How To Pay for Rehab?
You aren’t alone if you’re wondering how to pay for rehab. Fear of how much care will cost unfortunately prevents some from reaching out for help with substance abuse or their behavioral health. The good news is that many health insurance plans include some coverage for addiction treatment.
Some insurance providers and policies have full coverage, others may only have partial coverage. For those with insurance, it’s important to know your coverage if you’re thinking about getting help from an addiction treatment center. Then you can find a rehab program that not only offers the right care and works with your insurance policy.
How Does Health Insurance Work for Substance Abuse Treatment?
Health insurance works for substance abuse treatment like it does any other kind of medical care, like visiting a primary care physician or dentist. Insurance policies require plan holders to make monthly payments, and in exchange, insurance providers cover the majority of healthcare costs when needed.
Insurance plans and providers are not all the same. Some may cover rehab costs completely. Others may only cover certain treatment programs or therapies. However, the Affordable Care Act requires all health insurance providers to provide some level of coverage for addiction treatment. That means if you have insurance, it can help pay for at least some of the costs.
If you have active health insurance, check with your health insurance provider to learn more about the coverage and benefits you’re eligible for. Our team at South Coast is also available 24/7 to assist you in verifying your benefits for substance abuse treatment.
We are open 24 hours per day, 7 days per week, 365 days per year.
Types of Health Insurance
If you’re an active or former member of any branch of the U.S. Armed Forces, you and your family have insurance coverage available to you through the military and VA.
If you’re an Native American, you may have health coverage and protections from the US government and other tribal health insurance agencies.
All of these types of insurance coverage are required to provide some form of coverage for substance abuse or mental health treatment. If you don’t have insurance, looking into different plan options can help you decide which will pay for the treatments you need.
The Benefits of Health Insurance for Drug and Alcohol Addiction Treatment
Health insurance can be an invaluable resource for individuals seeking treatment for drug or alcohol addiction. Not only does health insurance provide coverage for the cost of addiction treatment, but it also provides access to care that may otherwise not be available. Additionally, health insurance can help individuals cover the costs associated with prescribed medications and other treatments necessary to support their recovery.
Typically, health insurance plans cover a portion of the costs related to drug and alcohol addiction treatment, including inpatient and outpatient care provided by mental health providers. In some cases, health insurance plans may also cover the cost of medications prescribed to help with withdrawal or cravings. Many insurance plans also provide coverage for counseling sessions and other forms of therapy, which can help to address underlying issues that may have contributed to a person’s addiction.
Private Health Insurance
One of the most popular types of coverage is private health insurance. This is what you have if your employer offers benefits or if you purchase health insurance from one of the many national providers. The policyholder either has a portion of their paycheck put towards insurance coverage with the company contributing as well, or they pay a monthly premium to their insurance provider if they have coverage on their own. Insurance then covers the cost of medical care set forth in each individual plan. Common private insurance plan types like PPOs and HMOs often require additional copayments when receiving care from medical professionals.
Common national insurance providers offerings plans for addiction treatment include:
Commercial Health Insurance
Commercial health insurance is similar to private health insurance, but in most cases, the coverage is provided by an insurance company, not an employer. Any of the providers listed above offer commercial insurance which will help those wondering how to pay for rehab. Just make sure to review the benefits of each policy so you know if the treatment you need is covered.
Like private health insurance plans, commercial plans often require monthly premiums and copays when receiving medical care. It’s important to review each plan for a better understanding of what you’ll have to pay when using the insurance.
Government Health Insurance
Another option for coverage is state or federal government health insurance. This type of insurance will often help pay for rehab, but you will still want to double-check your policy to see exactly what’s covered. For states with their own health insurance programs, residents without coverage can sign up for a plan which includes rehab insurance.
State Health Insurance
As you might expect, State Health Insurance is a type of insurance coverage provided by a state government. These policies will often cover rehab insurance for residents without access to another kind of insurance.
Common state health insurance coverage options include:
Medicaid is based on the needs of an individual and is intended for adults and children living in low-income households. CHIP is used for children (under 18 years old) from homes that don’t qualify for Medicaid. Eligibility for these programs is different depending on the state.
