January 24, 2017
Finding a way to pay for addiction treatment can be difficult for people looking to start their journey to recovery. With residential rehabs costing around $20,000 for 30-day programs and $60,000 for 60-to-90 day programs, treatment may seem like an impossible option for those seeking help for an addiction to drugs or alcohol. Although outpatient drug treatment programs–where clients remain at home and attend daily sessions–are cheaper than inpatient or residential programs, costs can still range from $5,000 to $10,000.
For those who are new to treatment or looking for ways to pay for an outpatient or inpatient program, insurance coverage, Medicaid or Medicare, and the Affordable Care Act are all options that provide coverage for rehab. Don’t let the cost of treatment deter you from getting the help you need.
For more options about treatment costs and coverage, call our 24-7 call center at (844) 318-0070. Our addiction specialists are standing by for your call so they can help you choose the best option for recovery.
Private Insurance Coverage for Treatment
Many private insurance companies provide medical coverage for addiction treatment. Depending on the individual’s health insurance plan, the client will be eligible for a certain percentage of coverage. For example: Insurance companies offer different types of plans, including a Health Maintenance Organization (HMO) plan, a Preferred Provider Organization (PPO), and an Exclusive Provider Organization plan (EPO). Within each plan, an annual deductible and co-payments for doctor visits are often required, depending on medical expenses and your primary care provider.
According to Forbes, America’s biggest health insurance providers include United Healthcare, Blue Cross Blue Shield, Aetna, Cigna, and Humana. For more information about coverage for drug rehab, contact the insurance provider for specific details about your network coverage and which type of treatment you are eligible for.
Here are specific details about some of the insurance company’s coverage for outpatient care or inpatient drug rehab.
UnitedHealthcare: United covers detoxification, alcohol and drug treatment when Medicare coverage criteria are met. Therefore, if the treatment services are covered by Medicare, then it can also be covered by United. So, United may cover a seven-day detox program for an acute addiction, and outpatient care or inpatient care at a psychiatric hospital for 190 days, but not residential treatment since it’s not usually covered by Medicare. Residential treatment is a 45-90 day program where clients live at the facility they are being treated at whereas outpatient services are shorter and don’t provide a residence. Check out UnitedHealthcare’s guidelines for addiction treatment eligibility and coverage.
Blue Cross Blue Shield: Anthem Blue Cross behavioral health coverage provides both mental health and substance abuse treatment at contracted facilities. For more information about its substance abuse coverage and eligibility, click here.
Aetna: Aetna’s behavioral health program not only provides financial support for substance abuse, but it also offers an Employee Assistance Program (EAP). Individuals enrolled in this program gain the flexibility of keeping their job while seeking substance abuse treatment. For more information about Aetna’s behavioral health program and coverage, visit Aetna.com.
Cigna: Depending on your family or individual plan, Cigna provides coverage for outpatient and inpatient treatment services. Cigna’s website provides a wide range of treatment centers located all over the US for its clients. These treatment centers are tailored to meet specific needs such as adolescent teen rehab, dual diagnosis, and LGBTQ+ rehabs. Check out the locator here.
Humana: Humana provides drug and alcohol treatment coverage for in-network facilities, which are facilities that have an agreement with the provider to provide coverage at a certain cost. To check which facilities are in your network, call your provider for more information.
Affordable Care Act (Obamacare)
The Affordable Care Act, informally known as Obamacare, provides subsidies to allow people to purchase insurance on the individual market. The law also enacted several health care reforms that broadened access to insurance. For example, people will pre-existing conditions can not be denied coverage.
Every year, during open enrollment, people can shop for affordable insurance within or outside of the health insurance marketplace, and qualify for Medicaid. Deductible, co-payments, and other out-of-pocket costs depend on the individual or family’s salary.
Generally, mental health services and addiction treatment are covered under the Affordable Care Act. Substance abuse treatment falls under the 10 essential health benefits covered by the ACA. If you are insured on the individual market, check with your healthcare provider to get more information about out-of-pocket fees, and in-network treatment services. Find more information about mental health and substance abuse services and eligibility here.
The Family and Medical Leave Act (FMLA)
The Family and Medical Leave Act (FMLA) provides certain employees with up to 12 protected weeks of leave a year for a family or medical emergency. During this time, employers are required to keep health benefits as if the employee is still working, according to the U.S. Department of Labor.
FMLA coverage applies to the following:
· The birth of a baby and to care for a newborn baby
· To care for a sick family member
· Any period of treatment at an inpatient clinic, hospital, hospice, or residential care
· Any absences to receive multiple treatments by, or on referral, a healthcare provider.
Although health benefits are maintained for employees protected by FMLA, some jobs may not pay an employee during their leave. If you are eligible for FMLA coverage to balance your job and personal life while getting addiction treatment, read more about the coverage here.
Alternative Ways to Pay for Drug Rehab
SAMHSA Grants: SAMHSA has many funding opportunities for those struggling to pay for drug rehab. The Tribal Action Plan (TAP) gives federally recognized tribes the right to protect their community against drug and alcohol abuse. For help applying for SAMHSA grants, visit Grants.gov.
Sliding scale fees: Many treatment centers offer payment plans based on the client’s income. When visiting a local treatment facility, ask about affordable payment plans that fit into your budget.
Nonprofit treatment programs: The Salvation Army is a faith-based program located in all major US cities. The program allows clients to work for the Salvation Army for six months while they are receiving treatment. During that time, clients are required to stay at least six months in the recovery program to receive therapy and educational training. Currently, the Salvation Army has about 200 drug treatment programs in the US.
Seeking Help for Addiction
Paying for rehab services doesn’t have to be the deciding factor when seeking help from substance abuse. With health insurance, federal and state-funded grants, and nonprofit drug rehab programs, anyone can have the opportunity they need to take back control of their life. For more information about treatment, insurance coverage, and payment plans, contact us today.