Once the important decision to seek out the right drug or alcohol rehab for you to finally begin your much-needed addiction treatment has been made, it is invariably the issue of cost (and all the added questions, like “How can I pay for this?” and “Will my health insurance provider cover the treatment costs?”) that often provides the highest hurdle you need to negotiate.
Contrary to the general public consensus about rehab costs, eg. being way too expensive for the ordinary blue-collar worker to attend, in reality, there are a variety of ways to pay your rehab costs, as well as a range of rehabs that actually vary in cost. Yes, there are the luxury, beach-fronted, 5-star hotel-type addiction rehabs, but they simply price themselves out of the market for most people.
There are the more mainstream addiction rehabs (where many health insurance policies will cover the majority of costs), as well as the low-cost, non-profit rehabs – many of which, you’ll not be surprised to discover, run far better and more successful treatment programs than the salubrious, luxury-model option mentioned earlier.
The aim of this article is to not only dispel any doubts you may have around affordability and healthcare insurance for drug and alcohol rehab, it will also highlight the wide range of addiction treatment programs that are available to you.
Does the Cost of Drug Rehab Depend on Where You Live?
Obviously, location is a significant factor when choosing the right drug and alcohol rehab for you. However, you should not limit yourself to “nearby” rehabs just because they are close to home. It really depends on the type of addiction treatment you’re looking for.
Making the decision to go to a drug rehab center is the first, decisive, and potentially life-changing step in finally getting healthy, prolonging your life expectancy, and avoiding the many health conditions and diseases that substance addiction can inevitably bring.
Furthermore, it’s your first, significant step in being able to develop healthy relationships with family, loved ones, and friends, and giving yourself a chance of real success in the future – something you may have unwittingly denied yourself for years.
When deciding which type of addiction treatment is best for you, this invariably means either an inpatient program, where you are resident at the rehab for a specified period of time or an outpatient program, which is far more ideal for those who have family, work or school obligations (these options are discussed in far more detail later in this article).
The Cost of Your Addiction vs. The Cost of Its Treatment
To return to our question above, everyone reading this should understand one vital socio-economic factor – regardless of the ultimate cost to you of drug rehab, addiction treatment, time spent getting clean, whatever you want to call it, understand this – the cost of getting help is far, far less than either the long-term financial cost of your substance addiction, whether it’s opioids medications, heroin, cocaine, or alcohol, and it’s far, far less than the social cost to you, and living your life from now on, as either a drug addict or an alcoholic.
The Law is On Your Side
Health insurance providers are now bound by law to cover the primary costs of treatment for substance use disorders (SUDs), including alcohol use disorders (AUDs). Here’s why.
The Mental Health Parity and Addiction Equity Act, 2008 stipulates that insurance companies cannot discriminate against or deny coverage to individuals with a SUD. In addition to this, the Affordable Care Act, 2010 classified mental health and addiction services as essential health benefits.
This means insurance companies have to treat mental health and substance abuse treatment in exactly the same way as they would any other regular health treatment. Now, every insurance company has a range of different coverage plans that can be tailored to the individual’s needs.
Furthermore, any of you that are concerned about losing your employment because you’re taking time-off to attend addiction treatment should relax, too, because there are laws in place to allow you time for treatment and to protect you from any discrimination.
Specifically, the American With Disabilities Act (ADA), the Family Medical Leave Act (FMLA), and the Affordable Care Act (ACA) all work together to protect you and your employment status should you wish to seek treatment while remaining actively employed.
Your Range of Options for Addiction Treatment (Guide)
Don’t let the idea that health insurance won’t cover your addiction treatment stop you from receiving the treatment you need. In addition, there is a wide range of various addiction treatment options you can choose from, all with varying costs; for example,
- A residential, inpatient program, ranging from 30-90 days
- An outpatient program, with flexible appointments, designed to allow you to fulfill family and work or academic obligations
- A number of programs run by facilities that offer payment assistance or sliding fee scales, and
- Programs provided free of charge, and/or paid for by state taxes
Please remember, if there is one thing that determines whether one type of addiction treatment is the better option for you, it’s this: your own personal situation. Your particular circumstances, whatever they may be, and how they may either open up or restrict your choices in life, are the best measure of where your decision should ultimately lie. Yes, cost may well be “the big factor” in your decision, but maybe family is too; therefore, your final choice may well be simply the best compromise considering your circumstances.
