Does Insurance Pay for Alcohol Rehab? | Alcohol Treatment Payment Options

How to Pay for Alcohol Addiction Treatment? 

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For years now, alcohol consumption has been an ongoing public health concern in the US. Approximately 138.5 million Americans aged 12 or older reported consuming alcohol during the previous month, according to the 2020 National Survey on Drug Use and Health. This means that roughly half of the US population aged 12 or older was at risk of developing alcohol use disorder at some point in the future.1

The same survey found that 61.6 million people who drank in the previous month resorted to binge drinking. Furthermore, the same survey showed that there were 17.7 million individuals who identified as heavy drinkers. Not everybody who drinks will develop alcohol addiction, but with alcohol, there is always a risk that moderate consumption may turn into an unhealthy drinking pattern. Sometimes difficulties and bad periods may turn people who have one drink during supper into those who turn to alcohol to overcome difficult moments in their lives.2

While isolated cases of people giving up alcohol on their own do exist, most people won’t be able to quit drinking without professional help. This is because people who suddenly stop consuming alcohol go through a painful process called withdrawal. Withdrawal makes it very hard to stop drinking even for people who have a strong desire and willpower to do so.3

People sometimes wrongly think that addiction treatment costs a lot of money, but research shows that costs of addiction far outstrip the costs of rehab. According to research, costs of rehab are 7 times lower than costs of maintaining alcohol addiction. With addiction, you risk losing your job or developing serious physical and mental health issues. Worst-case scenarios lead to overdosing and deadly outcomes.4

How Much Does Alcohol Addiction Treatment Cost? 

The cost of addiction treatment can depend on a variety of factors. One of the most important factors to take into consideration is the type of rehab approach. Treatment methods have been developed over time through a combination of previous rehab experience, approved medication, proven medical procedures, and advances in clinical technology.5

The most common treatment methods used in alcohol addiction rehab are:3

  • Detox.
  • Inpatient rehab.
  • Outpatient approach.
  • Partial hospitalization programs.

Detox

Detoxification, usually called detox, is a procedure that cleanses people’s bodies of harmful substances. Detox is not a standalone treatment approach, but the first step in the full recovery from alcohol addiction. Since the brains of individuals who suffer from alcohol use disorder have become used to an increased presence of alcohol, patients first have to cleanse alcohol from their system before enrolling in an appropriate rehab program.6

Detox is a short procedure that lasts from 3 to 7 days for most cases or 10 to 14 days in case of long-term or severe alcohol users. It’s important that rehab facilities offer same day admissions in case the patient needs an emergency detox. In addition to the duration of the detox procedure, costs largely depend on the setting in which the detox is taking place. Detox is a standard part of most inpatient rehab programs. If you choose to pay for detox out-of-pocket, the costs will be approximately $500 per day.6

Inpatient Rehab

Inpatient programs take place inside medical facilities that are designed to provide the maximum level of medical care and support to individuals during their rehab procedure. Patients spend time with peers who suffer from the same issues. They can empathize with each other and provide support and companionship during treatment. Inpatient rehabs utilize a structured environment of a rehab center to help people develop a healthy routine in place of bad habits they acquired while drinking.4

Since patients commit to staying inside the rehab center, inpatient programs cost more, but they also give medical professionals a chance to closely monitor patient’s recovery progress at all times. This enables doctors to modify treatment according to patients developing needs, which greatly aids overall recovery. Inpatient programs last at least 4 weeks, but it’s advisable to submit to at least a 3-month program for best results.3

Certain rehab centers resemble secluded resorts with state-of-the-art amenities like golf courses, swimming pools, acupuncture, private rooms, and gourmet chefs. Upscale rehab centers offer luxury and executive rehab programs and cost more, but there are also many cheaper options to choose from. Since costs vary depending on the type of rehab facility and treatment module, estimating the cost of inpatient rehab is not easy, but most programs will cost around $650 per day of treatment.6

