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Does Insurance Cover Rehab?

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Does Insurance Cover Alcohol Rehab?

If you or someone you know struggles with alcohol abuse or addiction, you are not alone. Help is available, and your insurance may cover it

Alcohol use disorder (AUD) affects 14 million adults in the U.S. It’s so prevalent that 1 in 10 children live with at least one parent who has a drinking problem. 10

AUD is a medical condition. It’s diagnosed when patterns of drinking cause a person distress or harm. Treatment for alcohol use disorder (AUD) is a covered medical condition under the Affordable Care Act (ACA).

Symptoms of alcohol use disorder range in severity. Severe alcoholism can be life-threatening, as alcohol can take a toll on your physical and mental health. But alcohol withdrawal can also be fatal if you try to quit a drinking addiction abruptly or alone.

That’s why seeking professional addiction treatment services is important. Fortunately, many treatments for AUD are considered essential health benefits.

Essential health benefits refer to the benefits that health insurance plans, including Medicaid, are legally obligated to cover under the Affordable Care Act (ACA). 

These fall into 10 different categories:4

  1. Ambulatory patient services (including outpatient care)
  2. Emergency services
  3. Hospitalization
  4. Prescription drugs
  5. Laboratory services
  6. Preventive and wellness services (including the management of chronic disease)
  7. Rehabilitative and habilitative services/devices
  8. Pregnancy, maternity, and newborn care (including before, during, and after birth)
  9. Pediatric services (including oral and vision care, though they’re not included for adults)
  10. Mental health and substance use disorder (SUD) services (including behavioral health treatment)

Alcohol rehab costs may be covered under mental health and substance use disorder (SUD) services. Associated treatment costs may also be covered, such as therapy.4

What Treatments Does Insurance Cover for Alcohol Rehab?

While these benefits currently exist, in 2018, only 11 percent of people with a substance use disorder (SUD) received treatment. One in five people reported not knowing where to find help.7

The Affordable Care Act was implemented to offer United States citizens easier access to lower-cost and transferrable care (between jobs or residences). Anyone who is a legal resident and isn’t already covered under Medicare can apply for a health insurance plan.9

The Department of Health and Human Services (DHHS) determines which services are covered.9

All insurance plans must cover mental health and substance use disorder services, but your specific benefits will depend on the state you live in and the health plan you choose.9

In general, every treatment provider will cover:6

  • Behavioral health treatments like psychotherapy and counseling
  • Mental and behavioral health inpatient services
  • Addiction treatment

Specific examples of costs your plan may cover include:

  • Alcohol and drug testing
  • Addiction evaluations
  • Clinic visits
  • Home health visits
  • Counseling (including cognitive behavioral therapy (CBT), family counseling, and marriage counseling)
  • Interventions
  • Medications to curb cravings and minimize withdrawal symptoms
  • Prescription drugs to treat mental health conditions like anxiety and depression

It’s important to know plans within the Marketplace cannot deny you coverage or charge you extra for pre-existing conditions. They also cannot put yearly or lifetime limits on coverage of essential health benefits.6

Mental Health Disorders and Alcohol Use Disorder (AUD)

Alcohol use disorder (AUD) is often linked to mental health issues like depression and anxiety. Your insurance plan may cover certain mental health treatments like therapy and medications.

Depression and AUD often go hand-in-hand. The presence of depression in alcohol-dependent people may influence the type of treatment they receive.5

For example, someone struggling with depression may drink to escape their problems. They might benefit from therapy to unpack their mental health issues, identify their triggers, and find healthier coping mechanisms.5

Anxiety disorders and AUD also commonly co-occur. While drinking can increase anxiety, anxiety can also cause some people to drink. The presence of anxiety in people with alcohol abuse problems also influences the course of treatment.8

People with both alcoholism and mental health disorders are more likely to have trouble maintaining abstinence. They’re also more likely to attempt or die by suicide.3

If you or someone you know is struggling with alcohol abuse or a mental health condition, seek help immediately. 

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How Much Does Alcohol Rehab Cost?

The cost of rehab for alcohol and substance abuse treatment depends on multiple factors:

  • Type of drug and alcohol rehab treatment centers (inpatient rehab vs. outpatient rehab)
  • Type of treatment programs (the various prescribed treatment practices)
  • Length of care
  • Location of center

The cost will also depend on how much of your drug and alcohol addiction treatment your insurance covers.

How to Check Your Coverage for Alcohol Rehab

You can see the complete list of covered services when you compare plans in the Marketplace. Call your insurance provider to confirm the full list of covered benefits.

Once you find a plan, take the following steps as you look for an alcohol rehabilitation center that accepts your coverage:

  1. Shop around: Check out various rehabilitation centers to find one that best suits your needs. Confirm whether or not they accept your plan. Make sure they have space available. Some facilities may be limited for those with Affordable Care Act (ACA) plans.
  2. Confirm that your providers accept your plan: Even if they work at the same rehab center, not all doctors take the same insurance plans.
  3. Ask for help: If you have questions or concerns, check out the Find Local Help tool. This tool will connect you to a navigator, agent, or broker in your area. 
Updated on March 7, 2022
10 sources cited
  1. Alcohol Use Disorder (AUD).” MedlinePlus, U.S. National Library of Medicine, 3 Feb. 2022.
  2. Alcohol Use Disorder.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 July 2018.
  3. Alcoholism and Psychiatric Disorders.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services.
  4. Essential Health Benefits - Healthcare.gov Glossary.” HealthCare.gov
  5. Kuria, Mary W, et al. “The Association between Alcohol Dependence and Depression before and after Treatment for Alcohol Dependence.” ISRN Psychiatry, International Scholarly Research Network, 26 Jan. 2012.
  6. Mental Health and Substance Abuse Health Coverage Options.” HealthCare.gov.
  7. Scutti, Susan. “21 Million Americans Suffer from Addiction. Just 3,000 Physicians Are Specially Trained to Treat Them.” AAMC, 18 Dec. 2019. 
  8. Smith, Joshua P, and Carrie L Randall. “Anxiety and Alcohol Use Disorders: Comorbidity and Treatment Considerations.” Alcohol Research : Current Reviews, National Institute on Alcohol Abuse and Alcoholism, 2012.
  9. Substance Abuse and the Affordable Care Act.” National Archives and Records Administration, National Archives and Records Administration.
  10. Treatment for Alcohol Problems: Finding and Getting Help.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services.

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All content created by Alcohol Rehab Help is sourced from current scientific research and fact-checked by an addiction counseling expert. However, the information provided by Alcohol Rehab Help is not a substitute for professional treatment advice.

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