Anna Spooner

Addiction Treatment and Levels of Care Alcohol use disorder (AUD) is a medical condition that impairs your ability to stop or control your use of alcohol. This means that even if using alcohol is causing problems with your social life, career, or health, you cannot seem to slow down or stop drinking. 1 According to NIAAA, about a third of people who successfully complete a rehabilitation program show no further symptoms 1 year later and have fewer alcohol-related problems. When it comes to selecting a treatment setting, it is important to familiarize yourself with the available options, such as: 1 Alcohol detox. This process often includes medication and helps you stop drinking safely and control the unpleasant withdrawal symptoms. Inpatient – Patients live in the facility full-time, and it is typically a 30-day, 60-day, or 90-day program. In an inpatient facility you have medical supervision and participate in behavioral and other therapies during the day. Extended Care or Long-term Rehab – A form of inpatient rehab that is also residential, and is unique for its longer length of stay (typically between 6 and 12 months, depending on the program). Outpatient – Rehab where the patient, in some cases, may attend 3 to 6 hours per day, participate in group, family, and/or individual therapy. Patients typically go home when not in treatment and are able to work or go to school. Generally, the longer the program and the higher the level of care and the more expensive the treatment will be. If your alcohol use disorder is more severe, you’ll need treatment that is longer and more intensive. Also, the type of rehab and the amenities will impact the price as well. A private or luxury rehab will cost more than a community program or one with fewer amenities. Is Rehab Covered By Insurance? The most common method of payment for rehab is using health insurance. The Affordable Care Act, passed in 2010, requires all long-term health plans to include at least some coverage for mental health and addiction treatment.3,  Your specific coverage will depend on your plan, so be sure to contact your insurance provider to get details about what is covered. You’ll likely have some costs that you’ll have to pay, such as:4 A deductible. Which is the amount you pay before your insurance coverage kicks in for the year. If you’ve already paid your deductible due to other health care needs, you won’t need to pay it again within the same year. Copayments and coinsurance. This is the portion of the cost of care for each service. Your insurance plan typically covers the rest. Together, deductibles, copayments, and coinsurance are your out-of-pocket costs, which is the amount you pay for your care. Some of the health insurance plans that might be able to help you with coverage for rehab include United Insurance, Blue Cross Blue Shield, Aetna, Cigna, Humana, and Kaiser Permanente. Medicaid and Medicare Plans for Rehab Medicare and Medicaid are both government programs that help specific people pay for healthcare. Medicare is a federal program that helps those who are 65 and older, along with those who have specific medical conditions. Medicaid is a state-based program for lower-income Americans. Both of these programs will help you cover some or all of your cost of rehab. Medicare covers addiction treatment when it is reasonable and medically necessary. This includes inpatient treatment, outpatient treatment, professional services, and more.5 In order to get Medicare, you must be a U.S. citizen or permanent resident who has lived in the country for at least five years, and one of the following must also be true:6 You’re age 65 or older You’re under 65 but disabled and receiving disability benefits from Social Security or the Railroad Retirement Board You have Amyotrophic Lateral Sclerosis (ALS), also known as Lou Gehrig’s disease You have end-stage renal disease (ESRD) Medicaid plans vary from one state to another, but they are subject to the Affordable Care Act and must provide at least some coverage for addiction treatment. You’ll want to contact your state's specific program to learn more. To qualify for Medicaid, you will need to meet the requirements in your specific state. This may include meeting the income requirements, having children, receiving Social Security Income (SSI) benefits. You’ll want to contact your state’s Medicaid office to apply.7 Local and State-Funded Rehab Many rehabs receive funding from the federal government, their state, or their local community. These grants can help them offer lower-cost or even free treatment to qualifying individuals. The government has found that every $1 invested in rehab centers saves $4 in health care costs and $7 in law enforcement costs.8 If you’re able to attend a state or federally-funded rehab facility, your out-of-pocket costs could be much lower. The eligibility requirements will vary depending on where the rehab center is located and the type of grant they’ve received. It is best to contact the center directlt to learn more about how to qualify. The types of treatment we mentioned above, including inpatient, outpatient, partial hospitalization programs, and aftercare are all available at local or state-funded rehabs. The Affordable Care Act (ACA) The Affordable Care Act (ACA) is a law that was passed in 2010. It significantly expanded the types of healthcare that health insurance plans were required to offer by setting up 10 essential health benefits that all plans have to cover. One of the 10 essential benefits is mental health and substance abuse services.9 Another important part of the law is the Mental Health Parity and Addiction Equity Act (MHPAEA), which requires health insurance plans to cover mental health and substance use disorders at the same level that they cover other medical needs. That means that out-of-pocket costs, days of treatment, treatment limits, and