The cost of addiction can be incredibly expensive. Unfortunately, a good addiction treatment program can be pretty pricey as well. But it helps to consider the cost of treatment as an investment in the future. A future free from the bondage of drug and alcohol dependence.
Knowing how to pay for rehab can be tricky. Sometimes, the path to finally getting yourself or your loved one into treatment is so long and arduous that you haven’t even considered the cost of rehab. However, there are plenty of ways to pay for treatment. Because drug and alcohol addiction treatment is a health issue, the most obvious answer is to pay for rehab with health insurance. But navigating the process and finding out exactly what services your healthcare provider will pay for can be confusing
If you or your loved one have an issue with drug and alcohol addiction, we’ll tell you what your options are when it comes to paying for rehab.
In the eyes of the law, addiction is considered a disability. Like other disabilities, the law protects people with an addiction issue from being discriminated against at work and in the health industry.
Laws like the Affordable Care Act (ACA), Family Medical Leave Act (FMLA), and the Americans With Disabilities Act (ADA) are there to protect you and your loved ones.
This law protects people with addiction from discrimination at the workplace. For one, it disallows employers from turning down employees based on their current addiction situation. So, even if you’re not currently seeking addiction treatment, you can still apply for a job, and the employer cannot deny you the work. Unless, of course, you don’t meet their qualifications.
Secondly, the law prohibits employers from firing employees with an addiction problem. So, for example, if you’ve been working at your company for a while and became addicted to alcohol, under the law, your employer cannot fire you. The employer cannot discriminate against any employee with addiction, as they live with a disability. Such employees need inclusion in promotions, growth opportunities, bonuses, and team-building exercises.
This law mandates that health insurance companies cover mental health disabilities, including addiction treatment. However, while insurance companies must do this, they’re not required to pay for the entire cost of treatment. This means that your insurance may only pay a portion of your total cost of rehab. In these circumstances, you’ll need to cover the remaining cost.
Similarly, you can use your employer’s insurance to enroll in a rehab center because this law requires you to receive addiction treatment when necessary. A person may have to show a medical necessity in order to receive treatment. In this circumstance, detoxification is almost always covered, because it is a medical necessity to undergo a safe and supervised withdrawal from drugs and alcohol. However, the necessity of a full 30-day stay in an inpatient rehab facility may be up for debate.
Another law is the FMLA, which protects you and your loved one from being denied leave to seek treatment. The law has two critical stipulations:
Note that the FMLA law only comes into play if you’re seeking leave for treatment, not for any other reason. Therefore, taking a leave to abuse substances makes the law null and void, and your employer can fire or suspend you.
Another loophole in the FMLA leave is if your employer has a formal non-discriminatory substance abuse policy. In which case, they can let you go if you defy it. All in all, if you qualify for FMLA leave, you can take time for rehab and return to work with no issues from your employer.
There are two types of insurance you can use; private insurance and public insurance.
You should familiarize yourself with rehab services to know which ones your insurance will cover. These services include, but are not limited to:
Once you know what your insurance will pay for you can begin looking for an addiction treatment center that provides those services.
Private Health Insurance plans are typically divided into three different types; HMO plans, PPO plans, and POS plans.
HMO (Health Maintenance Organization) plans allow patients to choose their primary care physician and see that doctor for most of their medical needs. When seeking a specialist or physician outside of the network with an HMO plan, a referral is needed by the primary care physician.
HMOs have lower or no deductibles and overall coverage is usually a lower cost than PPO’s. HMOs cover healthcare costs for all in-network providers and services. Payers will usually be responsible for paying out-of-pocket if they seek care with a provider that is out-of-network.
PPO (Preferred Provider Organization) plans allow patients to see healthcare providers in and out of their network without referrals. This provides paters with more flexibility on what doctors and specialists they see, however, in-network providers are often less expensive.
PPO plans have higher monthly premiums and lower copays for treatments and services, but PPOs can have higher deductibles than HMO plans.
POS (Point of Service) plans are similar to HMO plans. The primary difference is that you can sometimes see care providers outside of your network and pay at the “point of services”. Different insurance companies provide varying forms of POS plans, so check with your specific insurer about what type of addiction treatment this plan will cover.
The most common type of private insurance is the insurance provided through your employer. Employers typically cover their entire team under a group plan which, as the law requires, will cover addiction treatments.