In many cases, state health insurance will provide rehab insurance at state-funded addiction treatment centers. There are select private rehab facilities that accept state insurance policies but the number is limited and coverage may not include all treatments and therapies.
Federal Health Insurance
Federal health insurance is coverage provided by the United States. At the moment, only Medicare falls under this category of insurance. Unfortunately, rehab insurance through Medicare is limited. It often pays for a portion of addiction treatment costs, but there are more strict requirements regarding the level of care. If you or your loved one has a condition that fits the criteria for Medicare, federal health insurance coverage may be an option to pay for rehab.
Conditions that qualifiy for federal health insurance coverage include:
Those seeking addiction treatment insurance coverage through Medicare are generally at higher risk during the detox process due to their age or pre-existing condition. This makes undergoing detox and early-stage addiction treatment in a hospital setting important for safety and successful recovery.
Military and Veterans Health Insurance
For those in the military, both active members or veterans, insurance coverage is available through your branch of service. TRICARE is for active service members and is administered through the U.S. Department of Defense and the Military Health Care System. Those getting their rehab insurance through the military will complete treatment through the military’s global system of hospitals and clinics.
If you’re a veteran, you may qualify for health insurance coverage through TriWest or the Veterans health care program. TriWest is a type of veteran health insurance administered through the Veterans Health Administration. The program is a third-party administrator for the Department of Veterans Affairs (VA) Community Cares Program. It is important to remember, those getting help for addiction through TriWest will have to go through the VA for their coverage.
Health Insurance for American Indians and Alaska Natives
If you’re an American Indian or an Alaska Native, you may have access to affordable health coverage benefits and protections through government health insurance plans. Depending on your tribe, you may qualify for special health insurance coverage and services related to substance abuse treatment. According to HealthCare.gov, these benefits are welcome to all members of federally recognized tribes and individuals represented within the Alaska Native Claims Settlement Act (ANCSA).
Additionally, individuals who are of native descent have access to additional resources through the Indian Health Service (IHS). As a federal health program for American Indians and Alaska Natives, IHS provides health care services including substance abuse treatment.
During your recovery from drug or alcohol abuse, your tribe may offer additional benefits, such as access to traditional healing practices or home-based care. In some cases, your tribal health provider can coordinate with a state Medicaid agency or other insurers so that you can receive the services you need.
Verifying Your Insurance Coverage
South Coast is In-Network with Aetna, Anthem, and Cigna.
We also accept most major insurances.
We also work with many other major health insurance providers. If you would like to know if there will be any out-of-pocket cost for our treatment programs, the easiest way to find out is to check your insurance coverage.
Does Insurance Cover Rehab?
When does insurance cover rehab? There are a lot of different insurance providers and policies available so the answer depends on which one you have. Generally speaking, health insurance will cover at least some portion of rehab, particularly if it’s considered medically necessary. Most will cover the detox and early-stage recovery process, but other rehab insurance coverage will pay for treatment from start to finish. That includes outpatient treatment, inpatient treatment, therapy sessions, and medication management.
In order to see what coverage you have, check out your policy and find the part about addiction treatment. That will give you more information about whether or not your plan covers specific treatment needs.
What Affects Rehab Insurance Coverage?
Unfortunately, insurance isn’t always the easiest thing to understand. Plans have unique features which vary by the type of insurance coverage. Things like deductibles, copays, coinsurance, out-of-pocket maximums, and in-network or out-of-network providers are factors that affect rehab insurance coverage. Understanding how each insurance feature works will help you understand what the cost of rehab will be for you or your loved one.
Deductibles, copays, and coinsurance are all out-of-pocket costs that you, the policyholder, agree to when you sign up for health insurance coverage. Along with a monthly premium payment, the above costs are set in each policy for the different kinds of medical care available. Coverage for these services also varies by state, so it’s important to check with your plan to understand what is covered.
When looking at insurance plans that cover rehab, you’ll probably come across the terms PPO and HMO. They are two common health insurance coverage plans with some key differences to consider. HMO, or health maintenance organization, limits medical care to an in-network group of doctors, facilities, and treatments. However, this generally makes the cost of rehab lower as the options are fewer. Most HMO plans will not cover out-of-network medical care. PPO, or preferred provider organization, offers a wider range of coverage for out-of-network care, but the premium and out-of-pocket costs are generally higher.
