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It can be daunting to take the first step of recovery and begin researching rehabs. One of the biggest questions people ask when it comes to drug and alcohol rehab is, “Does insurance cover rehab?”
If you or a loved one is wondering this, read on to learn more about rehab coverage, rehabs that accept insurance, typical plans that do cover rehab, and how to find a good rehab.
Where You’d Be Staying
Using Health Insurance to Cover Substance Use Treatment?
If you have insurance and are wondering whether insurance covers alcohol rehab or drug addiction rehab, it’s important to know that many factors determine whether a rehab will take insurance and if your insurance will even cover the rehab. Things like the kind of plan you have, the type of addiction treatment needed, and the rehab you choose all impact coverage. However, because addiction and substance abuse is classified as disease/disorder, rehab and addiction treatment are typically covered by insurance.
What Levels of Care Are Covered By Insurance?
The levels of care covered by insurance depend on an individual’s insurance. However, many plans offer alcohol rehab insurance and drug rehab options. Below are four of the main levels of care in rehab that could be covered by insurance [1].
Detox
Detox treatment in rehab is the first step in the recovery process for individuals struggling with substance use disorder. It involves the safe and supervised elimination of drugs or alcohol from the body. The goal of detox is to help the person manage withdrawal symptoms while clearing the substance from their system, all under medical supervision.
During detox, the body undergoes the natural process of ridding itself of toxins accumulated from substance use. However, this process can cause physical and psychological discomfort and, in some cases, can be dangerous. Withdrawal symptoms can vary depending on the substance used, prolonged use, and physical health. These symptoms can include anxiety, nausea, sweating, tremors, seizures, and changes in blood pressure.
In a rehab setting, detox is medically managed, meaning doctors, nurses, and addiction specialists are on hand to monitor vital signs, provide medication to ease withdrawal symptoms and ensure the safety of the individual. This may include medications to reduce cravings, prevent seizures, or stabilize mood.
Detox treatment also often involves emotional support and therapy to help individuals cope with cravings and the psychological challenges of recovery. The purpose is not just to cleanse the body but to prepare individuals for the next phase of treatment, such as counseling or rehabilitation programs that help address the underlying reasons for their addiction.
Ultimately, detox in rehab is about ensuring that someone is physically stable and ready to fully engage in the ongoing therapeutic work necessary for long-term recovery.
Inpatient treatment
Inpatient rehab is a type of treatment program where individuals stay at a residential facility for intensive care and support while recovering from substance use disorder or addiction. In this setting, patients receive 24/7 medical supervision, therapy, and counseling in a structured environment.
The program typically includes detoxification, individual and group therapy, education on addiction, and various therapeutic activities aimed at helping individuals understand and overcome their addiction. The goal of inpatient rehab is to provide a safe, supportive space for people to focus solely on recovery without distractions or access to drugs and alcohol.
Inpatient rehab is particularly effective for those with severe addiction or those who have tried outpatient treatment without success. It provides a higher level of care and is designed to address both the physical and psychological aspects of addiction, helping individuals build a strong foundation for long-term sobriety.
Intensive Outpatient Treatment
Intensive Outpatient Treatment (IOP) is a structured addiction treatment program that provides more support and therapy than traditional outpatient care but does not require 24/7 residential care like inpatient rehab. IOP allows individuals to live at home or in a sober living environment while attending therapy sessions several times a week—usually 3 to 5 days, for a few hours each session.
IOP typically includes individual counseling, group therapy, education on addiction, and life skills training. It is designed for people who need a higher level of care than standard outpatient treatment but don’t require the round-the-clock supervision of inpatient rehab. IOP is often used as a step-down from inpatient care or for those who have less severe addiction.
The flexibility of IOP makes it ideal for individuals who have work, school, or family obligations but still need intensive support to overcome addiction. It helps individuals develop coping strategies, build a strong recovery foundation, and prevent relapse while living in a more independent setting.
Outpatient Treatment
Outpatient treatment is a type of addiction treatment that allows individuals to receive care while living at home or in a community setting, rather than staying at a treatment facility. This option is typically less intensive than inpatient or intensive outpatient programs but still offers therapy, counseling, and support to help individuals recover from substance use disorder.
Outpatient treatment usually involves regular sessions—ranging from once a week to several times a week—of individual therapy, group therapy, or both. It may also include educational sessions on addiction, relapse prevention, and developing life skills for maintaining sobriety. Because patients are not required to live at the treatment center, outpatient care is more flexible, allowing people to continue working, attending school, or managing family responsibilities while still receiving the help they need.
This level of care is most suitable for individuals with mild to moderate addiction or those who have already completed more intensive treatment and are transitioning to less structured support. It is often part of a comprehensive recovery plan that includes other forms of therapy, support groups, and lifestyle changes.
The Cost of Rehab vs. the Cost of Addiction
The cost of rehab versus the cost of addiction differs depending on the case. However, most would think rehab is more costly; this isn’t always true.
According to the National Center for Drug Abuse Statistics, the base for rehab prices are as follows:
- $1.75k for the cheapest detox program
- $6k a month for the cheapest inpatient rehabilitation program
- $5k for the cost of a three-month outpatient rehab program
The average cost of rehab is about $13,000, but this number can vary depending on how long you stay in an inpatient rehab program, what you are treating, and how much your insurance covers.
Is inpatient rehab covered by insurance? Some insurances may cover up to 80% of the cost, which makes the price tag of rehab much lower. It’s worth noting that treatment for opioids is more expensive than for other substances, with methadone treatment being one of the most expensive [2].