The Importance of Evidence-Based Addiction Treatment
Additionally, whichever program you choose, it has to contain the primary elements of evidence-based addiction treatment, which are:
- Substance detoxification (if required; more commonly known as detox)
- Group therapy
- Relapse prevention, and
- Individual counseling
Note: Any programs that fail to include these elements are not worth either your money or your insurer’s money.
Here are your drug and alcohol rehab program options in full, with their respective benefits:
1. Inpatient Program (IP)
An inpatient program (IP), also known as residential rehab, because you live 24/7 at the rehab facility, is recommended for those with severe substance addictions, and those who have a co-occurring disorder (or dual diagnosis), meaning they also suffer with a mental health condition, such as depression, PTSD or bipolar disorder.
Being a resident within a rehab that offers care around the clock helps enormously in avoiding influences and triggers from your previous, addicted life. IPs can either be short or long-term (anywhere between 28 days to a whole year and beyond), and often provide post-rehab programs, such as an outpatient program after the residency has finished ensuring the patient continues treatment.
Advantages of Inpatient Programs
Inpatient rehab programs offer a number of benefits to people who have the flexibility (or lack of obligations) to deal with the stringent restrictions:
- Residential inpatient rehab treatment is highly structured, focusing on all aspects of a client’s addiction, including one-to-one therapy on relationships, lifestyle and psychological factors (related to personal history and situation)
- IPs provide 24/7 care, usually in non-hospital settings, which can be exceptionally important for those also dealing with mental health issues and past trauma
- You will live with other drug addicts and alcoholics, encouraging a community and fraternity
Note: Please bear in mind, IPs are more costly than OP alternatives.
2. Partial-Hospitalization Program (PHP)
Partial-hospitalization programs, intensive outpatient programs, and outpatient programs are, fundamentally, all outpatient programs. However, they vary greatly in their intensity and their required schedules; for example, a PHP is normally around 30 hours or more per week, whereas a standard OP requires around only 10 hours per week.
A partial-hospitalization program (PHP) doesn’t mean “hospital” per se, – it is referring to the rehab facility where treatment will take place (a more relaxed setting than a hospital, but with medical care available, if required). PHP provides a highly-structured environment for up to 6 hours a day, while you reside at home or in sober-living housing, with peers who are also in the program. Lastly, a PHP allows clients transitioning from an inpatient or a detox program to move into a more flexible program that still offers a high level of structure and support.
3. Intensive Outpatient Program (IOP)
Intensive outpatient programs (IOPs) are treatment programs that do not require detoxification (although this may have happened prior) or round-the-clock supervision. IOPs enable patients to continue with their normal, day-to-day lives in a way that residential IPs do not.
IOPs are sometimes used in conjunction with inpatient programs as a way of helping clients to transition seamlessly back into their families and communities. They are designed to continue counseling, help establish support mechanisms, assist with relapse management, and provide further coping strategies, if needed.
4. Outpatient Program (OP)
Outpatient programs (OPs) involve a daily appointment schedule, spread through the week, and can provide particular therapies, counseling, or group sessions, held at a medical clinic or a rehab facility. Furthermore, as we are discussing cost, standard OPs typically cost significantly less than an inpatient rehab program, but the level of support may be less intensive. Additionally, if required, detox can also take place, usually at another facility, before the patient begins their OP.
Advantages of Outpatient Programs
- You continue to live at home, and work or study
- If you’re a teenager or adolescent, you have your family to provide additional support
- Treatment costs are significantly less than an inpatient program.
Important: In fact, many healthcare insurance plans actually cover the cost of an outpatient program in full
- Appointments can be made during the day, in the evening, and at weekends
5. Alternative Types of Addiction Treatment
Nonprofit & State-funded Programs
You may meet the requirements for low-income rehab, which are usually provided by non-profit organizations. Low-income rehab is either free or significantly reduced in cost. These programs are available so those in need can get the help they deserve – regardless of income.
