Cornerstone

Drug Rehab Health Insurance Coverage

Answering your questions about addiction treatment coverage

Get addiction treatment coverage

At Cornerstone, we recognize the intricate nature of addiction, understanding how it influences the mind, body, and soul. Our programs are designed to address surface symptoms and the underlying root causes, ensuring a holistic approach to recovery.

We utilize evidence-based strategies to ensure a thorough and lasting recovery. We’re also aware of the financial stresses of seeking treatment. The good news is that numerous health insurance providers, recognizing our dedication to quality care, often cover our programs.

We realize that dealing with insurance details can be overwhelming, so we’ve compiled a thorough list of answers to most commonly asked questions about rehab coverage. Additionally, our admissions team is on standby to guide prospective patients and their families through the process, ensuring they are fully aware of their coverage options.

We accept most insurances

Now Accepting AHCCCS Health Choice,
Mercy Care, TriCare, and Triwest

Addictions we treat at Cornerstone

Insurance Providers

UMR Health

Learn more about the UMR drug rehab and how to navigate finding addiction treatment.

United Healthcare

Learn about United Healthcare’s drug and alcohol rehab coverage. We guide you on the specifics.

Meritain Health

Learn about Meritain Health’s drug rehab coverage and what you can expect from your policy.

BCBS

Learn about BCBS drug rehab coverage. It’s important to understand the ins and outs of rehab coverage.

TriCare

Tricare offers coverage for substance abuse treatment, here’s how to begin the process of getting treatment.

TriWest

TriWest offers ample coverage for drug and alcohol rehab. Learn more about what to expect.

Aetna

Learn about Aetna’s drug and alcohol rehab coverage, and how to get substance abuse treatment at Cornerstone.

GEHA

Learn about the Government Employee Health Association and what to expect for substance abuse treatment coverage.

Cigna

Learn about Cigna’s drug and alcohol rehab coverage. Knowing what to expect and make an informed decision.

Will my health insurance cover drug rehab?

Understanding health insurance can be tricky, especially when seeking drug rehab coverage. The good news is that insurance is required to cover substance abuse treatment according to federal law¹. However, it’s important to know that insurance policies have room to determine what types of treatment they will pay for. The coverage can vary depending on your plan, the company, and the state. It’s crucial to look at your insurance details or talk to your insurance company to know what’s covered. At Cornerstone, our admissions team helps people figure out their insurance benefits, ensuring they can get the help they need without worrying too much about the financial aspects.

How do I use my health insurance rehab coverage?

Using health insurance for drug and alcohol rehab can help lower costs substantially or in some cases completely. If you want to use your health insurance benefits, we can help. At any time, you have the ability to contact your insurance company and get details on your specific policy coverages. If you’d like to save yourself the time and stress of doing this yourself, you can fill out our insurance verification form or give our admissions team a call and we will pull a verification of benefits for you or your loved one. Once we receive your insurance verification, we will have detailed information about your coverages and deductibles. From here, you can move forward with making plans for treatment admission.

Frequently Asked Questions

Which specific types of treatment are covered?

Knowing what your health insurance pays for in drug and alcohol rehab is important. Many insurance plans help cover different treatments, but the details can vary. Some might pay for a stay at a rehab center, but maybe only for a short time or under certain rules. Others might pay for treatments where you don't have to sleep at the center because it's cheaper and flexible. Detox, the first step for many getting off drugs or alcohol, is usually covered because it's seen as a needed medical service. However, every insurance is different. It's a good idea to check your insurance info or talk to your company to see what's covered and if there are any special rules. If you’d like us to pull those details for you, all we would need is the information on your insurance card to do so.

Are both drug and alcohol treatments covered?

Both drug and alcohol treatments are often covered by health insurance, especially with the increased focus on mental health in recent times. A key piece of legislation, the Mental Health Parity and Addiction Equity Act (MHPAEA) from 2008¹, makes sure that health insurance plans give equal benefits for mental health and substance use treatments as they do for regular medical care. However, even with this law, coverage details can vary. Some insurance plans may have special rules based on the drug involved, how severe the addiction is, or the treatment suggested. As an example, a person with a strong opioid addiction might get insurance coverage for a longer hospital stay than someone with a less severe alcohol issue. It's crucial to look at your insurance details or speak with your insurance company to fully understand what's covered.

