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Frequently Asked Questions
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Paying for Rehab
Depending on the type of program, rehab can be pretty costly. Luckily, there are several insurance programs to help cover the costs, at least partially.
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Options For Paying For Rehab
Every treatment facility charges differently. Depending on the needs of the treatment seeker, the options for paying for rehab will vary. No matter what insurance you have, or if you have to pay out of pocket, there is a treatment center out there willing to work with you to help you recover.
If you can’t afford to pay for rehab out-of-pocket, there are several other ways to admit to a rehab facility. Some options for funding include:
- Private Insurance
- Military Insurance
- Governmental Programs
- Affordable Care Act
The costs might seem high, especially out-of-pocket costs, however nothing compares to the cost of an addiction. Use disorders inspire intense cravings that push people to spend thousands of dollars on substances and paraphernalia to continue their habit. If their affliction is particularly intense, they may lose their job and their income altogether, along with valuable relationships all while accruing high cost medical bills due to addiction.
Private insurance is health insurance provided by private health insurance companies. Plans are usually issued through employers, which accounts for 49% of Americans’ health insurance, or individuals, which accounts for an additional 7% of Americans’ health insurance. Private insurance is largely a go-to option for covering the costs of rehabilitation. However, the coverage all depends on your specific plan as well as the facility in which the user wishes to admit to.
TRICARE is the health care program for military members and their families. The program covers:
Inpatient Hospital Services For:
- Any medical complications as a result of the disorder
Outpatient Programs If You:
- Have a psychiatric or substance abuse disorder
- Are in transition from an inpatient program or other treatment center
- Need stabilization or prevention or relapse
Depending on where they have served, on average, 11-20 veterans out of 100 have post-traumatic stress disorder (PTSD). TRICARE takes this very seriously which is why they offer coverage for these intense and much needed services.
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Taxpayer dollars go to several governmental programs that could help cover the cost of rehab. Read on to learn more about some options that may be available, and get a sense of how health care reform has helped expand coverage for those struggling with mental health and substance use disorders (SUDs).
The Affordable Care Act
The Affordable Care Act was put in place to make sure those seeking treatment are able to cover the costs with help of their insurance. It aims to cover around 27 million Americans who previously did not have insurance, potentially providing treatment to millions in need who would have stayed suffering otherwise. No one should have to worry about the cost of rehab, they should be focused on one thing- to recover.
Thanks to the Affordable Care Act, your “pre-existing condition,” such as alcoholism or a history of drug or mental illness, cannot be denied any longer, making treatment at any facility you choose, more affordable.
Medicaid And Medicare
Medicaid and Medicare are government-funded health insurance programs that aim to reduce the high costs of medical bills. The difference between the two is that Medicare (federally funded) is provided to people 65 or older or have a disability while Medicaid (state and federally funded) will supply health coverage if you have a low income. You are able to get both if you meet both requirements.
Medicare pays for treatments in both inpatient and outpatient programs if:
- You are already under treatment from a Medicare provider
- You doctor deems the inpatient or outpatient programs are “medically necessary”
- Your doctor creates and controls your treatment plan
Be aware: Medicare only covers up to 190 days of treatment within a psychiatric hospital, and if those days are used up, the insurance may not cover other rehab fees. However, they still may cover inpatient programs in a general hospital, but not a psychiatric hospital.
Another important note to consider, Medicare pays for 80% within approved limits of mental health services, meaning you or any other insurance you may have will be responsible for covering the remaining 20%.
Medicaid has several benefits for those who qualify for the program, however the benefits and coverage vary by state.
For example, in Delaware, 30 days of residential treatment are covered by the program. However, in the District of Columbia the rehab centers must be certified and approved before costs are covered and range by treatment length. While in Iowa, the coverage of services is limited to treatment of chronic illness. Taking into consideration the state on which the user picks for their inpatient program, the user’s costs could potentially be covered, or have they might be paying for rehab out-of-pocket.
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Factors That Come Into Play For Prices Of Addiction Treatment
There are several factors included in the cost of treatment, and every one should be considered separately. Some include:
Type Of Centers
Inpatient programs are typically costlier than outpatient programs due to round the clock observation and treatment. Outpatient programs allow the patient to stay within their own home, thus receiving less in-depth treatment and reduced costs for living arrangements. However, inpatient programs are generally more successful and are recommended in almost all circumstances.
Length Of Stay
Depending on the severity of the addiction and treatment plan, patients typically stay in treatment for 30, 60, or 90 days. The longer you stay, the larger the cost is due to prolonged services of treatment and use of amenities.
Different centers offer different treatments, and some patients take advantage of different treatments than others. For example, patients who do not experience severe withdrawals will require lower quantities of addiction treatment medications. As there are separate costs for many individual treatments, patients who utilize those treatments will often find themselves paying more.
Rehab centers have all kinds of amenities, including a pool, gym, meditation, massages, etc. Facilities with more amenities offered typically cost a little more.
Location of the treatment facility is a big factor of cost. For example, if the user chooses to stay in a facility in California, the price will likely be higher due to higher costs of living and doing business within the state.
Finding Out How You Will Be Paying For Rehab
Don’t let worrying about cost get in the way of your recovery. There are many solutions to help aid in paying for rehab. Contact a provider today to learn more about available payment options.
ASPE. (2013) Affordable Care Act Expands Mental Health and Substance Abuse Disorder Benefits and Federal Parity Protections For 62 Million Americans. Retrieved on February 21, 2018 at https://aspe.hhs.gov/report/affordable-care-act-expands-mental-health-and-substance-use-disorder-benefits-and-federal-parity-protections-62-million-americans
Cost Helper Health. (2018). How Much Does Drug or Alcohol Rehab Cost? Retrieved on February 21, 2018 at http://health.costhelper.com/rehab.html
HealthInsurance.Org.(2018). Private Health Insurance. Retrieved on February 21, 2018 at https://www.healthinsurance.org/glossary/private-health-insurance/
KFF. Medical Benefits: Rehabilitation Services- Mental Health and Substance Abuse. Medicare Interactive. (2018). Retrieved on February 21, 2018 at https://www.kff.org/medicaid/state-indicator/rehabilitation-services-mental-health-and-substance-abuse/view/print/?currentTimeframe=0&print=true&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Medicare Interactive. (2018). What is the difference between Medicare and Medicaid? Retrieved on February 21, 2018 at https://www.medicareinteractive.org/get-answers/introduction-to-medicare/explaining-medicare/what-is-the-difference-between-medicare-and-medicaid
Medicare Interactive. (2018). Medicare coverage of treatment for alcohol and drug abuse. Retrieved on February 21, 2018 at https://www.medicareinteractive.org/get-answers/medicare-covered-services/mental-health-services/medicare-coverage-of-treatment-for-alcoholism-and-drug-abuse
TRICARE. (2017). Intensive Outpatient Program. Retrieved on February 21, 2018 at https://tricare.mil/CoveredServices/IsItCovered/Intensive-Outpatient-Program
U.S. Department of Veteran Afairs. (2016). PTSD: National Center for PTSD. Retrieved on February 21, 2018 at https://www.ptsd.va.gov/public/PTSD-overview/basics/how-common-is-ptsd.asp