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January 24, 2022 By The Owls Nest

How to Pay for Rehab

If you are struggling with drug or alcohol addiction, you may wonder how to pay for rehab. You may also be wondering does insurance cover rehab. Having such questions is normal as most people believe that addiction treatment is too expensive for them. But, they don’t realize there are options. 

Rehab costs widely depend on the level of care. Residential or inpatient treatment is the highest level of care. Therefore, they are typically the most expensive. Outpatient programs are less expensive than inpatient or residential treatment. Still, outpatient treatment programs can still offer the support one needs for lasting recovery. 

It’s important to ask, does insurance cover rehab? And, even if you don’t have insurance, there are options to help cover the cost of rehab. At The Owl’s Nest, we verify coverage through your insurance company and help you find other options to pay for rehab.

Determining Your Rehab Needs is the First Step

Because the cost of rehab greatly depends on the type of rehab program, it is important to discover which rehab program best fits your needs. Keep in mind that a continuum-of-care treatment method, or stepdown method, will incorporate more than one level of rehab. 

Various treatment programs include:

  • Medical detox. Going through detox or withdrawal can be extremely uncomfortable. Medical detox provides monitoring and medications to ease the discomfort and encourage recovery. Some FDA-approved medications for detox include methadone, naltrexone, and buprenorphine.
  • Inpatient rehab. Inpatient and residential treatment provide 24-hour supervision and a safe, drug-free environment to their patients. Rehab patients that are inpatient have access to medical and mental health care, including individual therapy, group therapy, and various holistic therapies. 
  • Partial Hospitalization Program. A PHP is similar in intensity to inpatient treatment. The significant difference between the two is that PHP patients go to their own homes in the evening once rehab is over. The benefit of a PHP is the ability it gives you to handle your responsibilities outside of treatment. The downfall of a PHP is that patients will still face the daily triggers of addiction. 
  • Intensive Outpatient Program. IOPs generally focus on behavioral therapies. IOP patients spend a few hours, three to five days a week in therapy. This level of care is typically the next step down after partial hospitalization program treatment. 

Your addiction treatment needs will depend on the severity of your addiction, your drug of choice, and any co-occurring mental health disorders that you suffer from. 

Paying for Rehab

One stressor of getting sober is paying for rehab. In fact, it is often a deterrent for many people who need addiction treatment. While some rehab facilities are more expensive than others, it’s typically because they offer “extras” that are more a luxury than a necessity. 

If you are wondering how to pay for rehab, there are various options. The Substance Abuse and Mental Health Services (SAMHSA) derived a list of how people paid for rehab in 2017. These options include:

  • 12,248 people paid cash
  • 9,531 people used private health insurance
  • 4,767 people used Medicare
  • 8,685 people used Medicaid
  • 6,415 people used state health insurance
  • 4,638 people used military insurance
  • 8,024 people received treatment on a sliding scale

Does Insurance Cover Rehab?

Does insurance cover rehab? Well, for many people, their health insurance will cover at least a portion of rehab while some insurance plans cover rehab entirely. Call your insurance company or check their website to find out how much your insurance policy covers. 

If you are not sure what to ask, most rehabs will make the call for you. They will find out if they are an in-network provider, what services are covered, and how long they will cover rehab. 

The four major addiction treatment insurance companies are United Healthcare, BlueCross and BlueShield, Aetna, and Cigna. These companies cover millions of Americans. But, do they cover the cost of rehab?

Does United Healthcare Insurance Cover Rehab?

Many policies with United Healthcare cover a portion of addiction treatment such as medical detox and residential rehab. The amount insurance covers depends on your location and your insurance plan. 

To help their members overcome addiction, United Healthcare created the United Behavioral Health division. The goal of this division is to provide confidential addiction and mental health services. This helps to ensure the highest quality of treatment to promote lasting recovery.

How to Pay for Rehab with BlueCross and BlueShield

BlueCross and BlueShield cover a third of Americans. For this reason, they are committed to providing excellent care. Many insurance plans through BlueCross and BlueShield cover medical detox, inpatient rehab, and partial hospitalization programs. 

Additionally, members struggling with addiction have access to 24/7 support and educational tools on the OneHealth mobile app. To learn more about what your insurance policy covers, call BlueCross and BlueShield directly. 

Covering Rehab with Aetna Health Insurance

Aetna takes a unique approach to addiction rehab. Unlike other insurance companies, Aetna doesn’t set a predetermined limit on the level and amount of treatment it covers. Instead, the company bases its rehab coverage on the needs of its members. 

Aetna wants to help its members achieve lifelong recovery. For this reason, it helps the members of the church find therapy and aftercare services in their community. 

While most Aetna policies cover medical detox, partial hospitalization programs, residential treatment, and aftercare, it’s essential to call the company to find out your policy details.

Does Cigna Cover Rehab?

Cigna provides quality and affordable health insurance for almost 86 million people across the globe. Its insurance plans cover many of the expenses of addiction rehab, such as that of inpatient and outpatient treatment programs. However, your individual coverage depends on your specific insurance policy. 

Cigna members who struggle with addiction typically work with our behavioral health division. Our team of professionals provides educational tools and resources to encourage lasting recovery. Call Cigna today and ask them does insurance cover rehab?

