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Julie Miller

Addiction & Mental Health Writer

Last Update on March 6, 2024

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Does Health Insurance Cover Drug Rehab?

Drug rehabilitation costs billions of dollars to treat Americans that suffer from substance abuse. The National Institute on Drug Abuse states that $600 billion every year is what the nation spends to provide rehabilitation services for those who are suffering from substance abuse disorder (SUD).

We will go over the definition of substance abuse disorder and if drug rehab is covered under private health insurance, Medicaid, and Medicare. We will also examine some substance abuse statistics and go through the guidelines about drug rehab services outlined in the Affordable Care Act.

Will Medicare Cover Drug Rehab Treatment?

In the same 2017 National Mental Health Survey, 88% of psychiatric hospitals, 98% of Medicare, 50% of drug rehab centers for adults, and 85% of community mental health centers accepted Medicare services for those who needed drug rehab.

According to Medicare Advocacy, Medicare will cover the following treatments related to substance abuse rehabilitation treatment:

  • Follow-up services after being in a rehab center or psychiatric hospital
  • Psychotherapy
  • Prescriptions for treatment during rehab such as methadone
  • Structured Assessment and Brief Intervention (SBIRT)
  • Rehab treatment medications are covered by Medicare Part D
  • Educating patients about their disorder and ways they must rehabilitate

Drug Rehab Service Changes According to the Affordable Care Act

The Affordable Care Act has made it so that drug rehabilitation services have become more accessible to people via private health insurance, Medicaid, and Medicare.

As the opioid epidemic continues to wreak havoc on the nation, the Affordable Care Act has implemented four key avenues to make it so that people receive the rehabilitation services that they need:

  • Reforming insurance regulations to have SUD treatment included in the coverage
  • Increasing coverage benefits to make drug rehab better for recipients
  • Higher amount of parity
  • More efforts to interweave SUD treatment into usual healthcare practices

Schedule a Consultation with Cornerstone Healing Center Today!

Cornerstone Healing Center is here to help you in your time of need. We understand and are empathetic with the needs of individuals with substance use disorder (SUD). We want to help you turn around your life for the better to help you see a brighter future.

Give us a call at 800-643-2108 for a free consultation. If you prefer, you can also use the contact form on the “Contact Us” page to send your inquiry and we will return your message in 24-48 hours.

Sources

[1] Medicare Coverage of Mental Health and Substance Abuse Services

[2] The Affordable Care Act Transformation

[3] SCOTTSDALE DRUG & ALCOHOL REHAB PROGRAMS

What is Substance Use Disorder (SUD)?

Substance use disorder (SUD) is when an individual utilizes a drug more than they should and takes more than is prescribed to feel the drug’s beneficial effects such as opioids, heroin, meth, and more.

Whether the substances are legal to use or illegal in their state, any type of drug can be the cause of a person’s SUD. If a person continually uses a drug above the recommended dosage, it could cause him or her to have adverse side effects such as hindered brain functions, heart problems, and lung issues to where you find it harder to breathe.

Does Health Insurance Cover Drug Rehab?

Most private health insurances will cover drug rehabilitation services.

The 2017 National Mental Health Survey stated that 94% of psychiatric hospitals, 99% of general hospitals, 49% of rehabilitation treatment centers for adults, and 88% of community mental health centers accepted private health insurance for drug rehab treatment.

Cornerstone Healing Center is one of the top drug rehab centers that accept insurance. We offer four types of alcohol and substance abuse treatment programs that will help you turn your life around and get you back on track to leading a happy and healthy life.

The four programs include the residential program, partial hospitalization program, intensive outpatient program, and a less intensive version of the outpatient program. Learn more about each program to find the one that works best for you by clicking on the link above.

Cornerstone Healing Center is one of the rehabs that accept Aetna insurance in America. We also accept Beacon, BlueCross BlueShield, Cigna, Humana, UMR, and UnitedHealthcare.

Statistics About People With Substance Use Disorder (SUD)

It costs more to be under the influence of drugs than it costs to receive treatment. According to the American Addiction Centers, it costs as low as $14,000 to undergo a 30-day drug rehabilitation program at your local drug rehab center. Compare that to those on an opioid addiction who spend over $54,000 per year to purchase opioid pills to maintain their substance use.

The National Institute on Drug Abuse states that in 2011, there were 21.6 million people aged 12 and older that were suffering from substance use or alcoholism, but only a recorded 2.3 million in that group were recorded to have received drug rehabilitation services to turn their lives around.

Seniors aged 65 or older have a higher chance of contracting a substance use disorder because many take over-the-counter medications for other medical issues. In 2018, the National Institute on Drug Abuse stated that almost 1 million seniors within that age range were enduring a substance use disorder. What could onset the SUD in seniors are tragic or life-changing events such as the death of a family member or friend, a change in living situation, a dip in income, having to retire early, and other events.

Will Medicaid Cover Drug Rehab Treatments?

According to the Substance Abuse and Mental Health Services Administration (SAMHSA) of the 72 million people served via Medicaid every year, 12% of adults aged 18 or older have a substance abuse disorder, and 6% of teenagers aged 12-17 have a substance abuse disorder.

For those Americans that may not have access to high monetary resources, what if someone covered under a Medicaid plan is found to have a substance use disorder (SUD)?

Yes, Medicaid will cover drug rehab medication including naltrexone (oral or extended-release) buprenorphine, and buprenorphine-naloxone. A bulk of the states can cover acamprosate and disulfiram as drug rehab treatments.

42 out of the 50 states’ Medicaid programs allow Medicaid beneficiaries to receive methadone because they cover the treatment. Less than 70% of the American states’ Medicaid programs cover buprenorphine treatment whether via injection that is extended-release or an implant.

In a 2017 National Mental Health Survey, 88% of psychiatric hospitals, 94% of general hospitals, 81% of drug rehab treatment centers for adults, and 98% of community mental health centers accepted Medicaid at their medical practices to treat people that required drug rehabilitation services.

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Author & Reviewers

julie miller recovery writer and author
RECOVERY WRITER
Julie is a recovery advocate, with over two years sober. She is a recovery speaker who believes people can change for the better. Her mission is to write factual, helpful information about addiction, treatment, and recovery. She believes that no one should be left in the dark about the process at any stage of their recovery.
lionel estrada lisac clinical director
CLINICAL DIRECTOR

Lionel is the Clinical Director of Cornerstone’s treatment facilities in Arizona. He has had over 4 years at Cornerstone. He is personally in recovery and passionate about helping others overcome substance abuse and mental health challenges, he is trained as an EMDR, adopting a trauma-informed approach to treat the underlying issues of conditions.

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