Is Rehab Covered By Insurance?

Seeking help for an addiction is a brave move. It’s taking ownership of your life and stepping forward to change it.

Cost shouldn’t be the only thing that stands between you and a new life. So if you’re concerned about your ability to pay for rehab, here’s what you need to know.

General information

Most private and public insurance plans in both the United States and Canada have some coverage for addiction. Usually this coverage falls under normal rules about deductibles and maximum coverage limits.

Deductibles are the amount of money you must pay before the insurance kicks in. Deductibles work on a yearly basis, so once you’ve paid your deductible amount for any medical treatment, the deductible doesn’t reset until the following year.

Coverage limits are simply the maximum amount of money your insurance plan will pay out in total, for any medical treatment, during each year of coverage. You’ll need to know your own coverage limits, consider other medical costs you’ve already had in the year, and talk to your rehab facilities about costs to know if you are in any danger of hitting this limit.

Getting approval

Most health insurance plans have a list of shorter rehab treatments that are automatically approved as long as a doctor refers you for treatment. You can expect coverage for outpatient therapy and some withdrawal drugs over the short term.

For long-term treatment, you probably need to get approval from your insurance company. Your first step is always to see a doctor and get a medical opinion and referral for long-term treatment. You’ll need to be able to show your insurance provider that long-term treatment is necessary.

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Your second step should be to talk with your insurer about where you want to get treatment. It’s also a good idea to talk to the treatment center itself, too, and get their help in talking with your insurance provider. However, be aware that most insurance companies are not going to pay the entire bill for a long-term treatment program.

Alternative ways to pay

You can expect some help from your insurance provider, but it’s also highly likely that you’ll need some funds of your own to cover truly comprehensive treatment. Don’t let this discourage you: there are ways to get the treatment you need.

Choose your rehab facility wisely: All facilities are different, and it’s important you look for drug rehab centers with a compassionate understanding of financial difficulties. The right facility will be happy to work with you to plan a treatment program that works for you and that you can afford.

Many rehab facilities are also happy to set up installment plans for paying, allowing you to pay off your treatment over time rather than all in one lump.

Communicate early with your insurance company: Never wait to find out how your insurer will respond after you’ve already made a decision. Proactively call and find out what they’ll pay for and what they won’t. Make sure you ask about copays as well as your deductible.

Many insurance providers will actually be happy to work with you, but only if you contact them in advance and talk through your options. If you surprise them with a bill they weren’t expecting, you’ll risk having the payment rejected.

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Get creative: There are other options for getting the funds you need to pay for rehab. The Substance Abuse and Mental Health Services Administration can help you find sources of funds and connect with organizations interested in donating to those in need.

If your credit is good, you may also be able to get a loan or a line of home equity that will cover your costs. Some people turn to crowdfunding websites to allow friends and family to give a little, or a lot, as they’re able.

Don’t let costs stop you from getting the help you need. In the end, the cost of treatment will be well worth it, but the cost of avoiding treatment may be more than you can pay.

Post Author: Johnny R

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