Getting Drug and Alcohol Rehab Treatment When You Don’t Have Insurance
What is Drug and Alcohol Rehab Treatment?
Drug and alcohol addiction treatment provides professional rehabilitation services to those who struggle with chemical dependence and other substance abuse issues.
Addiction treatment can be expensive, especially for those who are either uninsured or underinsured. Unfortunately, finances often act as a significant barrier to care for many people who need addiction treatment. However, there are many resources to assist those who are under - or uninsured to help them gain access to treatment.
How Do I Get Immediate Treatment?
Unfortunately, many people may hesitate to seek treatment because they don’t know how to get drug rehab without insurance. While the cost of alcohol rehab and drug addiction treatment can be a burden for many, it is important to seek treatment immediately in acute situations, regardless of whether you have insurance.
Acute situations (emergency situations when treatment should be sought immediately) include cases of overdose, suicidal thoughts, or other medical emergencies precipitated by drug or alcohol addiction. There are many things you can do if you or a loved one are in acute need of substance abuse rehabilitation, even if you have no insurance coverage.
In acute situations, call 911 or go directly to a hospital or emergency facility. Focus on saving the life first and figure out finances later. After the emergency has stabilized, you can contact various resources for assistance, which hospital administrative staff may direct you to.
How to Get Treatment Without Health Insurance?
While every state is different, most have some type of financial assistance available for those who are uninsured and need low-cost or free drug rehab programs.
Another source for information is a simple Google search. Type in your state, county, or city and search for low-cost local mental health and substance abuse programs and services. If you are in a crisis but non-emergency situation (such as feeling like you may relapse or overdose), consider searching for a local crisis hotline and calling them immediately.
As much as possible, carefully consider the quality of the treatment-related information you find via internet resources, since not all the information will be legitimate. In some instances, the validity of such information may be more inherently trustworthy—for example, a listing of treatment resources maintained on a site with a .gov domain. You may also want to contact your general community resource center to see if they can provide you with referrals or more information.
There are many things you can do if you or a loved one are in an acute situation and need drug rehab, even if you have no insurance coverage.
Whoever you choose to contact, be sure to provide them with as much information as possible about your situation to ensure that you get access to the most appropriate care, treatment, and resources possible. For instance, specialized programs and resources are available to certain populations. There may be additional programs offered to you or you may be able to receive expedited treatment and services if you:
- Are under the age of 18.
- Are older than 65.
- Are pregnant.
- Are homeless.
- Have severe medical problems.
These programs may also provide same- or next-day services in acute or emergency situations.
How Do I Sign Up for Insurance?
Another common question among the uninsured seeking drug addiction treatment is “How do I get insurance to pay for drug rehab?”
Even if you are currently uninsured and unemployed, you can still sign up for insurance and, depending on your income, it may be at no cost to you. The Affordable Care Act of 2014 requires that all marketplace insurance plans provide coverage for substance abuse and mental health treatment services. These plans cannot deny coverage for mental health or substance abuse issues, even if they are considered a pre-existing condition.1
For more information on the Affordable Care Act and how it protects your rights to insurance coverage to help pay for the cost of drug and alcohol rehab, click here.
The Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008 also provides some protection for those who need substance abuse treatment. This law requires that health insurance companies provide the same level of coverage for mental health and substance abuse services as they do for primary care. 2
To learn about your low-cost insurance options, you can either visit healthcare.gov, conduct another Google search for state insurance options, or call your local county office to find out where you can go to sign up for Medicaid or Medicare programs (if eligible). To help remove barriers to care, these programs are designed to be easy to sign up for; each state often has representatives who can help you sign up at no charge.
What Are Medicare and Medicaid?
Many people don’t fully understand the differences between Medicaid and Medicare and which one is right for them, so here’s a quick breakdown of both programs: 3,4
- Medicaid is a federal- and state-funded program that was originally created in 1965 to provide health insurance for those with very low income. While coverage varies depending on your state and Medicaid insurance provider, substance abuse treatment is typically covered, since the Affordable Care Act requires that all insurers, including Medicaid, provide coverage. However, not all treatment facilities will accept Medicaid insurance coverage as payment, so check with the facility you plan to attend to make sure it will be accepted.
- Medicare is another federal- and state-funded program established in 1965 that provides insurance for those older than 65 or who have a severe disability, regardless of income. In some cases, people qualify for and receive both Medicaid and Medicare for health insurance coverage. Medicare provides coverage for substance abuse and addiction treatment in the following circumstances:
- When a doctor declares that substance abuse treatment is medically necessary or sets up the plan of care.
- When treatment is provided by a Medicare-participating facility or provider.
Inpatient addiction treatment is covered by Medicare Part A, and out-of-pocket costs are the same as those for hospital stays. However, Medicare will only cover up to 190 days in a psychiatric hospital per lifetime.4 This rule does not apply to general hospitals.
