss your benefits.
Does My Insurance Cover Addiction Treatment?
Drugabuse.com is a subsidiary of American Addiction Centers (AAC), a leading provider in addiction treatment. At AAC, we know firsthand the toll and devastation addiction causes. That's why AAC works to make treatment accessible for every person who needs it. We accept many insurance plans from the top insurance providers including Aetna, BlueCross BlueShield, Humana, and Kaiser Permanente.
AAC provides a process for easy verification of insurance benefits so you can quickly see whether your insurance plan will cover some or all of your treatment costs at an American Addiction Centers facility.
Navigating insurance coverage for SUD treatment can be confusing, but it can help to offset the huge cost of seeking addiction treatment. Federal laws have expanded insurance benefits to include more robust coverage for mental health and SUD care. Various forms of treatment are available, and insurance generally does offer some coverage for care. Before seeking treatment, checking your benefits and verifying that the facility you choose accepts your insurance makes it easier to start your recovery journey.
- National Institute on Drug Abuse. (2018). The science of drug use and addiction: The basics.
- National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (3rd edition).
- Substance Abuse and Mental Health Services Administration. (2016). Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health. Washington, DC: U.S. Department of Health and Human Services.
- Abraham, A.J., Andrews, C.M., Grogan, C.M, D’Aunno, T., Humphreys, K., Pollack, H.A., Friedmann, P.D. (2017). The Affordable Care Act transformation of substance use disorder treatment. American Journal of Public Health, 107(1), 31-32.
- United States Census Bureau. (2019). Health insurance coverage in the United States: 2018.
- Center for Substance Abuse Treatment. (2006). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series 45, DHHS Publication No. (SMA) 06-4131. Rockville, MD: Substance Abuse and Mental Health Services Administration.
- National Institute on Drug Abuse. (2019). Treatment approaches for drug addiction.
- Substance Abuse and Mental Health Services Administration. (2020). Behavioral health treatments and services.
- Healthcare.gov. (n.d.). Mental health & substance abuse coverage.
- Centers for Medicare and Medicaid Services. (2019). Medicare coverage of substance abuse services.