Will Insurance Cover The Cost of My Treatment?
Whether or not insurance will cover the cost of treatment depends entirely on the provider and plan you choose. Two individuals with insurance coverage through Anthem, for example, can have different plans and different costs for care. Understanding what your plan covers is important before you start a rehab program for drugs, alcohol, or behavioral health treatment.
Insurance verification starts with reaching out to the team at South Coast. We confirm your specific health insurance coverage when it comes to addiction treatment and clearly outline what the out-of-pocket costs will be for each person. The process is simple. Provide us with your provider and policy information and we’ll explain the options you have for rehab insurance, including copays, deductibles, and coinsurance payments.
Health Insurance That Covers Rehab
When discussing health insurance that covers rehab, it’s important to remember that there are several factors that determine your coverage. For example, the number of insurance claims you’ve submitted in a year or how severe your drug and alcohol abuse are can both affect insurance claims. A substance abuse assessment through a certified addiction treatment center is used to determine the severity of someone’s condition.
Taking a look at your plan or reaching out to a rehab facility for assistance can give you a better idea about whether or not you have health insurance that covers rehab completely, or just partially.
South Coast Behavioral Health is an in-network provider for Cigna, Aetna, and Anthem insurance plans. We also accept most major insurance providers and in some cases, they cover the entire cost of treatment.
FAQ About Paying for Rehab
I have a question about going to rehab with insurance...
Does health insurance cover rehab?
Yes! Most insurance providers cover a portion or all of a rehab program.
Do I need California health insurance to go to South Coast?
No, South Coast accepts national health insurance coverage as well.
Can I use my insurance out of state?
Depending on your health insurance policy, you may be able to use it out of state.
How to get insurance to pay for inpatient rehab?
Whether or not insurance will pay for inpatient rehab depends on each individual’s provider and policy. All insurance companies are required to provide some level of addiction treatment in their policies.
How much does rehab cost with insurance?
When paying with insurance, the cost of rehab depends on the details of your policy’s copay, coinsurance, or deductible.
How to verify insurance eligibility and benefits for rehab?
Contacting South Coast Behavioral Center is the best way to verify your insurance eligibility for treatment.
Can changing health insurance during treatment affect my coverage?
Every insurance policy is different, so yes, changing during treatment can affect the coverage, cost, and treatment options available.
I have a question about going to rehab without insurance...
How much does rehab cost without insurance?
The cost of rehab without insurance depends on the treatments and therapies necessary for recovery. Contact South Coast Behavioral Health for more information.
How to pay for rehab without insurance?
If you don’t have insurance, there are payment options available. The most common are state or local programs for free treatment, grants and scholarships, subsidized coverage options, sliding payment scales, fundraising efforts, or help from family or friends.
How much is inpatient rehab without insurance?
Inpatient rehab varies in cost depending on the treatments necessary. Contact South Coast Behavioral Health for more information.
Can I Go To Rehab Without Insurance?
Having insurance can make the process of getting help for alcohol or drug addiction easier. However, you can go to rehab without insurance and there are several ways to reduce the cost. There are local and state-funded programs for addiction treatment that may be free, however, these programs require people to prove certain qualifications like income level, a lack of insurance, or citizenship in a particular state or region.
If you don’t qualify for free state or local substance abuse treatment, there are options available. In some cases, individuals can finance their treatment and pay over time. There are also grants and scholarships available, subsidized coverage options, sliding payment scales, fundraising efforts, and of course, getting help from friends and family. Similarly, many nonprofit organizations offer free or low-cost treatment programs, including services related to substance abuse.
You can also find resources in your area by contacting your local health department or visiting the Substance Abuse and Mental Health Services Administration (SAMHSA) website. With all these options, cost should never prevent you from getting the help you need.
Reach Out for Help With Rehab Insurance
South Coast Behavioral Health is an in-network provider for Cigna, Aetna, and Anthem. Most major insurance providers are also and they may cover the cost of our treatment programs in full. Please call (866) 881-1184 or fill out our insurance form to check your coverage.
If you or someone you know is struggling with addiction, please don’t hesitate to reach out to us.
We are here to help because we’ve been there.