Outpatient Rehab

Outpatient rehab is the most popular treatment option in the US today. It can incorporate detox and various behavioral procedures, but also the medication-assisted treatment and follow-up programs of various kinds. Outpatient programs can last for years if needed since patients can continue fulfilling their obligations while attending their scheduled outpatient sessions. Another advantage is the ability to adjust the intensity in terms of the number and duration of daily sessions.7

Regular outpatient programs are a good choice for people who can’t afford to submit to full inpatient care, whether due to financial constraints or because they have prior engagements they are unable to postpone. Regular outpatient rehab may involve no more than one weekly session of counseling or therapy in case of mild alcohol dependence. More intensive modules are called intensive outpatient treatment, or IOT. This type of treatment incorporates up to 30 hours of weekly sessions usually divided into 5 daily 6-hour sessions.7

Besides patients sleeping inside their homes and continuing to engage in their everyday work or schooling obligations, outpatient rehab is popular because it costs less than inpatient programs. Patients are spared of costs that are related to full hospital care, which makes it a much more affordable form of treatment. Costs of outpatient rehab will also depend on the rehab center that provides the service. They may range between $250 and $350 per day.7

Partial Hospitalization Programs

Partial hospitalization programs (PHP) are very similar to outpatient ones since patients also sleep in their homes and visit the rehab center for scheduled sessions. The difference between PHP and outpatient is in the intensity of care and the duration of weekly sessions. PHP involve more than 20 hours per week, usually daily sessions that last for 4 hours at least. Since patients can spend as much as 10 hours in case of medically monitored ambulatory detoxification, PHP are sometimes called day treatment.7

Partial hospitalization programs differ from outpatient ones in that they try to mimic the inpatient level of intensity. PHP provide a structured type of care in a hospital setting while helping patients to remain functioning and avoid full hospitalization. They are ideal for people who suffer from severe forms of alcohol use disorder or one or more co-occurring disorders, but can’t afford paying for inpatient care. Some patients may use PHP to transition from an inpatient to an outpatient type of care.8

Partial hospitalization programs are designed to tackle stubborn alcohol issues and usually last for a few months. PHP are a good choice for people who have serious issues but still enjoy a stable and supportive home situation. PHP are cheaper than inpatient rehab, but usually cost more than the outpatient type of care. Typical programs will range from $350 to $450 per day, but this will largely depend on the intensity and type of service provided.8

How to Pay for Alcohol Addiction Rehab

Paying for treatment is one of the biggest challenges for people who suffer from alcohol use disorder. However, many positive developments over the years made quality treatment more available. The biggest problem today is the lack of awareness about the various ways people can finance their alcohol addiction treatment. Out of 40.3 million Americans over the age of 12 who had substance use disorder in 2020, as much as 93.5% received no treatment at all.9

One of the biggest changes when it comes to alcohol use disorder treatment was the passing of the Mental Health Parity and Addiction Equity Act (MHPAEA) that regulated health care benefits related to mental health coverage. With the passing of MHPAEA, insurance providers have to provide the same level of benefits and coverage for mental health conditions, including substance use rehab, as they do for surgical or medical issues.10

Here are some of the most common ways to pay for alcohol addiction treatment:11

Does Insurance Pay for Alcohol Rehab? 

Using insurance to pay for treatment is one of the most common ways to finance your alcohol addiction rehab. Most plans provide a certain amount of coverage for the treatment of substance use disorders. Keep in mind that states reserve their right to mandate coverage of certain healthcare benefits so there may be slight differences depending on your location.12

Some of the biggest and most popular providers in the country include:

  • United Healthcare
  • Blue Cross Blue Shield
  • Aetna
  • Ambetter
  • Cigna
  • Humana
  • Kaiser Permanente

