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Alcohol Rehab: Expenses & Insurance Coverage

Treatment and rehabilitation for alcohol use disorder are powerful tools to help someone recover. Unfortunately, some treatment programs are expensive. Not everyone understands the resources available to them. Others aren’t sure where to begin when it comes to paying for rehab.

If you or a loved one is interested in treatment for AUD, learning about rehab expenses and insurance coverage is a great place to begin. Treatment for alcoholism and addiction is available to everyone, but it isn’t the same for everyone.

Health insurance plans cover alcohol rehabilitation expenses, at least in part, for most people. It might cover inpatient, outpatient, or other services or a combination of these options. Most rehabilitation centers accept insurance coverage. They will also assist the patient in determining their coverage and any out-of-pocket expenses.

The cost of treatment should never be a barrier to recovery. And for most people, it won’t be. Figuring out how to pay for treatment (and what programs are best for you financially) takes time and research.

How Much Does Alcohol Rehab Cost?

The cost of rehab varies depending on where you live and the program you choose. 

Factors that influence the cost of treatment typically include:

  • Services offered
  • Intensity of services
  • Duration of treatment
  • Population treated (patients with dual diagnoses, pregnant women, elderly, veterans, etc.)
  • Amenities offered in addition to treatment services

The average cost of treatment in 2021 is as follows:

  • Medical detoxification (30 days) — $240 to $850 per day
  • Outpatient treatment (90 days) — $1,500 to $10,000
  • Intensive outpatient treatment (30 days) — $3,000 to $10,000
  • Residential treatment (varies) — $5,000 to $80,000

Cost of Inpatient Rehab

The average inpatient treatment program costs approximately $500 per day or more. This cost depends on what is included in the program. 

Some residential programs can cost $80,000 in total. This is because complementary services may be offered if a person spends a long time at the facility (30 days or more).

Cost of Outpatient Rehab

Outpatient treatment programs provide care without offering overnight facilities or round-the-clock care. Most programs range from $250 to $350 per day. Programs including medical detox or that are partial hospitalization programs can be more expensive.

Cost of Partial Hospitalization Programs (PHP)

Partial hospitalization programs (PHPs) offer hospital-based services on an outpatient basis.

These programs tend to run about $350 to $450 per day.

Cost of Medication-Assisted Treatment (MAT)

Medication-assisted treatment (MAT) includes prescription medications that ease withdrawal symptoms in a medically supervised environment. These programs are typically $500 to $650 per day.

Additional Costs

Additional expenses associated with rehab vary from program to program. Some treatment centers offer complimentary or holistic treatment as part of their overall plan. Others provide them optionally at an additional cost.

Your circumstances also determine if there are any additional costs associated with rehab. For example, some people need to pay for transportation to and from the rehabilitation center. Many people also have to adjust their work schedule around the treatment schedule.

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Does Insurance Cover Alcohol Rehab? 

Yes, health insurance covers alcohol rehabilitation, addiction treatment, and treatment for mental health disorders. The Affordable Care Act ensures that all Americans with insurance coverage have access to rehab. This is also in conjunction with the Mental Health Parity and Addiction Equity Act. 

However, this doesn’t mean that every plan or treatment from every facility is offered. Plans vary, and it’s essential to understand what’s provided to you under your plan before committing to a treatment program.

What is Covered by Health Insurance?

In most cases, health insurance covers:

  • Screening, preventative, and intervention services
  • Detoxification
  • Medication for detox, withdrawal, and recovery
  • Inpatient services at a hospital
  • Outpatient services 
  • Individual or group counseling and behavioral health programs

Insurance typically covers essential withdrawal and recovery services. Any additional services are less likely to be covered, but some insurance providers offer more comprehensive services than others. In most cases, you pay higher premiums for more extensive coverage. 

Most insurance policies do not cover so-called luxury services offered by some drug rehab programs, such as recreation, gourmet food, holistic services, or non-medical amenities. 

It’s important to note that some states allow private insurance companies to deny coverage to intoxicated people when they seek services. This usually applies to emergency treatment related to illnesses or injuries caused by intoxication. 