Does my plan cover both short-term and long-term treatments?

What your insurance covers depends on the specific details of your plan. Some plans cover short-term treatments, such as detoxing or a rehab program that lasts 30 days. On the other hand, long-term treatments could involve staying in rehab for a longer period or going to therapy for months or even years. Many insurance plans cover short-term and long-term treatments because they understand that fully treating addiction is essential. But keep in mind there might be some limits. Your insurance might set a maximum number of days you can stay in rehab or limit the number of therapy sessions they'll pay for in a year. Cornerstone accepts a wide range of insurance plans. Whether you have state insurance like Medicaid or a commercial insurance policy, there's a chance we are in-network with your plan. That means your treatment could be more affordable or even fully covered. To find out, please contact us, and we can help you understand how your insurance can work with our services.

What are the benefits of going to an in-network facility?

Going to an in-network facility has several advantages, and Cornerstone Healing Center is in-network with some, but not all, insurance plans. One of the most significant benefits is that treatment can be more affordable. When you choose an in-network facility, your insurance typically covers a larger portion of the costs. This means you might only have a small copay for each visit rather than paying a big chunk of the bill yourself. Another plus is that the paperwork is usually simpler. The facility and your insurance company handle most of the billing details, so you don't have to stress filling out many forms. Also, insurance companies often vet in-network facilities, giving you extra peace of mind about the quality of care you'll receive. It's a good idea to contact us at Cornerstone Healing Center to see if we are in-network with your specific plan, as that could save you both time and money.

What are the benefits of going to an out-of-network facility?

If a drug rehab facility is "out-of-network," it means that the facility doesn't have a special pricing agreement with your insurance company. Choosing such a facility might result in higher costs for you because your insurance might not cover as much as it would at an "in-network" place. In some cases, you might have to pay a larger portion of the treatment costs, or your insurance might not cover any of your stay. However, remember that just because a rehab is out-of-network doesn't mean it's lower quality care. In fact, some out-of-network rehabs might offer better care and treatments that can be more effective. So, while you might end up paying more, the quality of care and the potential for a successful recovery might make the extra cost worth it. Always weigh the benefits of the treatment and care quality against the potential costs when considering an out-of-network drug rehab.

What is the duration of treatment covered by my insurance?

The time that health insurance covers for substance abuse treatment isn't the same for everyone; it depends on your specific insurance plan. Some plans might only cover a short time, like a few weeks in a rehab center, while others could pay for several months or even support therapy for a longer time. What's essential to understand is the term "medical necessity." Insurance companies use this to decide how long they'll cover treatment. If a doctor or therapist says that you really need the treatment for your health, it's considered a medical necessity. So, if they believe you need longer treatment, the insurance might be more likely to cover it. But, every insurance plan has its own rules. To get a clear picture, you should look at your insurance papers or talk directly to your insurance company. They can explain how they decide on the length of coverage based on medical needs.

What is my deductible and how can I find out what I have met?

Your health insurance deductible is like a set amount you have to pay yourself before your insurance helps out. So, if you have a $1,000 deductible, you need to pay that first in a year before your insurance starts covering costs. You can look at your insurance papers or check their website to find out your deductible and how much of it you've already paid. Most insurance companies have a site where you can see your details, like how much of the deductible you've paid and any other bills. If you need clarification or need help finding it, we can help you by running an insurance verification. Knowing about your deductible is important, especially if you're considering admitting into drug rehab, so you don't get surprised.

What is the co-payment or coinsurance for rehab services?

A co-payment, or "co-pay," and coinsurance are ways you and your insurance share the costs of medical care. A co-pay is a set price when you get a medical service. For example, if you go to the doctor, you might pay a $25 co-pay, no matter how much the visit really costs. Coinsurance is a bit different. It's when you pay a part of the total cost, like a percentage. So, if your insurance pays 80% of a bill, you'd cover the other 20% with coinsurance. Regarding drug rehab, the co-pay or coinsurance you owe can change depending on your insurance. They can tell you how much you might pay for different rehab services. Remember, costs might be different if you go to a place your insurance is contracted with (in-network) versus places they aren't (out-of-network).

Do I need pre-approval to go to rehab?

