Does Insurance Pay for Drug Rehab?

Insurance Pay for Drug Rehab
November 18, 2022 12:46 pm - Published by

The cost of rehab can be a barrier to addiction treatment for some people. However, there are many options available to help make treatment more affordable. One option is to use insurance to help cover the cost of rehab. But does all insurance pay for drug rehab? 

Many health insurance plans offer some level of coverage for addiction treatment services. Depending on your insurance provider, policy, and benefits, you may have limited access to treatment services or a multitude of options at your disposal. That’s why it’s important to know if your insurance pays for drug rehab.

How Does Health Insurance Work?

In general, health insurance is a type of insurance that helps cover the cost of medical care. Health insurance works by collecting monthly premiums and other forms of payment that lower your cost of medical treatment. 

If you or a loved one is struggling with a substance use disorder, it’s important to make sure your insurance pays for rehab. More importantly, if you’re planning on making changes to your insurance plan, knowing what types of health insurance pay for rehab can help you receive the treatment you need to recover from addiction.

Types of Health Insurance 

While most people get health insurance through their employer, there are other forms of health insurance plans. 

The four main types of health insurance include:

  • Private health insurance
  • Commercial health insurance
  • State health insurance
  • Government health insurance

Alongside these four main types of health insurance, there is also military health insurance which is only accessible to active military personnel, veterans, and their families.

All health insurance plans are required to offer a certain level of coverage, but they can also vary in the types of services they cover and how much they will pay for those services. Taking a closer look at the different types of health insurance plans can help you to better understand which will help you pay for alcohol and drug rehab.

Private Health Insurance

Private health insurance is a type of health insurance that is provided by a private company, such as an employer or an insurer. If you have private health insurance, you will usually have to pay a monthly premium for the health services covered by your chosen insurance policy. 

The two main types of private plans are PPOs and HMOs, which usually require a monthly premium alongside routine copayments prior to receiving medical care.

While private health insurance plans typically have higher premiums than government-sponsored health insurance plans, they usually offer more comprehensive coverage.

With that said, private plans are also offered by companies as a benefit to employees. Companies will usually cover a portion of the cost, and employees can elect to have additional coverage through payroll deductions. When signing up for insurance at a company, you can always search your insurance provider’s website for private health insurance that pays for rehab. You can also work with an insurance representative through the company to review each policy for health insurance that covers rehab.

Commercial Health Insurance

In general, commercial health insurance is similar to private health insurance, but it is typically offered by an insurance company rather than through an employer. For example, commercial plans are offered by insurers such as Aetna or United Healthcare. In order to make sure your commercial health insurance pays for rehab, it is important to review the benefits offered within your plan.

The two main types of commercial plans are PPOs and HMOs, which work in the same way as they do for private plans. As such, these plans also usually require a monthly premium and copayments for covered services.

Commercial insurers are also similar to private plans in that they usually offer more comprehensive coverage for rehab and addiction treatment services than government-sponsored health insurance plans, but their premiums may be higher.

Government Health Insurance

Government health insurance, or public health insurance, is a type of insurance that is provided by the government. 

Types of government insurance include:

  • State health insurance
  • Federal health insurance

In states that offer their own health insurance programs, state health insurance plans are offered to residents who don’t have access to other coverage. Typically, government insurance provides coverage for addiction treatment services and will pay for rehab. With that said, it is important to review your plan’s benefits in order to find the plan that best suits your individual treatment needs.

State Health Insurance

State health insurance is a type of insurance that is provided by the state government. Typically, these state insurance plans are offered to residents who don’t have access to other coverage. Since the purpose of state insurance is to provide coverage for health care services for people who don’t have access, these plans typically pay for rehab.

State health insurance plans include:

  • Medicaid 
  • CHIP (Children’s Health Insurance Program)

Medicaid is a needs-based program that covers low-income adults and children, while CHIP covers low-income children who don’t qualify for Medicaid. Each state sets its own eligibility requirements for these programs. 

In general, state-funded rehab programs are covered by state health insurance. There are some privately owned addiction treatment centers that accept a number of state insurance policies, but these beds are typically limited. As a result, it may take more time to receive treatment at a private facility if you have state insurance.

Federal Health Insurance

Federal health insurance is a type of health insurance that is provided by the federal government of the United States. Currently, Medicare is the only health insurance plan fully sponsored by the federal government. While Medicare often pays for a portion of rehab, these insurance plans are more strict regarding the level of care required by the accepted treatment facilities.

Citizens and residents eligible for Medicare include:

  • People over the age of 65
  • People under 65 with certain disabilities
  • People with ASL or end-stage renal disease

Medicare is the federal health insurance program for people who are 65 years or older. It has expanded its access to younger people with long-term disabilities. 

With that said, people with Medicare are at a greater risk of complications during detox and require a higher level of care. In fact, if you have Medicare, you must receive addiction treatment services in a hospital setting.

Military and Veterans Health Insurance

Active members of the military, retirees, and their families can gain access to healthcare services through military insurance. 

The two types of military insurance include:

  • TRICARE
  • TriWest

Military health insurance for active members of the military is called TRICARE. TRICARE is the health care program of the U.S. Department of Defense through the Military Health Care System. As a result, military insurance provides medical services including drug and alcohol rehab through a global, comprehensive, integrated system of military hospitals and clinics.

The Veterans Health Administration also provides military veterans with health insurance through TriWest. TriWest is the third-party administrator for the Department of Veterans Affairs (VA) Community Care programs. Through Community Care Network, TriWest provides health care services for veterans within their local communities. 

Keep in mind that TriWest requires all medical and addiction services to go through the VA to receive coverage. Private rehab facilities also work closely with the VA to ensure that veterans receive quality medical care and rehabilitation services.

Does Insurance Cover Addiction Treatment?  

Does insurance cover addiction treatment? The answer to this question depends on your specific plan and situation. In general, insurance providers consider addiction treatment to be medically necessary. Therefore, most types of health insurance commonly pay for rehab programs at the detox level of care.

However, each individual policy is different. Checking with your specific insurance plan to see the benefits and coverage for addiction treatment is a must. Some plans may not cover any addiction treatment at all while others may only cover certain types of treatment. 

For the most part, health insurance plans will at least partially cover detoxification and inpatient treatment. It’s important to note, insurance providers are more likely to cover treatment that is deemed medically necessary by a medical professional. Some plans may also cover outpatient treatment, individual therapy sessions, and medication-assisted treatment (MAT). 

Insurance for Rehab Centers  

Addiction treatment insurance coverage is a necessity for many people seeking help for a substance use disorder. When signing up for insurance, an insurance representative can help you find the best drug rehab health insurance for you.

Many rehab centers accept insurance as a form of payment, but not all do. For this reason, it’s important to verify your insurance with your chosen treatment center beforehand. You can also search for rehab centers that accept insurance online when looking for treatment.

Some centers also offer sliding scale fees based on income. This is another way you can receive help in paying for treatment if you don’t have coverage through an insurer. No matter what your budget is, there are resources available to help you get the treatment you need. Finding insurance that pays for rehab can help you recover from addiction and start living a better life in recovery.

Reach Out to Verify Your Insurance

If you’re wondering, “Does insurance pay for drug rehab,” the answer is usually yes. However, the cost of rehab depends on your specific policy. It’s important to check with your chosen rehab and insurance beforehand to make sure that your treatment will be covered. 

If you need help finding a rehab that accepts your insurance plan, you can fill out our secure online form to verify your insurance benefits or call in to speak with our admissions team. We will help you find a facility that meets your needs, so give us a call today!