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Insurance coverage has come a long way with regard to addiction treatment. Even though some insurance companies save money by not offering mental health or addiction coverage, thanks in part to the Affordable Care Act, larger companies will now consider covering the cost of mental and behavioral health services just as with any other medical condition. This is assuming the treatment meets the insurance company’s criteria of being medically necessary.
If you have insurance, this would be the place to start to minimize your out-of-pocket expense. Unfortunately, insurance benefits are extremely confusing. Most people believe insurance either covers more than it actually does, or they think they have less coverage than they really do. When you call your insurance company, they try to direct you to the cheapest local option. The best way to understand exactly what you can expect your insurance company to pay is to talk to a professional who has lots of experience and understanding of the treatment system, works with many insurances, and doesn’t work for your insurance company. These individuals deal with this every day, and they can help you make sense of all your benefits.
Every insurance company has their own criteria for determining the intensity, duration, and cost they are willing to pay for the services you need and desire. Many want to start at a cheaper option, especially if you never had treatment before. For example, some insurance companies will only cover outpatient, not inpatient treatment. Others will cover outpatient only after the person has completed inpatient rehab. Some insurance companies will only cover a certain length of rehab stay, or services provided by certain facilities in their network. The first rule is: check your insurance coverage.
Medicaid and Medicare are very selective and restrictive in their policies, nor do they pay very much, so most rehabs do not accept Medicaid or Medicare. But when they do approve a facility, they will often pay for most of a 30 day residential rehab stay. Ask at your treatment facility or use SAMHSA’s treatment locator to look for facilities that accept government-supported plans.
How to Start
All this can be overwhelming, so we will walk you through finding out how you will be able to pay for alcohol rehab.
First, get your insurance information together (policy number, group number, primary policy holder, birthdate, Medicaid or Medicare information, and phone numbers for your insurance company, etc.). You can start to look up coverage on your own, but you will have much more accurate answers if you call up a treatment center or a placement service, and see what they can find out for you about your insurance coverage.
Second, learn about the costs of different types of treatment by calling and very openly discussing what a facility offers and charges. Ask what is included and what you pay extra for. Detox is the most expensive portion, then residential rehab, then outpatient rehab. Medical detox is more costly than outpatient detox. Understand that if you have your eyes on a vacation-like treatment center on the beach or in another prime location, you will pay much more. For a summary of costs you can expect with each level of care, click here.
Third, apply for loans if necessary. Talk to your bank or mortgage company, or ask at the treatment center for suggestions of institutions that might give you a loan. Or, check into Care Credit or a similar program that gives you money up front with no interest for six months to a year.
Finally, don’t be afraid to talk to family members or your church leadership about your need. Depending on your history, your family might be leery to give you money right now. Don’t blame them for this. However, if you have done your research and enrolled in a treatment program, you can demonstrate to them that you are serious about your recovery. They might just be willing to help out when they see you are committed to recovery and want to overcome your addiction, putting all its mistakes and costs behind you. Tell them they can pay the facility directly in case they don’t trust you handling the money. You can offer to pay the money back once you are on your feet again.
Stay Informed
You as the patient have a right to know what to expect with treatment, and what charges you will see for your rehab. Don’t be too shy, proud, or embarrassed to ask questions. Be especially careful with optional services. Some centers might charge extra for a single room, laundry services, or specialty therapies. You don’t need all the extras you will be offered. If you are concerned about cost, cut out as many of the extra perks as you can, and stick with a basic, but solid, treatment plan. You might need to look into a different level of care or even a state-run program if you can’t afford an elaborate a la carte program. If you invest your time and attention into even a basic faith-based program, you will see the results you want.