In contrast, the cost of addiction is far greater—and not just in financial terms. Addiction is a costly disease, and many who struggle with substance use often face severe financial hardships. For example, a person addicted to alcohol who drinks daily might spend around $3,000 annually. Over ten years, that’s $30,000 spent solely on alcohol, not counting the expenses from health complications or lost income. Addiction can contribute to job loss, reduced earnings, and significant medical bills, making it a heavy burden both personally and financially.
In the long run, addiction is much more expensive. Rehab has a price, but the cost of addiction could be your life.
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Insurance Providers and Rehab Coverage
If you are wondering, “Does insurance cover rehab?” you’ll be glad to know that, in most cases, it should. Here is a list of common insurance providers that could offer rehab coverage:
- Blue Cross Blue Shield
- Cigna
- Anthem BCBS
- Aetna
- United Healthcare
- Kaiser Permanente
Options With and Without Insurance
It can be worrisome if you don’t have insurance but know you need rehab. Whether you have insurance or not, there are always options. At the end of the day, the most important thing is attending.
If you have insurance, repayment will be easier since the cost will be less. Even so, paying for rehab with insurance could still be out of your budget. If this is the case, you can speak to your case manager or another rehab staff member to develop an affordable payment plan.
If you do not have insurance, you could still pay for rehab in several ways, including:
- Using money from your savings or your 401k
- Asking friends or family for financial help to get the treatment you need
- Applying for a financial grant or scholarship for rehab
- Working with your treatment facility to create a payment plan that is within budget
- Attending a government-funded, free rehab program
Common Types of Healthcare Plans and Benefits
Paying for rehab with insurance depends on your healthcare plan and benefits [3], such as:
- Preferred Provider Organization (PPO): A PPO is a health plan that saves you money when you use in-network providers. You don’t need a referral to see doctors or specialists, but out-of-network care will cost more.
- Health Maintenance Organization (HMO): This plan typically limits coverage to doctors and healthcare providers who work with (or are contracted by) the HMO. Out-of-network care is generally not covered, except in emergencies. HMOs may require you to live or work within their service area, often emphasizing integrated care and preventive services.
- Point of Service (POS): POS plans offer lower costs when you use healthcare providers within the plan’s network. You usually need a referral from your primary care doctor to see a specialist.
- Exclusive Provider Organization (EPO): This option covers services only when you use doctors, specialists, or hospitals within the plan’s network, excluding emergency situations.
What Factors Affect the Cost of Addiction Treatment?
The main factors that affect the cost of addiction treatment are:
- Your state: For example, rehab is more expensive in California than in Montana.
- Duration of stay: Many rehabs charge monthly. Inpatient treatment could cost 5k per month, meaning the longer you’re in rehab, the more money you’ll pay.
- Type of addiction: Going to rehab for opioids could be more expensive than going for an alcohol addiction. Statistics show that methadone treatment can cost about $8,836, while non-methadone treatment averages around $2,000 [3].
- Level of care required: Inpatient rehab programs are much more costly than outpatient rehab services.
- Amenities: You can choose the type of rehab facility you want to attend. Luxury rehabs offer premium amenities like holistic therapies, gourmet meals, and scenic locations for a more comfortable experience. Other options may be a bit more modest and affordable.
How to Verify Your Coverage Before Using Insurance to Pay for Rehab
“Is rehab covered by insurance?” It depends on your insurance and the kind of rehab you need.
There are a couple of ways to verify coverage before committing to a specific rehab. Many rehabs offer a free insurance check for prospective patients to try. You can also call the rehab directly. Most rehabs have insurance experts who can walk you through your options.
To know a more detailed breakdown of exactly what your insurance will and won’t pay, call your insurance provider directly using the number on your insurance card. Speak to a representative to ask in-depth questions—they’ll be able to give you a clearer picture of how much you can expect to pay out-of-pocket.
How to Find an In-Network Rehab Facility in California
Finding an in-network rehab facility in California will follow a fairly similar process as verifying your coverage for rehab. There are a couple of different options to explore to determine eligibility, including:
- Calling your insurance provider directly using the phone number on the back of your card and asking for a list of in-network rehab centers
- Searching the insurance company’s website for in-network rehab facilities
- Ask the staff at the rehab you have in mind to check if your insurance will cover your treatment.
Get Insurance-Covered Addiction Treatment at Gratitude Lodge
If you are looking for insurance-covered rehab, Gratitude Lodge is a standout option. Voted as one of the best rehabs in the state, Gratitude Lodge offers compassionate drug and alcohol addiction treatment through various science-backed therapeutic modalities, including:
- Individual and group counseling
- Medication-assisted treatment
- Cognitive behavioral therapy
- Dialectical behavioral therapy
- Adventure therapy
- A strong alumni network
- And much more!
We know that addiction treatment isn’t one-size-fits-all, which is why we create a customized plan tailored to your unique recovery journey.
At Gratitude Lodge, we are dedicated to helping our patients on their recovery journey in any way we can. In addition to evidence-based treatment offerings, we also offer luxurious amenities. We’re known for our upscale facilities, exclusive gym access, dedication to privacy and confidentiality, proximity to stunning SoCal beaches, and home-cooked meals.
Choose Gratitude Lodge for a real chance at lasting recovery from addiction. Call us at 844-576-0144
Sources
[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC6761814/
[2] https://drugabusestatistics.org/cost-of-rehab/
[3] https://www.healthcare.gov/choose-a-plan/plan-types/