Some insurance companies, though not many, put a cap on the number of days they'll cover for certain treatments in a year. These limits often apply specifically to certain types of care, such as residential or inpatient rehab centers. If your insurance has these caps, going over might mean you'll have to step down to a lower level of care such as partial hospitalization, intensive outpatient treatment, or outpatient treatment. Most of the time, insurance companies will cover as long of a stay as necessary as long it meets medical necessity.

Does my insurance require a referral from a provider to enter rehab?

Usually you don't need a referral from a provider to enter drug rehab. However, some insurance policies do require one. If you're concerned about this, our admissions team can help you navigate these requirements to make the process as smooth as possible for you. The best place to start is to call us and begin the process of insurance verification.

Are aftercare or follow-up services included in my coverage?

After finishing the main treatment for drug and alcohol addiction, aftercare is critical and helps keep you on the right path. Aftercare can include more therapy, going to support group meetings, and other helpful services. However, not all insurance plans cover aftercare the same way. Some might pay for these services because they know ongoing help is important. Others might only cover certain kinds of aftercare or for a limited time. Some might not cover it at all. To find out what your plan covers, it's really important to read your insurance policy carefully or talk to your insurance company directly. This helps you know what to expect when it comes to costs and makes sure you can continue getting the help you need for a successful recovery.

We Accept Most Health Insurance Plans

We can help you verify your benefits and get you a clear picture on your drug rehab coverage details.

Does my insurance cover both local and out-of-state treatment facilities?

Your insurance plan decides how much it will help with the costs of going to a treatment center in your local area versus one in another state. For some types of insurance, like HMOs, you usually have to stick to treatment centers in a particular area or you will get little help with the costs. Others, like PPOs, let you choose from a broader range of places, even out-of-state ones. But you may pay more if you go to an out-of-network place. If you're considering going to a treatment center far from home, it's really important to check your insurance plan or talk to the insurance company to see what's covered. Going somewhere far might have some benefits, like fewer distractions but you'll have to consider the costs and what your insurance will cover.

Is coverage available for luxury or executive rehab centers?

If you're looking at luxury rehab centers, know that insurance coverage varies. These centers offer extras like private rooms and special services, so they usually cost more. Most insurance plans cover basic drug and alcohol treatments but might not cover the extra perks. Some high-end plans do cover luxury centers. Before you choose a center, check your insurance details or talk to your insurance company to see what's covered and what you'll pay. You can also talk to the rehab's admissions team for more info. At Cornerstone Healing Center, we offer a luxury experience, and we offer executive program tracks, but we're in-network with many insurance plans to make it more affordable for you.

Does my plan cover alternative or holistic treatment methods?

Insurance plans can differ when covering alternative or holistic treatments like acupuncture, yoga, or art therapy. Usually, insurance focuses on traditional treatments that have strong evidence behind them. But as more doctors accept holistic methods, some insurance plans are starting to cover them too. These treatments aim to help the whole person, not just the addiction and can be a part of some rehab centers' regular programs. Before choosing a treatment, check what your insurance covers and decide if the extra services are worth paying for yourself. Cornerstone's holistic therapies are available to all clients, regardless of insurance type.

Are family or couples therapy covered as part of my treatment?

Family and couples therapy is a vital part of many effective addiction treatment programs because addiction impacts not just the individual but their loved ones. At Cornerstone, we know how crucial family relationships are in recovery. That's why we include family and couples therapy for all our clients, regardless of their insurance coverage. Many insurance plans cover this type of therapy, but the details can vary. Reviewing your insurance policy or speaking directly with your insurance provider to understand what they'll cover is a good idea. Cornerstone's admissions team is always ready to help you navigate your insurance options if you have any questions.

How Soon After Relapsing Can I Go Back to Treatment With Insurance?

If you relapse after rehab, how soon you can go back depends on your insurance plan and if more treatment is medically necessary. Most insurance companies know that addiction is a long-term issue, so they usually don't have a set waiting time before you can go back. However, they might ask for proof from a doctor that you need more treatment. If you relapse, it's important to talk to your healthcare provider and insurance company right away to figure out the next steps. The main goal is to get you the help you need as quickly as possible.

Is there a limit to how many times I can go to rehab with my insurance?

