How to Pay for Rehab? Does Insurance Cover This?

For people who struggle with a substance addiction or abuse disorder, a rehabilitation program is the safest way to get help and achieve long-term sobriety. Rehab programs keep clients away from addictive and toxic substances; offer counseling services, both individual therapy and group support; promote overall wellness; provide training to overcome addictive impulses and cravings; and immerse clients in the recovery process.
While the value of rehab is undeniable, many people have concerns about the cost of these programs. The National Institute on Drug Abuse recommends that people working to overcome an addiction stay in treatment for at least 90 days, in order to receive the full benefits. But when considering the cost of a three-month stay, many people might initially feel overwhelmed.

Fortunately, rehab is within reach for those who need it. There are options for every income level, and changes enacted by the Affordable Care Act, Medicaid, and other benefits may insurance coverage for rehab more likely.

Does Insurance Cover Rehab Programs?

As of 2014, the Mental Health Parity and Addiction Equity Act (MHPAEA) was officially enacted. This part of the Affordable Care Act, often referred to as Obamacare or the ACA, was passed by Congress in 2008 and requires insurance companies to cover mental health and substance abuse treatment programs to the same extent that they cover other healthcare services. This means that insurance companies must cover at least part of a person’s substance abuse treatment. This is true for people who have been with the same insurance company for years, and for people who have recently switched insurance. Companies are not allowed to deny coverage due to pre-existing conditions, including substance abuse disorders.

Does Insurance Cover Rehab Programs?For people who are able to pay for private insurance, or who have insurance through their employers, the ACA mandates at least partial coverage of these services, but the entire cost may not be covered. Contacting your insurance company to ask about services can help clarify how much of the treatment will be covered, and whether inpatient or outpatient services will be covered differently. Regardless, treatment for substance abuse disorders and addiction is now considered an Essential Health Benefit, and it has legal protection.

The Substance Abuse and Mental Health Services Administration offers a comprehensive list of treatment options, which they update every year with the help of the US Department of Health and Human Services.

For people who do not have or cannot afford private insurance, there are still many options for treatment. Here are a few:

  • Veterans should register with the Veterans Administration to receive their benefits, which includes help for substance abuse and mental health concerns.
  • For people eligible for Medicaid coverage, it is likely that substance abuse treatment is covered by the state-level program. The federal Medicaid website lists “other diagnostic, screening, preventative, and rehabilitative services” and “tobacco cessation counseling” as areas that Medicaid covers. However, federal Medicaid coverage lists basic medical services, while the state programs will offer more specifics. Contact state Medicaid programs for further help regarding substance abuse treatment.
  • There are a handful of free and reduced-cost programs for people who need substance abuse help, but who are very low income levels. The SAMHSA websiteoffers a search feature, allowing a person to search for local programs with “sliding scale” or “payment assistance.” Some religiously affiliated charities also offer counseling services, including residential treatment. The most famous of these is the Salvation Army’s inpatient rehabilitation program, which is completely free.

What Are Other Payment Options for Substance Abuse Treatment and Rehab?

If a nearby substance abuse treatment program does not accept a specific individual insurance plan, Medicaid, or offer sliding scale or discounted services, there are still ways that a person can pay for treatment. Here are a few options:

  • Financing or private loans: For people who will be able to pay a loan back, there are financing options through small lenders. These loans may have a high interest rate, so it is important to have a plan in place to pay these loans back over time.
  • Credit card: For people who have higher limit credit cards, this option can help to pay for at least part of a full 90 days of treatment. Like loans, however, it is important to have a plan to repay the charges.
  • Health Savings Accounts or Flexible Spending Accounts: These accounts are money earmarked specifically to help a person with a high-deductible insurance plan to pay for out-of-pocket costs, copays, deductibles, and other health-related expenses. Although these are specifically for “qualified medical expenses,” thanks to the enactment of MHPAEA, substance abuse treatment qualifies.
  • Treatment center payment plan: Some treatment programs offer a person the option of creating a payment plan, which helps to defray costs and make monthly payments more manageable. These can vary by type of treatment (inpatient or outpatient, for example), location, and treatment options in the program, so it is important to speak directly with the center to discuss their options.
  • Tax deduction: Medical treatment costs are tax deductible, and according to the Internal Revenue Service, that can include the costs of substance abuse treatment.
  • Crowdfunding sites: The social aspects of the Internet led to a boom in crowdfunding sites, starting with Kickstarter. While many of the more popular crowdfunding sites focus on business and product development, there are several that offer individual fundraising opportunities, including specific healthcare costs like substance abuse treatment. GoFundMeYouCaring, and GiveForward are three of the more popular personal crowdfunding sites.

Other options include personal loans from friends or family; cashing in retirement accounts; or taking a second mortgage or home equity loan. People can also take out loans against personal property, such vehicles or even jewelry.

Finding Help with Substance Abuse Treatment

Thanks to changes from the Affordable Care Act, payment plans, and changes in how society thinks about addiction, there are more ways than ever to get help overcoming addiction and substance abuse. Do not be afraid to discuss financial challenges and options with any prospective treatment center. Finances should not be barrier to anyone getting the help they need.

About The Contributor
Editorial Staff
Editorial Staff, American Addiction Centers
The editorial staff of Recovery First is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More