Additionally, the Salvation Army is a well-known non-profit organization that provides free rehab for those in need, and there are also state-funded rehabs for those with low incomes – however, there is usually a long waiting list for both of these options.
Support groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are other options for people in need of addiction help. Additionally, there are Self Management And Recovery Training (SMART) mutual-support groups, self-termed as “science-based, self-empowered addiction recovery.”
However, if either of these is your starting point, your addiction should be minor in nature, and not require any medical elements whatsoever, eg. detox, medication, etc., unless you are using these support groups as part of an overall treatment plan.
Typical Costs for Substance Addiction Treatment
According to data from a number of national surveys and studies published by the National Institute of Drug Abuse (NIDA), drug and alcohol addiction in the U.S. remains a formidable crisis. Currently, over 20 million U.S. adults (aged 12 and over) require treatment for a substance use disorder; however, only 19% (less than 1 in 5) will actually receive this treatment.
One of the biggest factors concerning this low percentage is treatment costs.
It is important to remember that finding the true and exact cost for the total cost of drug and alcohol addiction treatment (or even each stage of the treatment) is affected by the number of variables in any calculation. Accurate cost calculations depend primarily on these factors:
- The specific rehab facility chosen
- The type of treatment program you will undertake
- What is covered by the program cost and what is not, and/or
- If you are using insurance, exactly what costs will your healthcare provider cover
It is imperative that you speak directly to the rehab/facility concerned and your health insurance provider, if needed, to discuss and agree on all of this prior to beginning your addiction treatment.
Additionally, there are many other factors and variables that affect the cost of rehab, from the level of medical care down to the amenities offered at each facility. The following costs are estimated typical costs* for the main elements of addiction treatment.
Note: Typical costs* are based on those reported by a range of government studies, including a 2016 report by the U.S. Department of Defense, and a small number of individual facilities in the U.S. These estimated typical costs are solely provided to give a general idea of treatment costs.
|Detox||Most inpatient rehabs include detox, if required, in the cost of a program. The exact cost of detox can depend on whether it’s part of an inpatient program, and the type of drug addiction being treated. Substances with dangerous withdrawal symptoms require more careful monitoring, making the price higher. Outpatient detox can range from $250 to $800 per day, depending on whether medication(s) need to be administered.|
|Inpatient Program (IP)
|Rehabs can vary greatly in cost, $5,000 to $60,000 or more, primarily depending on program duration.|
|Outpatient programs for mild to moderate addictions are cheaper than inpatient rehab, with average costs around $3,000 to $10,000 for a three-month OP. However, OPs can cost much more, eg. an OP at a Hazelden Betty Ford facility costs approximately $10,000. The actual cost also depends on how often the client visits the facility each week, and for how long.|
|Medications||The type of treatment and the medications required will affect the cost of any program. However, not everyone requires medication for their type of addiction. Medications are commonly used when treating alcohol or opiate addiction. For example, year-long methadone treatment for ex-heroin users can cost around $4,700.|
How to Pay for Your Substance Addiction Treatment
If you decide on an addiction treatment option that does require payment, you basically have the following options: pay out of savings, arrange a loan that will cover the treatment, or, the most popular option, use your health insurance plan to cover all or part of the cost.
Addiction Treatment Through Your Health Insurance
Like any medical treatment in the U.S., the best way to pay for a drug and alcohol addiction treatment program is through your health insurance. However, the actual amount that your insurance will cover depends on both your chosen health insurance provider and what that health provider accepts as by way of treatment. The various types of insurance policy that can cover addiction treatment include:
For those that are without insurance, there are the other options discussed above, as well as treatment programs that offer financing options. Financing can be a better choice because low-cost and free rehabs often have both limited funding and long waiting lists.
