November 28, 2023

Understanding the Cost of Inpatient Mental Health Treatment

Understanding the cost of treatment after insurance can be a challenge. This guide breaks down the cost of inpatient mental health treatment.

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Understanding the Cost of Inpatient Mental Health Treatment

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Julie Miller

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Understanding the costs associated with inpatient mental health treatment can be overwhelming.

Let us guide you through the different payment options, including insurance and other resources.

Making those already challenging decisions easier by simplifying the financial aspects of your or your loved ones’ mental health treatment.

Understanding How Insurance Payments Work

Understanding a few key insurance payment elements can guide you through the finance-speak of inpatient mental health care.

Here are a few key terms to know:

  • Copay: A set fee that a member pays for a particular service, such as one hour of therapy, due at the time of the visit. 1
  • Co-insurance: This refers to the percentage of costs that you pay after the deductible, usually split between you and your insurance.2
  • Out-of-pocket Max: The maximum amount you’ll pay for covered services in a year, after which your insurance covers 100% of the costs.3

An Example of a Bill

Understanding what a medical bill might look like after insurance payments allows people to prepare for the costs that come after inpatient mental health treatment.

Insurance may cover most of it, but a portion will come from the individual’s pocket.

Out-of-pocket expenses may involve co-payment for session therapy, medication prescriptions, accommodation, and board costs.

The remaining balance will vary depending on your insurance plan, the type of facility, and the specific treatments received.

Here’s a breakdown of how a typical bill might look after insurance is applied, with an example total cost of $10,000:

Total Cost of Services: $10,000

Insurance Coverage (80%):

  • Insurance covers: $8,000
  • Amount you’re responsible for: $2,000

Out-of-Pocket Costs Breakdown (20%):

  • Deductible: $500
  • Copay: $100
  • Coinsurance (after deductible): $1,400

In this example, your total out-of-pocket cost would be $2,000 after your insurance has covered 80% of the overall bill.

This amount is broken down into your deductible, copay, and remaining coinsurance payments.

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The Breakdown of Inpatient Mental Health Care Costs

The cost of inpatient mental health care can be divided into several key categories, each contributing to the overall financial picture:

  • Treatment Costs: Session costs, both individual and group sessions, may depend on the length of experience of therapists and sessions involved. These sessions often form the foundation of inpatient treatment.
  • Medication costs: These will depend on the type of medication and how long the prescription is prescribed. The medication might be costly, especially if it is specialized or new.
  • Accommodation Cost: What a patient has to pay to stay in the hospital, depending on the comfort level and the facilities offered, ranging from basic to luxury.
  • Dietary Planning and Meals: This is for regular daily nutrition or special diets and nutrition, depending on the patient’s treatment.
  • Recreational Activities: Money spent on treatment related recreations or projects part of the treatment process.
  • Specialty Services: Other costs a patient may incur from treatment services such as occupational therapy, art therapy, or other focused treatments that enrich the care of the patient.

 

By breaking down these costs, a clearer understanding of the financial investment required for comprehensive inpatient mental health care is achieved, aiding in more informed financial planning and decision-making.

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Other Factors That Influence the Cost of Inpatient Mental Health Treatment

The overall cost of inpatient mental health treatment isn’t determined by therapy and medication alone.

Several additional factors can significantly impact what you might pay.

Understanding these elements is essential for effective financial planning. Some of the key factors include:

  • Duration of Stay: The length of time a patient spends in the facility directly affects the total cost. Longer stays generally result in higher expenses due to the ongoing use of resources.
  • Private vs. Public Facilities: Whether treatment is received in a private or public facility can make a big difference in cost. Private facilities usually charge more due to better amenities and higher staff-to-patient ratios.
  • Geographical Factors: The location of the facility also plays a role, with urban cities or areas with a higher cost of living typically having higher treatment costs.
  • Specialized Treatments: The use of specialized therapies or advanced treatment methods can increase the overall cost of care, depending on the patient’s specific needs.
  • Your Health Insurance Plan: The type of health insurance plan you have will determine how much coverage you receive and what your out-of-pocket costs will be.
  • Aftercare Costs: The cost of follow-up care and ongoing treatment after leaving the facility is another important factor to consider in the overall financial planning process.