Most providers will provide coverage for only a portion of treatment, but this will depend on the specifics of each individual plan. One of the best ways to lower the cost of rehab would be to find a rehab center that partners with your insurance provider as an in-house treatment option. If you are not sure about the specific details of your existing coverage, call the number that is written on the back of your insurance card to learn more.10

How to Pay for Alcohol Rehab Without Insurance

Treatment for alcohol use disorder was previously inaccessible to people who didn’t have insurance or the money to pay out-of-pocket. However, things have changed and there are now several ways to fund your alcohol rehab even if you don’t have an insurance policy. Options for paying for alcohol treatment without insurance include:13

  • Personal financing – Paying for treatment in cash, with a card, or using your savings. You could also finance your treatment by making a deal with the bank or with the rehab center to pay in monthly installments.
  • SAMHSA grants – SAMHSA funds rehab programs for people who struggle with addiction but can’t find a way to pay for treatment. Visit SAMHSA’s website to find out about the requirements that you have to meet to qualify for their grant program.
  • Subsidized coverage – There are various state and government agencies that offer subsidies for people who have financial difficulties and struggle with addiction issues. Visit the government’s Healthcare.gov site to check out possible government subsidies, or get in touch with your state agency to enquire about state-sponsored treatments.
  • Sliding scale – Out of 16,066 available rehab facilities in the US, as many as 9,181 provide some type of sliding scale programs that take into account your income status. You can use SAMHSA’s treatment locator tool to find sliding scale rehab options near you.
  • Fundraising – If you are ineligible for any of the previous options, you can always try raising the money through different channels. Selling the things you don’t need, or looking for cash donations may be a good option. Besides asking your friends, family and loved ones for help, there are numerous crowdfunding sites that you can use to kick-start a rehab funding campaign.

How To Get Financial Assistance to Pay for Alcohol Rehab? 

Since the passing of the Affordable Care Act (ACA) in 2010, commonly known as Obamacare, mental health treatment has been included in the list of 10 essential health benefits. All plans offered on the healthcare Marketplace have to provide coverage for addiction treatment since it falls under the category of mental health treatments.14

ACA-sponsored policies cover from 60% to 90% of treatment costs. The exact amount of coverage will depend on the type of plan that you choose. ACA offers 4 basic levels of coverage:15

  • Bronze plans that cover 60%
  • Silver plans that cover 70%
  • Gold plans that cover 80%
  • Platinum plans that cover 90%

There is also the Catastrophic plan that provides 60% coverage. It’s available to people under 30 and those who qualify under certain extenuating circumstances, including a hardship exemption or an affordability exemption. These plans have low monthly premiums but high deductibles. They are an affordable option to insure against potential catastrophic scenarios like serious injuries or illness.16

Do Medicare and Medicaid Pay for Alcohol Rehab

Medicare and Medicaid are federal and state-funded programs that offer healthcare coverage to eligible Americans. They are very popular in providing low-cost and in some cases free addiction recovery. The difference between them is that Medicare is available to people based on their age or disability status, while Medicaid covers people mostly depending on their income situation.17

Medicare

Medicare is available to Americans who are over 65 or who have certain disabilities. Medicare is paid through a monthly premium that is calculated based on the recipient’s income level. Medicare coverage includes addiction-related issues like alcohol use disorder treatment if you meet the following criteria:18

  • Your treatment provider has determined that alcohol rehab constitutes a medical necessity.
  • The rehab services you are about to receive are provided by a Medicare-approved provider or a facility.
  • You are ready to submit to a treatment plan that your provider deemed necessary.

Medicare provides coverage for:19

  • Inpatient rehab through its Part A.
  • Outpatient programs through Part B.
  • Medicare-approved private insurance through Part C.
  • Costs of addiction medication through Part D.

