Most insurance plans cover at least a portion of treatment for drug and alcohol addiction. Financial counselors at rehab facilities can provide you with an estimate of treatment costs, based on their previous experience with your insurance carrier and medical necessity criteria.
Some facilities offer low-interest loans, scholarships, sliding-fee scales or financing options. Centers that receive state or federal subsidies will accept lower-income patients (based on bed availability; there may be waiting lists). Other rehab centers are funded by religious groups and charitable organizations that grant scholarships based upon bed availability. There are also “therapeutic community” programs that will accept patients who cannot pay for treatment. In this situation, the patient will usually work during the day in exchange for room/board and treatment in the evenings (the program will often have contracts for some sort of manual labor).
Typical Cost & Coverage
The full cost of drug and alcohol rehab can range from $10,000 per month for outpatient treatment, on average, to $20,000-$30,000 or more for monthly inpatient residential stays. Cost varies with the location, type of services and amenities offered by each facility. Keep in mind that your investment in treatment reduces the cost of continually buying drugs and alcohol, and the consequences that may be associated with addiction – including lost wages, legal bills, incarceration, bankruptcy, overdose and declining health.
If you have no treatment history, insurance plans will typically approve partial hospitalization or intensive outpatient treatment for approximately 30 days. If you have been to treatment in the past but relapsed, plans will typically approve about 30 days of residential inpatient treatment, followed by 30 to 60 days of partial hospitalization or day treatment and/or intensive outpatient care. There are some plans that cover treatment at 100 percent after an out-of-pocket maximum is met.
Affordable Care Act
Beginning in 2014, the Affordable Care Act (Obamacare) expands substance abuse benefits for Americans, especially those who did not have access to rehab before. The legislation includes mental health and substance abuse in its list of 10 “Essential Health Benefits,” putting addiction treatment on a par with coverage for regular medical care. Under the Affordable Care Act, insurance companies cannot deny pre-existing conditions including substance abuse.
Previously, many lower-income Americans only had access to rehab treatment through the criminal justice system, when rehab was mandated by a drug court. Now, with access to insurance through the Affordable Care Act – which expands Medicaid coverage and low-cost insurance options – more people with addiction can access rehab treatment.