Outpatient treatment—such as counseling, pharmacological treatments administered at a doctor’s office, and patient education—are all covered under Medicare Part B at an 80-20 rate, meaning that Medicare pays 80% and the consumer or supplemental insurance is responsible for the remaining 20%. Prescription medications are covered under Part D. However, Part D will not cover methadone or buprenorphine for treating addiction. Methadone may be covered under Part A if administered at a hospital.4
There may be free drug rehab programs and community health centers able to provide these medications at little to no cost for those in need.
Even when people have insurance coverage, there may be difficulties in getting insurance to pay for certain aspects of drug rehab and treatment. While laws are in places that require insurers to provide coverage, patients may still have difficulties getting coverage for medication-assisted treatment such as buprenorphine and methadone. Some commercial insurance companies will provide coverage for these medications in certain cases, but it may be limited in scope and others may not cover it at all. There may be free drug rehab programs and community health centers able to provide these medications at little to no cost for those in need.2
Getting Treatment with COBRA
Job loss brings with it anxiety and stress, but there are options for maintaining your health insurance coverage. If you lose your job-based coverage, you may be offered COBRA (Consolidated Omnibus Budget Reconciliation Act) continuation. COBRA provides people who have lost their jobs, and their families, with the choice to temporarily retain the group health coverage they previously had under their employer’s group health plan.
In order to be eligible for COBRA, you must have insurance that is covered by COBRA, a qualifying event (including job loss), and be a qualified beneficiary. Your former employer will inform you of your eligibility to maintain your insurance through COBRA. You will have at least 60 days to decide if you would like to continue your coverage. Once you have decided to continue your coverage, you will sign up for COBRA, and you will be responsible for paying the entirety of your premium (what was previously covered by you and your employer).
Once you are enrolled in COBRA, you will have the same coverage you had with your previous employer. That includes any mental health and substance misuse treatment that was covered through your insurance plan. If you are pursuing treatment while covered by COBRA, you will be responsible for paying your premium. Although it might be slightly more complicated than it was when you were employed, losing your job does not have to mean that you cannot receive the substance abuse treatment that you need.
The first question often asked by those in need of treatment is often, “How much does drug rehab cost?” The exact price can vary significantly depending on many factors. Typically, the biggest factor involved in determining the cost of treatment is the type of treatment program a person chooses to attend.
There are many different types of drug rehabilitation facilities and the cost varies greatly depending on which facility you attend. Some of these choices include:
- Medical detox centers.
- Inpatient and residential treatment centers.
- Intensive outpatient programs (IOP).
- Partial hospitalization programs (PHP).
- Standard outpatient treatment.
Generally, outpatient rehabilitation options will be relatively less expensive than their inpatient treatment counterparts. Inpatient treatment centers tend to be more expensive because the person lives in the facility and receives daily meals, therapy, medical care, and supervision. Depending on the individual facility and the person’s length of stay, inpatient treatment can cost as much as tens of thousands of dollars:5
- A 7-day detox can run up to $7k.
- Depending on the duration of your stay, rehab may range from about $14k to $58k.
Additional Factors Impacting Price
Other factors that may affect the cost of drug rehab include:
- Treatments offered and used: Different treatment centers have additional staff, equipment, and specific expenses associated with each service provided, which contributes to the cost. Another consideration is the precise number and type of services a patient uses—meaning the cost for one person may be different from the cost of another person at the same treatment center. One example of this is pharmacological treatment, which creates an additional cost for those who need to take medications.
- Other services and amenities provided: Many treatment centers provide additional services and amenities that increase costs. Private, luxury, and executive rehabs, in particular, are likely to cost significantly more because they typically offer relatively high-end services and desirable amenities. Examples of services and amenities that may increase the cost of rehab include:
- Private rooms.
- Gourmet meals.
- Massage and spa treatments.
- Swimming pools and hot tubs.
- Fitness centers.
- Location of the facility: The cost of alcohol rehab and drug addiction treatment can also vary depending upon the location of the facility. Treatment may cost less in certain areas than others and is typically more expensive in desirable, vacation-like locations such as beaches and mountain ranges. If you do have insurance, you may also have more out-of-pocket costs if you choose to attend an out-of-state facility where your insurance coverage may be reduced.
- Duration of the program: The duration of the program you choose will also affect the cost of your treatment. On average, treatment lasts around 30–90 days, but in severe cases, people may participate in a program for a period of 6–12 months, possibly longer. Generally, the longer you attend rehab, the higher the cost will be.
Many rehab facilities will work hard to help you afford your stay in treatment. When you call to get help, ask them about options like:
- Sliding scales. Some facilities adjust the cost of treatment based on the client's income/need.
- Financing options. Not all rehabs will require you to pay the full cost upfront. You might be able to work out a system where you can pay over time, lessening the immediate financial burden.
- Loans. Some treatment centers offer loans to help you afford the care you so desperately need.
- Scholarships. Some centers will waive all or part of their program fee for those in need. Ask specific programs if they offer this benefit and if so, if you qualify.