The Affordable Care Act Requires Health Insurance to Cover Rehab

The Affordable Care Act (ACA) is also known as Obamacare. The ACA prevents insurance companies from penalizing for pre-existing conditions. As a result, a person already struggling with addiction can get coverage.

 In addition, the ACA requires insurance companies to treat addiction and mental health disorders as significantly as they treat other medical issues. How much insurance covers for your addiction treatment depends on your plan, but ACA- sponsored policies cover between 60 and 90 percent of rehab costs. 

Marketplace health insurance plans include:

  • Bronze plans – cover 60 percent of rehab
  • Silver plans – cover 70 percent of rehab
  • Gold plans – covers 80 percent of rehab
  • Platinum plans – covers 90 percent of rehab
  • Catastrophic plans – available for extenuating circumstances and covers 60 percent of rehab

Terms to Know When Asking Does Insurance Cover Rehab

Health insurance is the most common way to pay for drug and alcohol rehab. However, every insurance policy is different. It is crucial to understand some insurance terms in order to know how much treatment will cost you. 

  • Co-payments are the set amount for treatment you are responsible for when entering rehab.
  • Deductibles are the amount you pay before insurance covers 100 percent of treatment. 
  • Other out-of-pocket expenses are costs that insurance doesn’t cover and you are responsible for.

What is the Difference Between In-Network Providers and Out-of-Network Providers?

Doctors, hospitals, and other providers who have a contract with an insurance company are in-network providers. Out-of-network providers do not have contracts with an insurance company. Depending on your policy, out-of-network providers typically cost more money. 

Types of Health Insurance Plans

Trying to understand your insurance coverage can be frustrating, especially when you want to get sober. The type of insurance plan you have will answer the question, does insurance cover rehab?

However, how much your insurance covers depends on if you have an HMO, PPO, or POS plan. Let’s break down what each plan is and which ones will help pay for rehab. 

HMO: Health Maintenance Organization

All your healthcare needs go through your primary care physician (PCP) with an HMO insurance plan. Your PCP manages all your care and refers you to specialists and other providers when needed. 

The monthly premiums with an HMO are typically lower, but you are limited on the providers you can see. Most HMOs won’t cover out-of-network care. 

Additionally, many services require preapproval. So contact your insurance company before signing into detox or rehab. 

PPO: Preferred Provider Organization

A PPO insurance plan is the most flexible plan. But, it is also the most expensive. Typically, PPOs do not require a PCP, and you do not need a referral to see a specialist or other provider. 

Insurance companies have a list of preferred providers for their PPO plans. If you use one of these providers, your co-payments and deductibles will be much lower. Simultaneously, using providers not on the preferred list may be extremely expensive. 

Some services, such as addiction rehab, may require preapproval before paying for treatment. If you have a PPO plan, be sure to get the details of your coverage before entering rehab.

POS: Point of Service 

A POS plan combines some parts of an HMO plan and PPO plan. For example, you choose a primary care physician and need referrals for specialists and other healthcare professionals. 

The difference between a PPO and an HMO is your PCP can refer you to an out-of-network provider. Always check with your PCP and insurance company about coverage before entering rehab.

How to Pay for Rehab with Medicare and Medicaid

Specific segments of the population may qualify for Medicare and Medicaid. These types of health insurance can help when you are wondering how to pay for rehab. 

  • Medicare is primarily for individuals over 65 and those with specific disabilities.
  • Medicaid is a state-funded program for lower-income individuals. People with long-term chronic addiction generally struggle financially, and Medicaid such people pay for rehab.

Private Funding and Financing to Pay for Rehab

If you do not have health insurance, there are other options for how to pay for rehab. If paying for rehab is holding you back from getting sober, then ask the treatment center that you are attending rehab at if it is offering scholarships for rehab. 

They may offer payment plans to help make rehab affordable. These plans are typically through a third-party lender, and payments are often not due until after treatment. 

If you have been at your job for some time, you may have a 401k plan or an IRA. If insurance doesn’t cover rehab, you may need to take out money from one of these plans. Home equity loans are another way to pay for rehab.

Fundraising and Crowdfunding to Cover Rehab Costs

When you struggle with an addiction, you may feel like you are alone. However, your friends and family only want the best for you. They may even help you pay for rehab. 

People can make payments directly to the facility on your behalf, so they know how it’s being used. Crowdfunding sites such as GoFundMe are great for raising money for rehab.

State and Federally Funded Rehab Centers

Addiction rehabs funded by the government typically provide free rehab for those who qualify. Sometimes these programs are part of a more extensive treatment program, and other times they are a small local agency. Either way, rehab includes inpatient and outpatient treatment as well as aftercare services. 

There is usually a waiting list for these programs, and you will have to prove the following. 

  • Proof of citizenship
  • Proof of residency
  • The severity of addiction
  • An inability to pay for rehab

Non-Profit Rehab Centers 

Non-profits offer rehab programs at little or no cost. For example, The Salvation Army provides free treatment plus room and board in exchange for them working in the warehouses. In this program, individuals spend 40-hours a week sorting items and helping with clerical duties. 

Don’t Let Finances Stop You from Starting Treatment

Now you know the answer to, does insurance cover rehab? And you know how to pay for rehab when you don’t have insurance. The next step is discovering what treatments best fit your needs. 

At The Owl’s Nest, we offer a variety of therapies to address all types of addictions and co-occurring mental health disorders. Contact us today and get on the road to lasting recovery.