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The Guide to Insurance Coverage for Drug Rehab

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Estil Wallace, Phoenix Arizona

Author: Cornerstone Content Team

karen-williams

Clinically Reviewed By Karen Williams, LPC

All of the information on this page has been reviewed and fact-checked by certified addiction professionals.
Author

Cornerstone Content Team

karen-williams

Clinically Reviewed By

Karen Williams, LPC

All of the information on this page has been reviewed and fact-checked by certified addiction professionals.

The Guide to Insurance Coverage for Drug Rehab

Drug and alcohol rehabilitation can be costly. Drug addiction affected the lives of 19.7 million people aged 12 and older in 2017. Out of those individuals, 74% of them also suffered from an alcohol disorder in conjunction with drug dependency.

Today we answer the question: Is rehab covered by insurance? Yes, it is covered! However, every insurance company is different, so . Read on to find out more information you or your loved one needs for recovery!

Searching for help with drug and/or alcohol addiction? Call us now at (888) 201-4610.

Content

Does Health Insurance Cover Drug and Alcohol Rehab?

The Patient Protection and Affordable Care Act (ACA) has become the most popular method for health insurance covering rehab services.

In 2010, legislation passed that the government must assist with insurance coverage for drug and alcohol rehabilitation services.

So does health insurance cover rehab? Yes! There are many types of addiction rehab care that health insurance covers.

Not every rehabilitation need is a cookie-cutter case, so this is why many services are covered under health insurance.

What are the types of addiction rehab care covered?

Health insurance for addiction covers all the popular modes of rehab care, including inpatient and outpatient services, as well as partial hospitalization plans. Here is a summary of the types of rehab care covered under health insurance.

Inpatient Rehab

Inpatient rehab is for individuals who need the most guidance and monitoring during drug and alcohol rehab. Those with co-occurring disorders may benefit from inpatient rehab since alcohol or drugs triggers another disorder such as PTSD or depression and vice versa.

Outpatient Rehab

Outpatient rehab allows individuals to seek the rehab treatment they need without staying at the facility. Depending on program requirements, you will have to come to the facility a certain amount of hours per week to receive treatment.

Partial Hospitalization Rehab

Partial hospitalization rehab is a hybrid of inpatient and outpatient rehab programs. Patients may have to do up to 12 hours of group therapy at the facility each week and be able to go home for the rest of the time. Intensive outpatient therapy can be as low as 9 hours each week or as high as 20 hours.

One-on-One Therapist Sessions

Sometimes rehab patients need someone to talk to, especially if they do not have family or friends to act as a strong support system for them through the rehabilitation process. One-on-one therapist sessions allow you to confidentially discuss how you are feeling, your fears, and how your rehabilitation is going. Having someone to discuss these concepts can lessen the chance of rehab patients relapsing.

Equine Therapy

Equine therapy is one of the alternative approaches to drug and alcohol rehabilitation. This therapy allows more than just horses to act as companion animals for rehabilitation patients. Other animals such as dogs, cats, rabbits, guinea pigs, and even llamas have helped drug and alcohol rehab patients to recuperate.

Other Types of Rehab Care

The other types of rehab care in health insurance for addiction covers include:

  • Detoxification services.
  • Withdrawal management.
  • At-home visits from the rehab center.
  • Medicines for co-occurring disorders.
  • Substance abuse testing.
  • Intervention services are based on treatment needs.
  • Contingency management
  • Other alternative rehabilitation healing services.

Does Insurance Cover All Types of Addictions?

Does insurance cover drug rehab? Because of the decree of the Affordable Care Act made in 2010, health insurance for addiction covers all types of addictions, whether to drugs or alcohol. All health insurance companies must have some coverage for addiction rehab for their clients per this decree.

What Health Insurance Companies Provide Drug And Alcohol Rehab Coverage?

While many health insurance companies cover drug and alcohol rehab services, we cannot cover them all here. Here are some of the popular health insurance companies that cover addiction rehab. Check with your insurance company to see their coverage percentages for rehab services.

Aetna

Aetna has copay only, open access, and high deductible insurance plan options for rehab services. The company covers inpatient and outpatient rehab. Health insurance plans for Aetna also cover detoxification services, intensive outpatient rehabilitation, and other alternative care for rehab.

Amerigroup Insurance

While Amerigroup Insurance covers alcohol and drug rehab services, it operates only in specific states, including:

  • Georgia
  • New Jersey
  • Maryland
  • Texas
  • Arizona
  • Iowa
  • New Mexico
  • Tennessee
  • Washington

Amerigroup Insurance covers partial hospitalization programs, medically assisted detox, inpatient and outpatient treatment, and counseling. Other rehab services include intensive family intervention, substance abuse screenings, and medication-assisted treatment.

Blue Cross Blue Shield

Blue Cross Blue Shield is the parent company of 36 health insurance companies throughout America.

There are four categories of health insurance coverages and will determine the percentage of rehab coverage the health insurance company will cover.

  • Bronze: Higher deductibles with lower monthly premiums and a rehab service coverage of 60%.
  • Silver: 70% of rehab services covered.
  • Gold: 80% of rehab services covered.
  • Platinum: Lowest deductibles but higher monthly payments with a rehab coverage of 90%.

Humana

Humana covers detox services, inpatient and outpatient rehab, prescription medications, and aftercare services for its clients.

