Does health insurance cover drug rehab or drug treatment?

Health insurance companies will usually cover at least part of the cost of drug rehab or drug treatment. Read on for more information on health insurance coverage and what you can do when don’t have any here.

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Insurance coverage for drug rehab or drug treatment

Health insurance may cover part of your drug rehab or drug treatment, but it doesn’t usually cover the entire cost. It’s best to check with your insurance company to find out if drug rehab or drug treatment is covered and how much your out-of-pocket costs will be.  Still, most health insurance policies require policyholders to pay for a portion of their own treatment, usually in the form of a co-pay or deductible.

Co-pays are usually low set dollar amounts that you’ll need to pay directly to doctors or treatment facilities, while your health insurance company pays the rest. Deductibles require you to pay for your healthcare costs up to a certain amount for the year, before your insurance company will begin coverage.

According to a 2006 survey, the average co-pay for a doctor’s visit in the United States was just under $20;  the majority of health insurance companies use this method. A co-payment for a residential facility, though, will usually be much higher, and you can expect to pay around $100 per day. If you have a deductible on your health insurance, however, you can expect to pay anywhere from $500 to $5,000 in a year before your health insurance will start covering the tab.

Does insurance cover drug rehab or drug treatment?

It depends. Some insurance policies cover only specific treatments, such as psychotherapy, or will limit their reimbursements to certain amounts.  Other insurance policies pay for medical detox or medications.  You can find this information out by reading your benefits guide or contacting the company directly.

If your insurance company denies you coverage, you may also be able to appeal this decision. However, it’s important that you closely follow the appeals process and guidelines set forth by your insurance company.

Drug rehab or drug treatment no insurance

Since drug rehab or treatment is expensive (more than $100 a day for outpatient treatment and $700 per day for inpatient treatment), even with health insurance coverage, there’s a chance that you may not be able to afford treatment. In this case, you’ll usually be able to work out payment arrangements with the treatment facility.

Coming up with the money to cover the costs of drug rehab or drug treatment with no insurance may seem impossible. Fortunately, there are a number of resources that can be used to lower or even eliminate these costs.

1. Sliding scale fees. One of the best options for drug rehab or drug treatment with no insurance is sliding scale drug treatment facilities. These facilities only charge individuals an amount based on what they could reasonably afford to pay. This amount is primarily determined by your income, and may also be influenced by factors such as your expenses and household size.

2. Government assistance. If you have a low income, you may also qualify for government assistance to help pay for drug rehab or drug treatment without insurance. The eligibility requirements for Medicaid or for participation in low cost addiction treatment centers vary by state, but you’ll need to have an adjusted household income below the poverty line. To determine your household income certain necessary expenses, such as rent and utilities, are taken into consideration. Call the Medicaid office or the SAMHSA treatment locator hotlines for more information on this type of funding.

3. Personal financing. Financing drug rehab and drug treatment may be another option for individuals who do not qualify for reduced cost treatment or assistance. Some facilities are willing to finance some or all of the cost of treatment, meaning that you’ll make payments toward these costs until they are eventually paid off.

Medical insurance for drug rehab or drug treatment questions

Taking the first steps toward a drug-free life can be frightening and stressful. This is especially true if you’re unsure of how much you’ll have to pay for treatment. Questions and concerns about medical insurance for drug rehab or drug treatment can be left in the comments section below. We’ll do our best to guide you with any issues you may have during every step of your journey.

Reference Sources: MEPS: Co-pays, Deductibles, and Coinsurance Percentages for Employer-Sponsored Health Insurance in the Private Sector, by Firm Size Classification, 2006 Is your health plan at work any good?
Compdata Surveys: Medical Insurance Co-Pays in 2010
Wisconsin Department of Health Services: Benchmark Plan-Covered Services and Co-pays
Blue Cross and Blue Shield FEP
ASPE: Affordable Care Act Expands Mental Health and Substance Use Disorder Benefits and Federal Parity Protections for 62 Million Americans
Treatment Solutions: Does Health Insurance Cover Drug Treatment or Rehab?
Legislative Analyst’’s Office: Review of Health Coverage for Substance Abuse Treatment
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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