If your employer doesn’t automatically include you in the company’s health coverage, you can approach them and request coverage. Once you get this coverage, you’ll be able to seek more treatment options than with public insurance coverage.
The second most common type of insurance is one provided through a parent. Young adults can use their parent’s insurance as long as they are listed as a dependent. As a dependent, a person should have the same coverage as their parents. A child can be listed as a dependent on their parent’s health insurance plan until they reach 26 years old, with some caveats.
Private insurance can be costly, but it compensates for more treatment options, meaning you can pay for more than one treatment program. But, this doesn’t mean your employer’s insurance will pay the total amount for your treatment.
Instead, you’ll need to cover a deductible, then the insurance will cover the rest. Additionally, you’ll have to check that your rehab center of choice accepts your private insurance. Remember, not all rehab centers use the same insurance, so it might be best to pick a rehab that accepts your insurance.
Below we’ve listed some more information on each of these carriers handles treatment for Alcohol Use Disorder and Substance Use Disorder.
Aetna takes an individualized approach to addiction treatment. Rather than setting a limit on how much care a person can receive, Aetna works to determine how much coverage is needed for a successful recovery. They can also help you find therapeutic and aftercare support services. People with Aetna insurance may be covered for partial hospitalization (PHP), detox, inpatient rehab, and continuing care. However, the specifics of a person’s individual plan will determine their coverage.
Learn More About Paying for Rehab With Aetna Insurance.
Anthem is a licensee of the Blue Cross and Blue Shield Association and provides insurance to people in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, Nevada, New Hampshire, New York, Ohio, Virginia, and Wisconsin. Anthem Blue Cross Blue Shield’s Behavioral Health programs include mental health and substance abuse benefits as part of its insurance plans. Anthem typically covers drug and alcohol rehab, but the extent of coverage depends on the patient and their specific insurance plan.
Beacon Health Options provides health insurance coverage for over 50 million customers and provides benefits for over 350 employers. Beacon specializes in providing care for people with mental health and substance abuse disorders. Because of this, many other health insurance providers make deals with Beacon Health Options to provide behavioral health and substance abuse treatment to their clients.
Learn More About Paying for Rehab With Beacon Insurance.
Nearly 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.
Cigna prides itself on providing affordable, quality healthcare coverage to nearly 86 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.
Learn More About Paying for Rehab With Cigna Insurance.
Also known as the Empire Plan, The New York State Health Insurance Plan (NYSHIP) came into existence in 1957 with the objective of giving New York State employees access to affordable world-class medical services. NYSHIP provides wide-ranging insurance coverage to over 1.2 million employees, retirees, and their loved ones, both at the state and local government levels.
The Empire Plan provides coverage for substance abuse treatment. The extent of benefits you will receive is to a large extent dependent on your chosen plan.
Learn More About Paying for Rehab With NYSHIP Insurance.
Many people’s policies under United Healthcare cover at least a portion of addiction treatment. This often includes detoxification and inpatient rehab.
The amount that United will cover depends on the patient’s individual plan level and the state where they live. In order to address the growing concern regarding mental health and substance use issues, United Healthcare created a United Behavioral Health division to focus specifically on Behavioral Health issues.
Learn More About Paying For Rehab With United Healthcare.
For those with public insurance like Medicaid, you can either get into the state-level program or federal level program. Both programs cover addiction treatment, but the state-level one covers more specifics.
If you’re 65 years and older, you’re eligible for Medicare, while Medicaid covers people living with disabilities and those that make less money. So, as you can see, there are several options for paying for rehab with insurance.
However, no matter the rehab pricing, your public insurance will only cover part of the treatment, and you’ll foot the rest from your pocket.
Depending on the rehab center you enroll in, the pricing will vary. The type of treatment program you choose will also significantly affect the cost of rehab. The program you enroll in relies on your addiction and history, dictating the suitable treatment plans and length of treatments.
For example, if you experience a long-term alcohol addiction, it may affect your overall health, increasing your treatment period. Moreover, if your addiction results in severe withdrawals, you will need to undergo a medical detox program prior to the rehab process.
Choosing an outpatient treatment will cost relatively less than an inpatient program due to their dynamics. For one, an outpatient program doesn’t require you to stay within the center’s premises. Instead, you only come in for your appointment several times a week and don’t use many of the center’s facilities.
