Finding help when you or your loved one are struggling with addiction can feel like a never-ending mountain to climb. Deciding what treatment is best for your situation, finding a treatment facility that offers what you need, and making arrangements in your work and home life are all momentous challenges you must face when seeking help for addiction.
One of the many pieces that must come together in arranging your treatment program is the cost and insurance coverage for rehab services. Today, we will examine using insurance to pay for rehab.
What is the Average Cost of Rehab?
The expenses associated with a rehabilitation program can differ significantly based on the kind of treatment facility and whether you opt for inpatient or outpatient care.
While some recovery options, such as programs provided by non-profit health centers, are available free of charge, luxury centers designed for celebrities can charge as high as $80,000 per month. The majority of standard drug treatment centers typically charge between $2,000 and $25,000 per month.
What Types of Treatment Are Covered?
The majority of private health insurance plans provide coverage for some types of treatment. It is important to look into specifically what levels of treatment are covered under your plan, as your insurance provider may not provide coverage at all levels of care. For example, your plan may say it covers 30 days of inpatient treatment, but your provider could decline coverage for this benefit if they believe a less intensive option is sufficient.
In addition to the forms of treatment covered, be sure to research what treatment facilities are in-network with your insurance provider. Most insurance companies provide a search option on their website where you can look up treatment centers or medical providers by name to find out if they are in-network with your provider. In-network treatment facilities will allow you to receive more comprehensive coverage under your insurance.
It is always wise to contact your insurance provider directly to find out the exact levels of care covered under your plan and what the out-of-pocket cost might be for the portion you will be required to pay.
Mental Health Parity and Addiction Equity Act of 2008
If you have private insurance under a group plan (such as what you’d receive from an employer) that includes more than 50 employees, your insurance must provide coverage for addiction treatment under the Mental Health Parity and Addiction Equity Act of 2008.
The Affordable Care Act (ACA) and Rehab
The Affordable Care Act (ACA) was signed into law in 2010. It addresses addiction treatment coverage as an essential part of healthcare and requires that all insurance plans on the Health Insurance Marketplace provide coverage for Substance Use Disorder (SUD) in the same capacity as other medical or surgical care.
If you have insurance under the ACA Health Insurance Marketplace, it is still essential to research and understand what levels of addiction treatment are covered under your plan. Although the ACA requires coverage for SUDs, the level of coverage varies widely across plans and from state to state.
Medicare and Medicaid
If you or your loved one receives insurance coverage via Medicare or Medicaid, research whether your plan provides coverage for rehab treatment. Coverage varies widely, and you will want to know what levels of care are covered under your specific plan.
Levels of Care
When researching coverage for rehab treatment, look into whether coverage is provided and the portion that is covered for the following levels of care:
- Medically supervised detox: programming that provides patients with inpatient medical support while going through withdrawal.
- Inpatient rehab: Patients live at an inpatient facility for a period of time, allowing them to completely focus on recovery and have access to medical care at all times.
- Outpatient rehab: patients continue to live at home but visit a treatment center on a regular schedule.
- High-intensity outpatient programs (HIOPs): Often known as partial hospitalization programs, this level of treatment provides care to patients 4-8 hours a day, most days of the week.
- Intensive outpatient programs (IOPs): These are less intense partial hospitalization programs that offer patients care in the outpatient setting for 9-20 hours per week.
- Aftercare: This level of treatment is typically ongoing and used after patients have completed more intensive rehab treatment programs to continue the recovery process.
The Cost of Addiction
While rehab can come at a high toll in both time and finances, it is imperative to remember just how much addiction costs you and your loved ones as well as the community, not only financially but also emotionally. Untreated addictions cost an average of $43,200 a year per person. Most of this cost is due to incarceration.
In addition to monetary costs, addiction can disrupt your relationship with work. Not only can it affect things like attendance and productivity, but workplaces can choose to perform random drug testing on employees, which could result in the loss of your job.
Finally, addiction can cause severe health problems depending on the chemicals that a person is dependent on. This can lead to medical bills causing unexpected financial burdens.
When comparing the cost of enrolling in a rehab program versus the costs associated with addiction, rehab treatment will easily cost far less than the ongoing struggle with addiction.
The Path to Recovery
No matter your insurance situation, seeking addiction treatment is worthwhile. We are here to answer any questions regarding insurance coverage and various payment methods. With a tailored treatment plan, you can embark on the path to recovery and achieve lasting sobriety.
All it takes is one phone call. Our specialists can work with you to create a treatment plan that encompasses your needs. New Jersey Behavioral Health is ready to work with you.
References:
- U.S. Department of Labor: Fact Sheet: Final Rules under the Mental Health Parity and Addiction Equity Act
- Georgetown University: Substance Abuse, Facing the Costs