Types of Health Insurance Plans

Understanding the differences between insurance plans can help you make informed decisions about your mental health and substance use treatment options.

Each of the types of insurance has something different: flexibility, cost, and with respect to the providers involved.

You may want to know how each applies to you, especially when trying to get the best care for your specific needs.

Below are basic features summarized for PPO, HMO and commercial plans that help to compare coverage options and find the best fit for your treatment.

Insurance Type:Key Features:
PPO (Preferred Provider Organization)Higher flexibility in choosing providers, no need for referrals, higher premiums and deductibles.
HMO (Health Maintenance Organization)Structured network with a primary care physician, lower out-of-pocket costs, referrals required for specialists.
Commercial InsurancesVaried options, can offer tailored mental health care, wide range of premiums and coverage levels.

Alternative Financing Options

Apart from insurance, there are a number of alternative financing options that can help make inpatient mental health treatment more affordable.

These options are designed to ease the financial burden and provide access to necessary care without overwhelming costs. Some of the most common methods include:

  • Out-of-pocket: While the immediate benefit could be quick and give you direct access to treatment, using your savings or getting a loan can be financially challenging.
  • Payment Plans: A number of facilities offer patient-friendly payment plans that allow them to spread the cost of treatment over time, making it more manageable.
  • Financial Aide: Some inpatient facilities provide financial aid or reduced fees based on a patient’s financial situation, helping those who might otherwise struggle with the costs.
  • Scholarships, Grants, and Community Resources: Most non-profit organizations, mental health advocacy groups, and local charities offer scholarships/grants to those in need. These resources can be crucial for accessing affordable treatment.

 

These alternative financing options are a real game-changer for people and families who would otherwise be burdened by extremely high costs of inpatient mental health care, ensuring that necessary treatment remains accessible.

Quick Tip

Managing Costs for Inpatient Mental Health Treatment

To manage costs for inpatient mental health treatment, start by verifying your insurance coverage to understand what services are included and any out-of-pocket expenses. Look into programs that offer payment plans or sliding scale fees to reduce upfront costs. Additionally, ask about financial assistance options that may be available through the treatment center.

Strategies for Reducing Treatment Costs

Here are some steps you should take when looking for a low-cost facility and therapeutic types:

  • Researching facilities that can provide quality care at a realistic price and then selecting therapies that will balance effectiveness with affordability.
  • Consulting with mental health professionals about what treatments are essential in order to avoid costly treatments that are not so effective.
  • Compare multiple options, considering the quality of care, available services, and the price.
  • Then, use this information to negotiate better terms or discounts, potentially leading to significant savings.

By combining careful selection with strategic price negotiation, you can manage treatment costs more effectively, ensuring access to necessary care without undue financial strain.

Frequently Asked Questions

Inpatient mental health care costs include treatment sessions, medication, accommodation, dietary planning, and recreational activities. These costs can vary significantly depending on the facility and treatment options selected. Understanding the breakdown of these costs helps in making informed financial decisions.
Insurance helps cover many of the costs, but patients are often responsible for co-pays, co-insurance, and out-of-pocket expenses. The specific costs depend on the type of insurance plan, the facility, and the treatments received. It’s important to know your coverage and plan for out-of-pocket expenses.
Yes, several options can help reduce costs, such as financial aid, payment plans, and scholarships from non-profit organizations or advocacy groups. Researching facilities and comparing prices can also help manage costs more effectively.
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Key Takeaways

Moving Forward with Hope and Informed Choices

Managing mental health care costs effectively starts with informed financial planning and knowing your options.

The more informed one is, the greater the chances are toward recovery.

Despite the challenges, remember that with the right support, hope and sustainable treatment is possible.

At Cornerstone Healing Center, we’re here to help.

We accept most mental health insurance plans and offer free insurance verification to ensure you understand what’s covered.

If you or a loved one is seeking inpatient mental health care, contact us today to learn more about how we can support you on your path to recovery.

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Author & Reviewers

lionel estrada lisac clinical director
CLINICAL DIRECTOR & REVIEWER

Lionel is the Clinical Director of Cornerstone’s Scottsdale treatment facilities. 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.

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