Their plans include HMOs, PPOs, high deductible plans, classic plans, coverage first, and point of service plans.

Providence Health Plan

Most of the Providence Health Plan coverages include rehab services, but you must read their premium disclosures to find more information. This company will allow coverage for one rehab period, but you must follow specific steps before being allowed assistance.

Providence Health covers inpatient and outpatient rehab as well as medically-assisted treatment. 

State Farm Medical Insurance

State Farm Medical Insurance offers a variety of health plans that can cover rehab services. These include individual, family, group, and supplemental insurance plans. Medicare supplemental insurance and Medicare Part D are also other offered plans.

State Farm Medical Insurance covers inpatient rehab, outpatient rehab, detox, and medically-assisted recovery. Call the insurance company to seek rehab services coverage so that you know what is covered and what is not.

United Healthcare

United Healthcare covers a variety of rehabilitation services for their clients. They cover treatment planning, referral services, intensive outpatient treatment, medication management, partial hospitalization, and many other service needs. Therapy types such as individual, family, and group are also covered.

What is a Deductible?

According to Healthcare.gov, a deductible is an amount you must pay for a claim before the health insurance steps in to help pay the rest. Once you pay this deductible, you can pay the designated copay, and then your health insurance company will cover the rest of the payment for rehab services.

Check your health insurance company for the specific deductible for health care services. The deductible for drug and alcohol rehabilitation services may differ from what you have to pay for a checkup or another medical treatment.

What Is A Health Insurance Premium?

A health insurance premium is a monthly cost you must pay to receive health insurance coverage. Your health insurance plan may require that you pay other costs such as a copayment before receiving services at your primary care doctor or a rehabilitation facility.

While lower monthly payments can save you money in the short term, they will not save you money in the long term. This is because if you seek rehabilitation services, you will have to pay a higher deductible before the health insurance company assists you with other costs.

Sometimes paying a higher monthly premium will save you money in the long term because you can pay a much lower deductible before the health insurance company starts assisting you with covering costs. Think about possible needs before choosing a health care coverage plan.

What Are Out-of-Pocket Costs?

Out-of-pocket costs are what you have to pay yourself without any medical insurance assistance. If you cannot pay out-of-pocket costs in one sitting, you may have to set up a payment plan with the company to get the bill successfully paid off.

Drug and alcohol rehabilitation services can amount to thousands of dollars, which is why health insurance companies step in. Depending on your health insurance plan, your health insurance company will pay for some of the costs, and you are responsible for the rest as out-of-pocket costs.

How Do I Get My Health Insurance Company to Cover Drug and Alcohol Rehab?

Does insurance cover rehab? Yes, it is! However, there are certain steps you must take to get your health insurance company to cover drug and alcohol rehab services for you.

Call your insurance company for more details as the specific steps may differ from other companies. You must ensure that the facility is in your insurance company’s network. This can be done simply by phoning the insurance company or calling the rehabilitation facility to check if they take your insurance.

Before petitioning for coverage from the health insurance company, you will have to phone them and let them know you need coverage. If you go directly to the rehabilitation facility, you may be directed to phone your insurance company to take the first steps before starting your rehab treatment.

How Much Does Drug Rehab Cost Without Insurance?

The cost of rehabilitation services depends on several factors. The first begins if you do inpatient or outpatient services. The second factor of cost is the treatment center that you choose to go to for treatment. Inpatient rehab costs much more than outpatient rehab because inpatient rehab requires more monitoring and medical provider assistance compared to the outpatient alternative.

The good news is that many inpatient treatment centers will work with you on cost. The best way to find a program you can afford is by calling around. 

We encourage you to call us and ask about our cash-pay options for drug and alcohol treatment. Call us at (888) 201-4610

 

How Do I Find Out What Exactly My Policy Covers?

While you can phone your insurance company to find out what your health insurance policy covers, we are always happy to help you to understand your policy. Navigating a health insurance policy can be tricky, especially at a time when you need help the most and attempting to survive the day.

Cornerstone can help you discover what your health insurance policy covers through drug and alcohol rehabilitation services. Our insurance representatives can help you understand how much you have to pay for your deductible before health insurance coverage kicks in to assist with paying for the rest of your treatment.

How Do I find out What My Policy Covers?

So yes, health insurance also covers alcohol and other types of addiction rehab. But what about your specific policy? How do you determine exactly what type of drug rehab your policy covers? Reach out today and contact Cornerstone; we can help you figure that out. Call us or visit our insurance verification page. We will get back to you within a few hours with the verification of benefits for your specific policy. 

Do not let your inability to pay for rehabilitation treatment stop you from seeking the help you need. Health insurance companies can pay for most, if not almost, of your rehabilitation treatment.

While some out-of-pocket costs may have to be paid, you will not have to pay as much as long as you have great health insurance coverage.

At Cornerstone Healing Center, we are ready to help you in your time of need. Call us today at (888) 201-4610 or start a chat with us when you need help to turn around your life in a new direction.

Family and loved ones, if you are concerned about the treatment needs of someone you love, contact us today for the next steps on how to approach your loved one for them to start seeking treatment as soon as possible.

Sources:

[1] Paying For Rehab With The Affordable Care Act

[2] Alcohol and Drug Abuse Statistics

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