Don't assume you can't pay for your treatment because you're currently uninsured. Always ask a potential facility about any options they have to make your care more affordable. It might help to have documentation of your income, such as a recent pay statement, prior to calling.
Getting a Professional Assessment
If you don’t know how severe your addiction is or what type of treatment options may be right for you, talk to a doctor, counselor, or other treatment professional who can evaluate your situation and make appropriate treatment recommendations. Consider getting a professional Screening, Brief Intervention, and Referral to Treatment (SBIRT) from a state-certified medical professional or credentialed substance abuse treatment professional.
The SBIRT is an evidence-based early intervention approach that helps identify problematic substance use behaviors and provides effective intervention strategies before the need for more extensive substance use disorder treatment arises. The SBIRT begins with an assessment (screening) for risky substance abuse behaviors. It is then followed by a brief intervention and referral to treatment or therapy when necessary.6
There are many resources available to help find low-cost or free inpatient drug and alcohol rehab centers. These resources typically provide contact information, links to websites, and up-to-date descriptions of the programs and services offered at each facility. Other resources and hotlines are available for times of crisis and acute need.
Some of the treatment-finder resources include but are not limited to:
- SAMHSA’s Behavioral Facility Tool. Designed to be a confidential source of information for those seeking addiction treatment in the United States or its territories. SAMHSA 24-hour helpline: 1-800-662-HELP (4357).
- Boys Town National Hotline. A 24-hour crisis line staffed by counselors to provide support and resources: 1-800-448-3000.
- National Runaway Safeline. A hotline providing confidential and nonjudgmental support for those who are contemplating running away or who have already done so: 1-800-RUN-AWAY (786-2929).
- Alcohol & Drug Help Line. A 24/7 treatment referral helpline for those suffering from alcohol and drug addiction, which may be able to help you locate low-cost or free drug rehabilitation centers near you: 1-206-722-3700.
- National Suicide Prevention Lifeline. This is a free, confidential support line available 24/7 to those in distress, crisis, or need. It provides crisis services, emotional support, and resources to those thinking about or impacted by suicide: 1-800-273-8255.
What to Know Before You Call
When you call to find treatment, you'll want to gather some information before picking up the phone, especially if you're calling for a loved one. Information to prepare includes:
- How long the substance abuse has been occurring.
- An estimation of the amounts of drugs or alcohol being used.
- If prescription drugs are involved, the average dose being regularly used.
- Any medical issues, such as disease or infection.
- Any medications currently being taken.
- Previous attempts at treatment.
- Whether medical detox is needed (Note: This is usually recommended for those dependent on alcohol, sedatives, or opioids.)
- The existence of any other mental health issues, such as anxiety, depression, or any process disorders such as compulsive gambling.
- Whether travel to another city or state may be arranged.
- The date you want treatment to begin.
As much information as you can gather will help you to have a productive phone call and get treatment started right away.
A variety of community support groups are available to those struggling with substance use disorder.
Some of the groups following a traditional, 12-step approach, include the following:
- Cocaine Anonymous (CA). A global, 12-step program for both men and women suffering from cocaine addiction. Membership is free; the only requirement to join is that people have a desire to stop using cocaine and other drugs and alcohol.
- Crystal Meth Anonymous (CMA). A fellowship of people who come together to support one another in quitting crystal meth through the 12-step process. There are no membership dues and the only requirement to join is a desire to stop using.
- Narcotics Anonymous (NA). An international 12-step peer-support group for those who are pursuing a drug-free lifestyle. Membership is free and regularly scheduled group meetings are available at a variety of locations around the world. If there is not a meeting in your area, contact NA to learn how you can start one.
- Alcoholics Anonymous (AA). The founding 12-step fellowship program first established in 1935, this international support group is available to help people achieve and maintain sobriety through peer support and following the traditional 12 steps. Membership is free; the only requirement to participate is a desire to stop drinking and using other mind-altering substances.
There are also support groups that provide an alternative to the 12-step philosophy, including the following:
- SMART Recovery. An empowering, worldwide recovery support group based on the latest scientific research. Membership is free and services are provided online and in face-to-face meetings.
- Secular Organizations for Sobriety. A non-profit network of local support groups to help people recover from addiction. There is no charge to attend a meeting, and if there isn’t one in your area, information is available on its website about how you can start one on its website.
- LifeRing Secular Recovery. An abstinence-based peer-to-peer support network to help people obtain and maintain sobriety. It is a secular community whose focus is on empowerment and sharing. Meetings are available in person as well as online.
- Healthcare.gov. Mental Health and Substance Abuse Coverage.
- Substance Abuse and Mental Health Services Administration. (2015). Insurance and Payments.
- U.S. Department of Health & Human Services. (2015). What is the difference between Medicare and Medicaid?
- Medicare Interactive. Medicare Coverage of Treatment for Alcoholics and Drug Abuse.
- American Addiction Centers. 2017.
- U.S. Department of Health and Human Services. (2015). Screening Brief Intervention and Referral to Treatment (SBIRT) Services.