Medicaid

Medicaid is the nation’s single largest payer when it comes to coverage of services for various mental health conditions. Since the adoption of the MHPAEA in 2008, Medicaid’s role in coverage of substance use disorder treatment is ever expanding. Out of roughly 83 million Medicaid beneficiaries, almost 12% received coverage for substance use disorder-related treatment programs.20

Coverage varies from state to state, but to be eligible for Medicaid you must:21

  • Have less than 19 years of age, or
  • Be older than 65, or
  • Be a parent, or
  • Currently pregnant with a child, or 
  • Fall in a specified income bracket.

Since it provides coverage to people who have financial difficulties or live below the poverty line, in most states Medicaid doesn’t require co-payments. Even in states that still charge co-payments, the out-of-pocket maximum is fixed in order to lower the costs of treatment.22

What are the Factors that Affect the Cost of Addiction Treatment? 

As previously stated, every successful rehab should be tailored to meet the specific needs of affected individuals. This means that there is no one-size-fits-all approach since multiple factors need to be taken into account to develop a personalized plan. A combination of these factors will end up influencing the cost of treatment. The most important factors are:3

  • The length of the treatment program – This is one of the most important factors when it comes to determining the costs of rehab. Treatment can last for a month in case of short-term programs, or a year or more in case of long-term rehabs that deal with severe cases of alcoholism.
  • The type of rehab center – Numerous rehab centers specialize in catering to specific parts of the population, like Native Americans or US Veterans. There are also luxurious rehab centers that cater to a demanding high-end clientele and cost a lot more than regular rehab facilities.
  • Type of treatment offered – Some patients may be satisfied with a regular outpatient rehab with 2 one-hour weekly sessions, while others may need a medically managed detox in an inpatient rehab center before starting a dual diagnosis treatment. There is a great difference between these two approaches and the cost of treatment will reflect this. 
  • Amenities used in treatment Some rehab centers offer a wide range of amenities that are designed to make a patient’s recovery process more comfortable and enjoyable. Amenities range from a private room to more exotic offerings, including spas and saunas, indoor and outdoor swimming pools, golf courses, meditation and yoga programs, horseback riding, and private security.

How Much Does Alcohol Rehab Cost Out-of-Pocket? 

Because every case of addiction differs, the insurance Marketplace offers a variety of insurance plans. However, most plans will still include certain expenses that aren’t included in the coverage and will have to be covered as out-of-pocket costs. Depending on the plan you have and certain differences in state legislation, there are certain expenses that will have to be paid as out-of-pocket costs, including:23

  • Premiums – Monthly or annual cost of having insurance coverage. Premiums will differ between individual insurance plans, so they have to be paid on an individual basis.
  • Deductibles – Expenses that have to be covered before your health insurance policy kicks in. Usually, people who have higher premiums end up paying lower deductibles.
  • Copays – Flat fees or fixed amounts you have to pay on the spot once you receive certain services, like visits to a doctor or a specialist, prescription drugs, or lab tests. The exact amounts will vary from plan to plan and from service to service. 
  • Lifetime limitations – Dollar limits on what your insurance provider will cover while you hold that specific plan. If your expenses exceed the set amount, you will have to cover them yourself.

How to Pay for Alcohol Rehab

The decision to enter into treatment is not an easy one, but it’s the best choice when it comes to alcohol addiction. American Addiction Centers is the nation’s leader in delivering proven medical solutions for treatment of all types of substance addiction. Located around the country, American Addiction Centers (AAC) partners with all the major providers of healthcare insurance in the US.

You can easily get in touch with AAC through one of their numerous hotlines. AAC operates hotlines that are dedicated to different substances of choice including alcohol, opioids, heroin, or cocaine. Hotlines are a great way to get informed about your situation and possible solutions because they carry no obligation to enter into treatment.

All AAC’s hotlines are strictly confidential so whatever you say will remain between you and AAC’s knowledgeable staff. With just one phone call, AAC’s staff can look into the details of your insurance coverage, check your benefits, or verify your eligibility to use insurance for treatment. If you don’t feel ready to talk, try the free text support option and get informed that way.

Frequently Asked Questions