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Navigating Health Insurance and Rehab

by Andy Andersen


Finding the right rehabilitation program for a recovering drug or alcohol abuser is an intricate process. It involves rigorous consultation with doctors and specialists, in addition to unexpected financial planning. Though rehab of some kind or another is universally a must for drug addicts seeking recovery, insurance difficulties can be an unbearable obstacle. In order to ensure the success of the individual seeking treatment, it's important to know what insurance related difficulties may lie ahead and how to best navigate them.

Is rehab covered by most insurance plans?

Rehab is covered by a wide variety of insurance plans. The challenge is getting the insurance company to cover the right one. If insurance companies can find a cheaper option for you than the program you are requesting, they will. According to substance abuse and behavioral health billing specialists, "insurance companies believe that the cheapest option for care is substantial, and therefore the most beneficial for the customer because of the lower out of pocket cost." In order to function, insurance companies must make a profit like any business.

The only way to make a profit while giving coverage to the clients who need it is through denials. As inpatient care is almost always more expensive than outpatient, many addicts are only covered for outpatient care when inpatient care is what they really need. Many heroin addicts, for example, are denied inpatient treatment coverage, which often results in unsuccessful outpatient treatment. For more information on why and how insurance companies steer clients away from inpatient care, visit this article for more information.

Knowing what your insurance will cover

Because addiction is technically an "incurable disease", insurance coverage will always be tricky. Though private insurance companies may cover it as treatment for a medical disease, many insurance plans state upfront that they don't cover rehab. Nor do they offer add-on coverage for drug rehab as an individual policy. The only real advantage to this is that there are also some policies that do cover rehab upfront, so you can choose an insurance policy accordingly, should you have the option to purchase or change your insurance before entering rehab.

There are also instances when drug rehab will simply be considered a "medical cost", which makes it possible that your insurance will cover it, if only partially. But this all depends on your individual policy, and how expensive your particular rehab program of choice will be.

With the advent of the Affordable Care Act, much has changed (in theory) in regards to coverage for drug rehab. While the ACA requires coverage for drug addiction as one of the ten essential elements of excellent health care, it's still difficult to tell how well it covers specific rehabilitation programs until it's put into action by an individual client.

Other financing options

Most rehab centers offer their own financing programs for patients. Whether it's through the center itself or a third-party lender, a financing program offered by a rehab center may be your best option. Most rehab centers offer payment plans that patients can agree to comfortably, since it's in their best interest to do so. Even if your insurance has covered your treatment, you may still want to speak to your perspective rehab facility about what type of payment options they offer. You may be able to get treatment better suited for you at a more affordable cost.

Other alternative payment options may require you to do a little legwork. Asking for loans from friends or family, for example, may be incredibly difficult, especially if you're dealing with loved ones who have already loaned you money that you have used to feed your addiction. If they see, however, that you are making significant steps toward recovery, it may be in their best interest to help. They may also be more inclined to help if they are making payments directly to your rehab facility, instead of giving money to you.

Selling assets may also prove effective. If you have a boat, car, or even a larger home that you can do without, perhaps it's time to consider getting rid of those things in favor of a sober life.

If you have any other questions about how to finance drug rehab, consult with your insurance agent and qualified addiction treatment professionals.

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and Finally Remember:

"Ask and it will be given to you; seek and you will find; knock and the door will be opened to you. For everyone who asks receives; he who seeks finds; and to him who knocks, the door will be opened."
- Matthew 7:7-8






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