Emergencies are unpredictable, so this isn’t something for which you can plan, but knowing your insurance policy does not offer coverage in certain circumstances could be the impetus to begin recovery.

What Will I Pay Out-Of-Pocket?

You will need to pay any expenses not covered by your insurance provider. There might also be additional costs that are assigned to you by your insurance provider. For example:

  • Premiums (the cost of your insurance coverage)
  • Co-insurance or co-pays (fee paid to service provider)
  • Deductibles (amount of healthcare expenses that are the policyholder’s responsibility)
  • Lifetime limitations (healthcare expenses may go above what your provider is willing to pay; not all policies have lifetime limitations). 

How to Find Alcohol Rehabs That Accept Insurance

Finding treatment programs that accept your insurance is challenging. You can do a few things to make the process easier and ensure you get the help you need. For example:

  • Speak to your doctor about treatment. They can assess your specific situation and your insurance coverage and refer you to the ideal program for you.
  • Use SAMHSA’s Treatment Services Locator or consult your state or local Health and Human Services Department.
  • Contact your insurance provider and ask about the programs for which they provide coverage.
  • Ask friends, family, Alcoholics Anonymous participants, or others with whom you are comfortable sharing your struggle and ask if they know of any programs. You can then contact the suggested program and ask if they accept your insurance coverage.
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How to Use Insurance for Alcohol Rehab

Once coverage levels are confirmed through the individual’s insurance company or policy, there are some steps to take to use insurance coverage for alcohol rehab.

Consult a Doctor

First, speak with a doctor to determine your treatment requirements. This is the essential first step because of the general requirement that treatment must be medically necessary. A doctor can assess to determine and understand the degree of abuse or addiction and what type of treatment is needed.

The assessment is typically covered. The information gathered can be used for the subsequent steps.

Find a Suitable Rehab Program

Your doctor may recommend rehab programs. Or you can find them yourself using several resources, such as the SAMHSA website. To ensure that insurance will cover your rehab program of choice, it is essential to verify that the program provides professional medical treatment.

Determine Ability to Use Insurance

Once you find a suitable center that provides the suggested treatment level, it is essential to confirm that they accept insurance and your specific plan.

A reputable center will be honest and upfront about their ability to accept insurance and support you in getting the coverage details worked out.

Work With the Rehab Center to Determine Insurance Coverage

Your chosen rehab center should assist the insurance company in working out the level of coverage for the specific program. They should present you with the information at the beginning of the process.

In some circumstances, the center will also communicate with you about ways to help pay for the portions of rehab that are not covered by insurance and other out-of-pocket costs, like deductibles or copays.

Some rehab centers provide various financing options, so be sure to ask about this before enrollment.

Alternative Ways to Pay for Alcohol Rehab

Medicaid

Medicaid programs in many states cover rehab center costs for alcoholism and other substance use disorders. According to the ACA, anyone eligible for Medicaid is eligible for substance abuse and recovery support. Some states offer coverage through the ACA, while others have specific state programs.

Medicaid coverage is available for low-income families and individuals based on:

  • Age
  • Children
  • Income level
  • Disability

Medicare

Medicare is a federal health insurance program offered to seniors aged 65 or older or have certain disabilities. The alcohol and substance abuse treatment coverage under Medicare includes:

  • Inpatient programs
  • Outpatient programs
  • Medication (except methadone)
  • Partial hospitalization
  • Individual, group, and family therapy

Resources

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“Inpatient Rehabilitation Care Coverage.”, Medicare

“Medicare Guidelines for Inpatient Rehab Coverage.” Healthline, 6 Aug. 2020

Andrews, Christina et al. “Despite Resources From The ACA, Most States Do Little To Help Addiction Treatment Programs Implement Health Care Reform.” Health affairs (Project Hope) vol. 34,5 (2015)

Breithaupt, D. “Why health insurers should pay for addiction treatment. Treatment works and would lead to net societal benefits.” The Western journal of medicine vol. 174,6 (2001): 375-7

Huebner, Robert B, and Lori Wolfgang Kantor. “Advances in alcoholism treatment.” Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism vol. 33,4 (2011): 295-9.

Mental health & substance abuse coverage, Healthcare

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