Alcohol is the most commonly used recreational substance in the United States. According to the 2019 National Survey on Drug Use and Health, more than 14 million people had an alcohol use disorder. Only a fraction of those people get the help they need to effectively treat alcohol-related substance use problems.
Alcohol rehab is an important part of recovery for many people with alcohol use disorder, but the cost leads many to avoid getting help. You have many options when it comes to funding your recovery efforts, especially if you have insurance coverage. But does your insurance cover alcohol rehab? And if so, what kind of treatments will be covered? Learn more about alcohol rehab insurance and your options.
How Do People Pay for Alcohol Rehab?
When you recognize that you have a problem with alcohol, there are many barriers between you and getting the treatment you need. Many of those barriers are related to your own readiness to change and resolve to make it happen. You may also fear the stigma of admitting you have an alcohol use disorder. However, the cost can also be a significant barrier for you to overcome.
Like many health care programs and procedures, alcohol rehab can be expensive, especially if a stay in residential treatment is necessary. But there are many options available to help you get the treatment that’s right for your needs. Some people pay for treatment out of pocket. If you have insurance, you may be able to cover your treatment with help from your medical insurance plan.
Is Rehab Covered By Insurance?
Yes. Private insurance companies are required by law to offer coverage for mental health services, and addiction treatment falls under that category. When the Affordable Care Act was passed, mental and behavioral health services were deemed essential health care benefits. The law required insurance companies to treat mental health services as an important part of health care.
That means the law requires plans to cover behavioral health treatment, mental and behavioral health inpatient treatment, and substance use disorder treatment. However, that doesn’t mean your health insurance plan will cover all of your treatment, no matter where you go or what your treatment entails. Still, if you have insurance from a private health insurance provider, you should be able to find a treatment program that is at least partially covered by your plan.
The coverage you receive will depend on your specific plan. To find out more about what’s covered, you can speak to your insurance provider or review the specifics of your policy. If you’ve found a treatment program that looks promising, they may also be able to help you navigate your insurance coverage.
How Do You Use Insurance to Cover Alcohol Rehab?
The first step in using your insurance to cover addiction treatment is to speak to a doctor to determine the care that you need. You can schedule an appointment with a family doctor or visit a hospital. However, addiction treatment programs may also start your treatment with an assessment with a doctor. The assessment is important for several reasons. It lets your doctor know how severe your substance use problem is, which can have an impact on the type of treatment you need. It can also uncover other complications that may need to be addressed alongside treatment.
For instance, malnutrition is common among people that are seeking alcohol rehab. After that, you’ll need to find a rehab center that’s ideal for your needs. During the intake process, your rehab center will verify your insurance and check on your coverage. Through treatment, your treatment center will work with your insurance company to get coverage for the therapies you go through.
What Are Out-of-Pocket Expenses?
Out-of-pocket expenses are the portions of your treatment that you have to pay on your own. This can be a part of your treatment that isn’t covered or a predetermined amount that your insurance company expects you to pay before you receive treatment. With insurance, you know that you must pay a monthly out-of-pocket expense called a premium. This tends to go up or down depending on your deductible. Your deductible is the money you pay for health care expenses each year before your insurance policy starts paying.
Your insurance policy may also require you to pay a copay, which is a small portion of a bill you have to pay when you see a doctor. You may also run into some out-of-pocket expenses if your insurance company doesn’t want to pay for a specific therapy you go through. However, your treatment program will work to get your therapy covered as much as possible.
What Does Insurance Cover in Rehab?
According to the Affordable Care Act (ACA), your insurance company is required to offer coverage for psychotherapy, counseling, inpatient services related to mental and behavioral health, and treatment for substance use disorder. However, there is a wide variety of addiction treatment approaches, and therapies and the specifics of which therapies are covered will depend on several factors. For the most part, insurance companies are more likely to cover therapies that are evidence-based.
Evidence-based treatment is one that has been tested scientifically and shown to be reasonably effective. That doesn’t mean every evidence-based treatment is effective for every person, but they are generally valuable and worth attempting as a part of the typical treatment program.
On the other hand, insurance companies may be reluctant to cover alternative therapies. These are therapy approaches that haven’t been tested in a scientific setting or have failed to produce consistent results during research. Many of these alternative therapies are still used in addiction treatment, but they’re better off as supplementary to evidence-based approaches. Each person is different, and the treatment plan you go through should be tailored to your needs. Your treatment center will work to convince your insurance company when therapy is necessary and right for you.
Does Medicaid Cover Alcohol Rehab?
Yes, technically, Medicaid offers coverage for alcohol rehab and other mental health services, just as private insurers are required to do. However, even if you have Medicaid and you have alcohol rehab coverage, finding rehab may be more difficult for you. Medicaid is a health care option that’s provided, in part, by the federal government, but it’s administered by your state. Unlike Medicare, which is for seniors and people with disabilities, Medicaid is primarily for people with low-income levels and other qualifying individuals.
Even though you might have rehab coverage through Medicaid, you might find it challenging to find an addiction treatment center. Many private addiction treatment programs don’t accept Medicaid. Medicaid often requires more paperwork and administrative work than private insurers, causing clinics to have to hire more administrative workers.
Medicaid also tends to pay doctors and clinics less than Medicare and private insurance. For those reasons, many doctors and clinics avoid Medicaid. However, Medicaid can cover alcohol rehab at some facilities, even if your options are more limited than someone with Medicare or private insurance.
Is Alcohol Rehab Worth the Cost?
Facing alcohol rehab can be daunting, especially when you see the price tag. But alcoholism is a disease that’s both chronic and progressive. That means it’s unlikely to go away on its own, and it’s more likely to get worse over time.
Over time, alcohol use disorder can start to take over every aspect of your life, including your health, relationships, and even your finances. Plus, addiction is identified by compulsive drug use despite serious consequences. It is, by definition, out of your control. Neglecting you get help may only lead to worse consequences. Alcoholism can lead to long-term health consequences that can mean expensive medical bills.
Alcoholism often leads to job loss and the inability to maintain a job. On the other hand, finding an effective addiction treatment program for your needs can help you start to take control of your life. While relapse is a reality for many, treatment has proven to improve your ability to avoid alcohol and drug use, your occupational capabilities, and your ability to build healthy relationships with others.
Addiction treatment is an effective way to address a problem that may otherwise jeopardize your finances if it’s ignored. For that reason, effective, evidence-based alcohol rehab is worth the cost.
What If I Have No Money or Insurance?
Unfortunately, addiction is a disease that can rob you of many things, including your connection to family and your financial security. If you have no insurance and you don’t have access to the funds to pay for it, your options are limited. However, you still have some avenues to get help in dealing with your addiction.
The Substance Abuse and Mental Health Services Administration (SAMHSA) can help connect you to offices in your state that are responsible for state-funded addiction treatment programs. You may also be able to find private addiction treatment programs that offer pro-bono treatment spots, though the number of these options is very limited.