Does Insurance Cover Rehab?

A group of people holding hands during group therapy

If you or a loved one are dealing with addiction and considering rehab, then the financial implications of this important decision are likely weighing heavily on your mind. Fortunately, while insurance plans can vary significantly, most cover at least some portion of addiction treatment. Rehab is also usually categorized as high-intensity residential treatment. Here we’ll break down the type of insurance coverage you can expect for residential treatment, as well as how to access your coverage.

Is Rehab Covered by Insurance?

Yes, rehab or residential treatment is typically covered by health insurance plans. Under the Affordable Care Act, addiction treatment is considered an essential health benefit, which means that all major medical plans must cover it. This includes employer-sponsored insurance, Medicaid, Medicare, and individual coverage purchased through the health insurance marketplace.

The amount of coverage and the specific services that are covered can vary significantly depending on your provider, plan type, and policy limits. Generally speaking, most plans will cover at least some portion of residential treatment and outpatient programs, as well as drug-related counseling. However it’s important to note that the majority of plans will not cover the full cost of rehab.

Cost of Inpatient Rehab

The cost of inpatient rehab can vary significantly depending on the length of stay and the services offered. Generally speaking, most 30-day stays at a residential treatment facility range from $9,000 to $30,000 depending on the level of the center’s amenities.

Cost of Outpatient Rehab

Outpatient rehab usually costs less than inpatient treatment, but can still be quite expensive. The exact cost will depend on the type and duration of services offered, as well as any additional therapy or counseling sessions required. Generally speaking, outpatient rehab programs range from $1,000 to $15,000 depending on the level of care needed.

Addiction Treatment Services Not Covered By Insurance

Not all addiction treatment services are covered by health insurance plans. For example, most policies will not cover the cost of an intervention specialist or a sober living home. Some may also not cover the cost of detoxification-specific medications. Additionally, many plans will not cover the use of holistic-only services.

How to Access Your Rehab Insurance Coverage

The first step in accessing your coverage is to contact your insurance provider directly and ask about your specific plan details. When speaking with a representative, it’s important to have all the necessary information handy such as policy numbers, the name of your health plan, and the type of coverage you have. Additionally, you should ask about any pre-authorizations or referrals needed to access your rehab coverage.

Once you have all the necessary information, it’s important to shop around for a rehab center that is in-network with your insurance provider. This is important because in-network providers have already negotiated their prices with your insurance provider, so you will likely save money. Additionally, out-of-network providers may not be covered by your plan.

Can You Go to Rehab Without Insurance?

Yes, it is possible to go to rehab without insurance. Many private treatment centers offer a variety of payment options for individuals who do not have access to insurance or have limited coverage. Some facilities offer sliding scale rates based on income, while others may provide financing, scholarships, or payment plans. Additionally, some states offer programs that can help cover the cost of rehab for those without insurance. Veterans of the Armed Forces of the United States have access to residential treatment and outpatient rehab with minimal cost through the Community Care Network.

If you are ready to take the next step in your recovery journey and seek treatment, we can help. Williamsville Wellness is in-network with a majority or private health insurance companies and we also offer self-pay options. Contact us today to verify your benefits and get started.