On the other hand, an inpatient program means you stay within the premises; you eat, sleep and get treatment there. So, you receive 24/7 care, therapeutic programs, and other customized programs; hence, the cost increases. Besides, accounting for these and other primary factors, like location and pricing, rehab can cost anywhere from $2000- $80,000. Paying for rehab with insurance can lower this price by half, allowing you to afford treatment.
In some cases, depending on your insurance plan and rehab center, your insurance can cover all your treatment options. That being said, ensure to do your due diligence about what your plan covers to get the most out of your addiction treatment.
First, rehab treatments are broad, from detoxing, medication, training, rehabilitation, and more. Second, each treatment varies depending on your addiction history, type of addiction, and overall health status.
Third, you can only know which treatments to get after consulting an addiction caregiver from the rehab.
A caregiver can prescribe certain medications to curb symptoms associated with your treatment plan. For example, if you’re detoxing, you’ll experience nausea, headaches, and other discomforts, which you can only alleviate with medication.
Not to worry though, regardless of your insurance, they will pay part of the medication cost.
Detoxing is critical in your recovery process, and it involves many complicated stages. As part of your treatment, your insurance will cover your detox partially or entirely.
As with any mental disability, recovering addicts will need guidance and counseling to get to the bottom of the issue and strengthen recovery. Ergo, counseling is a fundamental part of the treatment which your insurance will cover.
Other times, you may need aftercare counseling; so, if your insurance covers rehab aftercare, you may be able to take advantage.
if you have a severe addiction, an inpatient program may be right for you. Here you’ll receive round-the-clock care and enjoy the facility’s amenities. In addition, because this program works like a hospital program, your insurance will pay a certain percentage.
Some insurances only cover outpatient care, so if this is you, you’ll benefit more from outpatient care than inpatient care. Of course, depending on your needs, you should get the insurance that will take care of you.
Rehab centers may offer aftercare services to ensure you’re abiding by your recovery process and offer support. In such cases, if your insurance covers rehab aftercare, it’ll cover part of the total amount.
Rehab payment options make it convenient for you to receive and pay for treatment on time. Although you can start immediate treatment if you have insurance cover, you’ll need to pay the total cost at the end of your treatment.
In such a case, you’ll need to complete the payment at the end of your treatment, before discharge, or sometimes after treatment. Of course, depending on your agreement with the treatment center.
Regardless, there are several ways to foot the remaining payments on time. Here are some options:
You can invite your friends, work colleagues, and family to fundraise for your treatment. If possible, do this towards the end of the treatment, because your loved one will have witnessed your progress, encouraging them to fundraise.
Also, getting treatment before paying the total amount makes you accountable, motivating you to find ways to pay.
Crowdfunding can also be online through GoFundMe. You set the account, and anyone who sees it can contribute however much they wish. The beauty of this online fundraising is that it’s international.
Believe it or not, some rehab centers offer treatment scholarships where you don’t have to pay a single dime. Non-profit organizations make most of these scholarships, but even the standard centers can provide free treatments.
If you’re ineligible for public insurance and don’t have private insurance, an excellent option for how to pay for rehab is through public programs. These programs are subsidized, if not free, for eligible participants.
The only downside is there are specifications for who can enjoy them, such as the inability to seek treatment options and addiction history.
Also, there’s a long waiting list due to their benefits, meaning you’ll stall your treatment if you can’t afford other treatment centers. Besides that, these government programs offer aftercare, so your treatment doesn’t necessarily end when you leave the program.
You’ll still receive support to get you on your feet independently.
Please remember that your insurance will only cover part of your rehab treatments. If you have multiple treatments, your insurance will partially pay for each one, if not all.
So, while rehab payments are available through insurance, you also need to have some cash saved up. This will enable you access to treatment so you can get on with your life.
Nobody actively seeks to have any form of addiction; it’s a disability that can unravel the addict’s and loved one’s lives. However, with the support of family, friends, and rehab centers, you can recover from addiction and get your life back.
Don’t worry about how to pay for rehab. This article has guided you on paying for rehab with insurance and the laws protecting you during your treatment.
Call us today to enroll in our rehab center and start your recovery journey.