The number of times you can go to rehab using your insurance primarily hinges on whether the treatment is medically necessary. Most insurance companies don't cap how many times you can receive treatment. For many policies, they are required by law to cover healthcare services deemed medically necessary, including addiction treatment. This is based on the understanding that addiction is a chronic, long-term condition that may require ongoing care over time. Having no lifetime limit is a big deal because you can focus on your recovery journey without worrying about "using up" your insurance benefits. However, some insurance plans might still have yearly limits, like a certain number of covered days in rehab or therapy sessions.

Does my insurance cover co-occurring treatment?

Treatment for addiction and mental health conditions, known as dual diagnosis treatment, is increasingly considered crucial by healthcare professionals. Most up-to-date insurance plans offer some coverage for this integrated approach due to the interconnected nature of addiction and mental health. However, the specifics of this coverage, such as types of therapies and duration of treatment, may vary according to your insurance plan. Reviewing your policy details or consulting directly with your insurance provider to understand the full extent of coverage for dual diagnosis treatment is essential. This ensures you or your loved one can receive the most comprehensive care while maximizing your insurance benefits.

How does the coverage differ between drug/alcohol rehab and mental health services?

Insurance plans often treat drug and alcohol rehab differently from mental health services. Rehab usually focuses on short-term treatments like detox and counseling. Mental health care often involves long-term therapy for issues like depression or anxiety. You might find that your insurance limits the days you can stay in rehab but restricts the number of therapy sessions for mental health. You may also need special permission or a doctor's referral for either type of treatment, but the rules can vary. It's worth noting that the Mental Health Parity and Addiction Equity Act says that insurance must cover mental health and addiction roughly the same as other medical issues. But the money you pay out of pocket, like co-pays or deductibles, could be different. Also, your insurance might work with certain rehab centers and different mental health professionals. Always read your policy or talk to your insurance company to know what's covered.

What will my out-of-pocket costs be for different types of treatments?

Addictions We Treat

Is financial aid or a payment plan available if insurance doesn't cover all costs?

Understanding the costs of drug and alcohol rehab can be complicated, especially if your insurance doesn't cover everything. At Cornerstone Healing Center, we offer payment plans for those who qualify. These are decided on an individual basis and allow patients to break down the total cost over time. Some places also have financial assistance based on your income to help if you can't afford treatment. It's important to talk directly with the treatment center about these options so that money issues don't stop you from getting the help you need.

What types of rehabs accept people with no insurance?

Does insurance need progress reports to keep covering treatment?

Insurance providers often link continued coverage for drug and alcohol rehab to noticeable progress in treatment. This ensures that the care paid for is effective and beneficial for the patient. Treatment centers, like Cornerstone regularly assess patients and send progress reports to insurers. These reports may cover behavior changes, therapy attendance, drug tests, etc. The reality is that when you're in treatment, you should be focused on getting better. Staying in regular contact with your health insurance company is something that reputable treatment centers will take care of. If progress stalls, insurers might re-evaluate the coverage. Understanding your insurance policy's details and talking with your provider is vital. Our admissions team can help clarify any insurance questions if you're considering Cornerstone for treatment.

Are post-rehab services like sober living or outpatient counseling covered?

Coverage for post-rehab services, such as sober living homes or outpatient counseling, varies significantly across health insurance providers and plans. Sober living homes, often seen as a transitional step between inpatient rehab and full reintegration into everyday life, may not be directly covered by some insurance plans as they're not always considered a medical necessity. On the other hand, outpatient counseling, which includes regular therapy sessions to maintain sobriety and address underlying issues, is more commonly covered, albeit with varying extents and conditions. Insurance coverage for post-rehabilitation services like sober living homes or outpatient counseling can differ widely among various health insurance providers and plans. While sober living homes serve as an important bridge between inpatient treatment and a return to daily life, they may not be universally covered by insurance, as they're not always deemed a medical necessity. Outpatient counseling, which involves regular therapy sessions for sustained sobriety and mental well-being, is more frequently included in insurance plans, although the extent and conditions can vary.

How does the insurance company protect my privacy when discussing my treatment needs?

Federal laws like HIPAA and the insurance company's own privacy rules make sure your personal health information stays private when you talk about your treatment needs. This means your medical records and conversations about your care are kept confidential unless you say otherwise. Some insurance companies even have extra privacy protections in place. Still, it's a good idea to ask directly how your information will be used and to share any privacy concerns you have with both your healthcare provider and insurance company.