more have to be the same for mental health and addiction treatment as they are for other medical needs.3 Payment Plans Many treatment programs and rehab facilities are able to work with families to set up payment plans that work within a family’s budget to make payments manageable. These payment plans are generally set up before admission into a treatment program, and individuals are responsible for making payments in a timely fashion, often through automatic monthly payments or via a graduated payment plan. Treatment facilities may even offer a “sliding scale” for payment, allowing people to pay what they are able to for services Find Rehab Treatment Entering a rehab program is often the first step in moving toward a healthier, substance-free life. Our addiction specialists are available to talk to you confidentially and help you navigate through the options for rehab. If you or a loved one is struggling it’s important to talk to a qualified professional who can walk you through the process of finding the most cost-effective options for treatment that will also provide the care you need. Does My Insurance Cover Alcohol Rehab? American Addiction Centers can improve treatment outcomes for those in recovery for alcohol use disorder. Find out if you or your loved one's insurance covers treatment at an American Addiction Centers facility by filling out the confidential form below:[vob] [sources] National Institute of Alcohol Abuse and Alcoholism. (2021, April). Understanding Alcohol Use Disorder.National Institute of Alcohol Abuse and Alcoholism. (2021, December). Rethinking Drinking - Alcohol and Your Health.Healthcare.gov. (n.d.). Mental health & substance abuse coverage.Healthcare.gov. (n.d.). Your total costs for health care.Centers for Medicare and Medicaid Services. (2019, May 10). Medicare Coverage of Substance Abuse Services.U.S. Department of Health and Human Services. (2014, September 11). Who is eligible for Medicare?Medicaid.gov. (n.d.). Eligibility.White House Office of National Drug Control Policy. (2012). Cost Benefits of Investing Early in Substance Abuse Treatment.Healthcare.gov. (n.d.). What Marketplace health insurance plans cover. [/sources] ...

When searching for alcohol rehab, you may worry about how to cover the cost of treatment. Some people may worry that they won't be able to afford treatment, and others may worry that they will have to spend a lot of money. Luckily, insurance can provide a way to help you cover some or all of the costs of addiction treatment. Whether its private or public, insurance plans are required to provide some type of coverage for medically necessary substance use disorder treatment. Understanding your insurance benefits, how to verify your coverage, and how to find rehab treatment near you can help you start your journey to recovery. Does Insurance Cover Rehab for Alcohol Addiction? Private or public insurance may be able to help you cover some or all of the cost of addiction treatment. The Affordable Care Act (ACA), requires long-term private and public insurance plans to cover 10 essential health benefits including treatment for mental and behavioral health disorders.3 This includes treatment for substance use disorder. The exact amount of coverage will depend on your specific insurance plan, and you may be responsible for costs like your deductible, copayment, or coinsurance.4 The two main types of insurance are private and public. Private insurance includes coverage you get through an employer (group plans) and coverage you buy on your own (non-group plans).1 Public health insurance consists of Medicare, a federal plan for older and disabled Americans, and Medicaid, which is state-based coverage for lower-income Americans.2 Both private and public insurance are bound by the provisions of the ACA, meaning both can help provide coverage for medically-necessary substance use disorder treatment.3 One important factor is choosing a treatment program that’s within your insurance provider’s network. Many health insurance plans don’t offer any coverage for non-emergency care outside of the network, and if there is coverage it will be much more expensive.5 Alcohol Rehab Services Covered by Insurance There are a variety of treatment options for substance use disorder. Some are more intensive than others, and some allow you to live at home while others do not. The right treatment for your needs will be determined by working with your doctor. They may ask questions about the substances you use, how long you’ve been using them, and what your home environment is like. Some common rehab options include:6,7 Medical detox: Detoxification is a process during which your body rids itself of substances. During detox you may experience potentially life-threatening withdrawal symptoms. As a result, many may find detox programs that are managed 24/7 by a team of licensed medical professionals a safer option. This process can help you stabilize before moving onto a more intensive type of treatment. Inpatient rehab programs: Inpatient and residential treatment programs enable you to live at the facility so that you can receive 24/7 assistance while working towards recovery. inpatient programs generally offer a variety of group and individual therapies, one-on-one counseling, and specialty programs to help you achieve recovery. Inpatient programs usually take place in a hospital setting and can last for a few weeks to a month. Residential programs are usually set in rehab facilities and can last a few months to a year. Outpatient programs: Outpatient programs can assist individuals who need to reside at home during treatment. Outpatient programs allow you to receive treatment at a facility while still living at home and participating in work, school, and daily life. Aftercare: Aftercare is a program that helps individuals maintain recovery after completing a comprehensive inpatient