Verifying Your Health Insurance
Once you’ve made the decision to seek addiction treatment, finding out if your health insurance will cover your costs is relatively straightforward. Contact the facility of your choice, and their staff will contact your insurance company on your behalf to determine the percentage that the company will pay for your rehab, and what you will be responsible for paying.
If you have public health insurance through the state, then this will usually cover most of the facility’s treatment cost. Additionally, many rehab centers have payment options, so, if needed, you don’t have to pay for the entire service upfront or at one time.
For example, your health insurance plan may cover your addiction recovery at SpringBoard – verifying your insurance with us is quick and easy. Regardless, before making a final decision about where you want to get help, contact SpringBoard Recovery to get the latest information about the services we provide, as well as the payment options we can make available to you.
Frequently Asked Questions
- Can I Afford Rehab?
Unsurprisingly, many people who are in need of addiction treatment will not be able to pay “out of pocket.” The cost for therapists, the chosen facility, medication, etc., can add up. Here are several ways you can lessen the financial burden:
- Using your insurance agency will only require a copay or a small out of pocket fee
- Just over 73% of substance abuse treatment facilities offer payment assistance, or discounted treatment for those who pay out of pocket
- You can also inquire with the treatment facility about payment plans, free care, or partially -waived fees
- What is The Cost of Treatment After Insurance?
The cost of treatment after insurance varies depending on your health insurance benefits and coverage. Most insurance providers have a list of rehab centers that are in-network with the agency, and will cover the majority of the cost of treatment, only leaving you with a small co-pay.
Covering the majority of the cost, your insurance provider will release the financial burden that comes with addiction treatment. There are also federally accessible insurance policies (i.e. Medicare and Medicaid) that are low cost, and in some instances, free – depending on your annual income. However, in this instance, you might have to pay more out of pocket. The best way to ensure you are making the best financial decision for you is to:
- Contact your insurance representative to see if the drug and alcohol addiction rehab you have chosen is in-network – often, there is a list on their website
- Call the center directly, and inquire whether they accept your insurance agency or not
- Visit SpringBoard Recovery’s Insurance Verification Page to find out if your provider is in-network with us
- How Do I Sign Up For Insurance?
To sign up for health insurance, you do not have to be currently employed or insured. Different providers charge at different rates, so you can look around for the right coverage and rate for you. The rate of your insurance will depend on your annual income. The Affordable Care Act requires coverage for substance abuse and mental health treatment services for all marketplace insurance plans – even with pre-existing conditions.
- Should You Choose a Treatment Program Based on Cost?
In most cases, the decision between an IP or an OP is made as to whichever is more affordable, with an OP the least expensive. However, rehab cost should be associated with investing in your future. Most facilities will work with payment plans, discounted treatment rates if you pay out of pocket, or Medicare or Medicaid to lessen the financial burden.
- How Can I Access Immediate Addiction Treatment?
Any acute situation (cases of overdose, suicidal thoughts, other medical emergencies induced by drug or alcohol addiction) that requires immediate emergency care, please do not hesitate to call 911. Medical staff / doctors at the ER can direct you or recommend you to many resources and facilities available for next step options for addiction treatment.
- Centers for Medicare and & Medicaid Services: https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/mhpaea_factsheet
- Centers for Medicare & Medicaid Services: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca-new-patients-bill-of-rights
- United States Department Civil Rights Division: https://www.ada.gov/
- U.S. Department of Labor: https://www.dol.gov/agencies/whd/fmla
- National Institute on Drug Abuse: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment
- US National Library of Medicine: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4152944/
- The Salvation Army: https://www.salvationarmyusa.org/usn/
- Alcoholics Anonymous: https://www.aa.org/
- Narcotics Anonymous: https://na.org/
- Self-Management and Recovery Training: https://www.smartrecovery.org/
- Medicaid.gov: https://www.medicaid.gov/
- Medicare.gov: https://www.medicare.gov/
- Arizona Health Care Cost Containment System: https://www.azahcccs.gov/Resources/StatePlans/
- Oxford House: https://oxfordhouse.org/userfiles/file/purpose_and_structure.php
- HealthCare.gov: https://www.healthcare.gov/