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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.
The cost of rehab varies depending on where you live and the program you choose.
Factors that influence the cost of treatment typically include:
The average cost of treatment in 2021 is as follows:
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).
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.
Partial hospitalization programs (PHPs) offer hospital-based services on an outpatient basis.
These programs tend to run about $350 to $450 per day.
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 expenses associated with rehab vary from program to program. Some treatment centers offer complementary 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.
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.
In most cases, health insurance covers:
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.
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:
Finding alcohol addiction 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:
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.
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.
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.
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.
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.
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:
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:
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