or outpatient program. Aftercare plans usually connect you with sober individuals, groups, and support networks like Alcoholics Anonymous (AA) to help you maintain recovery. Insurance Providers that Offer Alcohol Rehab Coverage There are a wide variety of insurance companies with plans that offer rehab insurance. For example, you’ll find addiction treatment insurance coverage in plans from providers such as: [accordion title="Insurance Providers for Rehab"] Aetna Ambetter Blue Cross Blue Shield BCBS CA Bright Health Cigna Humana Health Plan of Nevada Kaiser Permanente Sierra Health Tricare Triwest United Healthcare Veterans [/accordion] The exact amount of coverage and how much you pay out of pocket depends on your individual plan, so if you have the opportunity, compare plans before making your final decision on insurance coverage. Types of Insurance Plans Used for Alcohol Treatment There are different types of health insurance plans available, and each one works a bit differently. This can impact how your provider network works, as well as how much you pay out-of-pocket when you use your rehab insurance coverage. Two of the most common are Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) plans. HMO plans limit your coverage to providers within the insurance plan’s network. You might be able to get emergency care outside the network, but regular care (and substance use rehab) will need to be from doctors and providers in the network.8 PPO plans have more flexibility but may have a higher monthly premium. You pay less if you use in-network providers, but may be able to use other providers at a higher cost.8 Knowing the type of insurance plan you have will help you find the right treatment center for your needs. How to Pay for Rehab Without Insurance Even those who do not have private insurance can attend rehab at an affordable cost. You might qualify for public insurance coverage that can help you with your treatment costs. Medicare is available for those 65 and older and those who are disabled or have specific health conditions.9 Medicaid eligibility varies by state but is generally based on income and family size.10You may qualify for VA coverage if you are an honorably discharged veteran.11All three of these public insurance plans can help reduce the cost of addiction treatment for eligible individuals. If you can’t get health insurance, you can still pay for your substance use treatment in other ways. For example: Private Pay & Payment Plans: You can use savings, a loan, or money from friends and family to pay for your treatment privately. Many treatment centers also have payment plans that can make this process easier. Sliding Scale Fees: Some treatment centers have a sliding scale of fees where you pay less if you’re lower-income. Scholarships and Grants: Many treatment centers have scholarship options for those who cannot afford treatment. You’ll need to find out the requirements and how to apply. State-Funded or Free Rehab Programs: Many states have specific rehab programs that are low-cost or free. These can be a great way to get the care you need even if you can’t afford the costs of traditional private treatment. How to Find Alcohol Rehabs that Accept my Insurance Finding a rehab near you that works with your insurance doesn’t need to be a difficult process. A good starting step would be to contact your doctor or medical professional and talk to them about your substance use concerns. They can determine what treatment you need and connect you to in-network rehab centers. The SAMHSA treatment locator is another way to find rehabs that are near you. Another option is to contact an addiction helpline. These helplines can answer questions you have about the rehab process and how to use your insurance to cover some or all of the costs. For example, you can contact American Addiction Centers (AAC) at any time by calling [phone]. AAC operates a variety of treatment centers around the country and is proud to be in-network for many insurance plans. If you’re ready to start on the path to a happier, healthier life, we can help. Contact us today. [accordion title="American Addiction Centers (AAC)"] Laguna Treatment Hospital Adcare - Boston Sunrise House Desert Hope Greenhouse Oxford Treatment Center Recovery First River Oaks [/accordion][accordion title="Alcohol treatment near me"] Arizona California Colorado Florida Georiga Illinois Indiana Kentucky Maryland Massachusetts Michigan Mississippi Nevada New Jersey New York North Carolina Ohio Oklahoma Oregon Pennyslvania Rhode Island Tennessee Texas Washington Wisconsin [/accordion][accordion title="Rehab"] Alcohol rehab centers Alcohol rehab centers near me 28 day alcohol rehab 30 day alcohol rehab 60 day alcohol rehab 90 day alcohol rehab Choosing a rehab center Dual diagnosis rehab Executive rehab Extended care rehab Mens rehab Womens rehab Free rehab High profile rehab Holistic rehab programs Paying for rehab Inpatient rehab Luxury rehab Nature based rehab Outpatient rehab Private rehab Residential Rehab Court-ordered rehab State funded rehab Teen rehab Veterans rehab [/accordion] [sources] Congressional Research Service (2021, January 26). S. Health Care Coverage and Spending. National Cancer Instititute. (n.d.). Public health insurance definition. gov. (n.d.). What Marketplace health insurance plans cover. gov. (n.d.). Your total costs for health care. gov (2021, May). What you should know about provider networks. gov (2019, October). Treatment Options. National Institute on Drug Abuse. (2014). Types of Treatment Programs. gov. (n.d.). Health insurance plan & network types. S. Department of Health & Human Services. (2014, September 11). Who is eligible for Medicare? S. Department of Health & Human Services. (2017, August 4). Who is eligible for Medicaid? S. Department of Veteran’s Affairs. (2022, January 18). Eligibility for VA health care. [/sources] ...