Will seeking treatment impact my future insurance premiums or coverage availability?

When seeking addiction treatment, many wonder if it will affect their future insurance premiums or availability of coverage. Under the Affordable Care Act (ACA), health insurance providers can't deny coverage or raise premiums based on a pre-existing condition, including substance use disorders. However, life or disability insurance might view past treatment differently, potentially leading to higher premiums or coverage limitations. Additionally, certain jobs with strict substance use guidelines could consider a history of therapy when assessing eligibility. While these concerns are valid, it's crucial to prioritize health and well-being above all. Always consult with insurance providers directly if you have concerns about the implications of seeking treatment.

Does my insurance offer telehealth or online counseling services for addiction?

Many wonder if their insurance will cover online health services like telehealth or online counseling, especially for addiction treatment. Thanks to the growth of online health care and the recent focus on remote services, many insurance companies now cover virtual therapy, online group meetings, or video chats with doctors for addiction help. However, what you're covered for and how long can differ depending on your insurance plan. It's essential to check with your insurance company or your policy to see precisely what online services are covered for addiction treatment.

Can I speak to helplines or counselors directly through my insurance for guidance?

Many insurance companies understand how important quick support is for people dealing with addiction or mental health issues. That's why they often have special helplines or direct access to counselors you can talk to for help. These services are usually open 24/7, so you can call anytime. Talking to these counselors can help you figure out what treatments your insurance covers, guide you to the right treatment, or even give you emotional support immediately. If you're considering using this kind of help, you should check your insurance paperwork or go to the company's website. You'll find the phone numbers or info you need to get this support.

Does my insurance cover support groups or community-based programs?

Many insurance plans acknowledge the value of support groups and community-based programs as vital to recovery. Typically, these programs, such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or SMART Recovery, offer peer-led support in a group setting. While many of these groups are free to attend, there can be associated costs with some community-based therapeutic programs. Depending on your specific insurance plan, coverage for these costs may vary. Some plans cover group therapy sessions facilitated by licensed professionals, while others may include coverage for intensive outpatient programs incorporating support groups. Reviewing your policy details or consulting with your insurance provider to clarify the extent of coverage for such services is essential.

How often is my coverage for rehab and related services reviewed or updated?

Coverage for rehab and related services is usually reviewed periodically by insurance providers in line with policy renewals, changing healthcare regulations, and advancements in medical best practices. Most insurance plans have an annual renewal process during which terms, coverages, and associated costs might be updated. Additionally, insurance companies regularly reassess the treatments they cover based on new research, evidence-based practices, and feedback from healthcare providers. It's crucial for policyholders to review any changes to their plan annually during the open enrollment period or when notified by their insurance provider. This ensures they remain informed about the covered treatments and services and any out-of-pocket costs or coverage limit adjustments. If uncertain, contacting the insurance provider's customer service can provide specific details on coverage review frequencies and updates.

How will I be informed of any changes to my rehab coverage?

Insurance providers are diligent about notifying their policyholders regarding any changes to rehab coverage. Most commonly, policyholders receive these updates through mailed documents or digital notifications. These communications detail the specific changes and the effective date of those modifications. It's essential for policyholders to frequently check their mail, email, or insurance provider's online portal to stay updated. If there's any uncertainty regarding coverage adjustments, it's advisable to proactively contact the insurer's customer service or benefits department for clarification.

Meet Our Arizona Clinical Team

Lionel Estrada, LISAC

Clinical Director of Scottsdale Program

Lionel is a Licensed Independent Substance Abuse Counselor (LISAC) with over 4 years at Cornerstone. Passionate about helping those with addiction and mental health struggles, and he has trained as an EMDR therapist, adopting a trauma-informed approach to find and treat underlying root causes with empathy.

Nate Bush, LCSW

Clinical Director of Phoenix Program

Nate began his recovery journey in 2010 and earned a Master’s in Social Work from ASU. He’s been in the Behavioral Health field since 2013. Specializing in CBT, DBT, and grief, Nate is now the Clinical Director of our Phoenix program, underlined by his passion for helping others who struggled with substance abuse issues as he did.

Still have questions about treatment?

Our admissions specialists are here to explain the process, answer any questions you may have, and ensure you’re getting the help you need to live a healthy life free from addiction.

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