Recovering from addiction is a wonderful accomplishment, but it comes at a cost. Although the price of drug and alcohol addiction can vary from program to program, most standard addiction treatment programs can cost thousands of dollars. Simply put, drug and alcohol recovery isn’t cheap.
That’s why many people turn to their insurance company to help cover the cost of drug addiction treatment. Dealing with insurance policies can be complicated, especially when addiction treatment is involved. The good news is that most insurance companies will cover a portion of the cost of addiction recovery.
Understanding the cost of addiction treatment, different types of insurance, and the types of services insurance policies typically cover can help you afford the type of treatment you need.
Recovering from addiction can be costly. Depending on the type of treatment you’re looking to receive, addiction treatment can cost hundreds to thousands of dollars a month. In general:
Thinking about these costs of treatment can be daunting, but when you compare the cost of addiction to addiction treatment, rehabilitation easily proves to be the most cost-effective option.
Even though rehabilitation isn’t cheap, living with an addiction is much more expensive than recovery. Here’s why.
Addiction is an expensive and dangerous way to live. Addiction treatment can help you put an end to addiction-related expenses, which can, in turn, save you money — and your life.
Yes. The Affordable Care Act (ACA) lists drug and alcohol addiction services as one of ten categories of essential health benefits. In other words, private insurance companies and any insurance policy sold on the Health Insurance Marketplace must cover addiction treatment. The ACA also mandates that insurance companies must help cover the cost of treatment for mental health disorders. This can be especially helpful if you’re grappling with anxiety, depression, or another mental illness alongside drug or alcohol addiction.
Thanks to the ACA, your insurance can help cover the cost of treatment for both conditions. However, the amount your specific insurance policy will cover depends on the state you purchased the benefits in and the particular healthcare plan you chose.
Many insurance companies ask their members to choose from a set of approved or “in-network” providers. Depending on your policy, you might also have to pay some premiums, deductibles, or copayments. Some policies may also require you to obtain a referral from a primary care physician before the insurance provider will pay for treatment.
Even though the type of services covered can vary from plan to plan, most insurance companies typically cover the following:
1. Call the Member Services number for your insurance company. Be sure to have your membership information ready.
2. Ask what “levels of care” are covered under your specific plan for addiction treatment. Don’t be afraid to ask about assessments, detox, inpatient, outpatient, residential, hospital-based, or partial hospitalization care.
3. Inquire about in-network and out-of-network providers and the percentage that your insurance company will cover for each type of provider.
4. Ask about any co-pays and deductibles you’ll have to pay.
5. Ask what your maximum out-of-pocket expense is. After you spend this amount on deductibles, copayments, and coinsurance for in-network care and services, your health plan pays 100% of the costs of covered benefits.
6. Ask what criteria must be met for the insurance company to determine that addiction treatment is a medical necessity.
7. Write down the name of the representative you spoke with, as well as any notes you took during the call.
Medicaid and Medicare are government-sponsored insurance plans that cover screening for substance abuse. If you have one of these plans, here’s what you need to know about them.
Medicare is available for anyone 65 years or older or people with a severe disability. Medicare will cover up to 190 days of inpatient care during your lifetime, but there is currently a $1,260 deductible and variable co-payments. For outpatient treatment, Medicare covers counseling, therapy, annual screening, and medication management, while you are responsible for 20% of the treatment costs. If you need residential treatment, you’ll pay a percentage of each service as well as daily co-payments and a deductible.
Medicaid is an insurance program for low-income households. The plan is run on a state-by-state basis, with each state covering varying degrees of treatment. However, Medicaid can cover inpatient and outpatient care as long as the facility you choose accepts Medicaid.
MassHealth is Massachusetts’ Medicaid program. Through it, low-income individuals in Massachusetts can receive substance abuse treatment through Massachusetts Behavioral Health Partnership-certified programs. Services include detox, therapy, crisis counseling, and more.
Addiction treatment can be expensive, but insurance can help cover some of the costs. Here at Meta, our mission is to empower you to take charge of your recovery. Part of that means calling your insurance company and determining what they will cover so you can get the help you need.
If you don’t have insurance, don’t fret. Many addiction treatment programs have options you can take advantage of, including:
Don’t let the cost of drug addiction treatment hold you back from living a thriving, sober life. Contact us today to talk to one of our recovery experts to learn more about covering the cost of addiction treatment.