Does Your Insurance Cover Addiction Rehab?
Most health insurance plans cover substance abuse treatment under federal law. Learn what's covered, how to verify your benefits, and explore payment options to make recovery accessible.
Free, confidential verification • No obligation • Available 24/7
Accepted Insurance Providers
Treatment centers in our network accept most major insurance plans
Don't see your insurance? Call us — we work with many additional providers.
What Does Insurance Cover for Rehab?
Under the Mental Health Parity and Addiction Equity Act, insurance must cover addiction treatment at the same level as medical/surgical care. Here's what's typically included:
Important: Coverage Varies by Plan
While federal law requires coverage, the specifics (number of days, copays, deductibles, network restrictions) vary significantly between plans. Always verify your specific benefits before starting treatment.
How to Verify Your Insurance Coverage
Follow these steps to understand exactly what your insurance will cover for addiction treatment.
- Member ID number
- Group number
- Insurance company phone number
- Subscriber name and date of birth
- Ask about substance abuse/addiction treatment coverage
- Inquire about mental health parity benefits
- Request benefit details in writing
- What levels of care are covered? (detox, inpatient, outpatient)
- How many days/sessions are covered per year?
- What is my deductible and has any been met?
- Do I need prior authorization?
- What facilities are in-network?
- Provide your insurance information
- Get a detailed breakdown of estimated costs
- Ask about payment plans for any remaining balance
Don't want to navigate insurance alone? Our team can verify your benefits for free.
Free Verification: (844) 834-5681Understanding Insurance Terms
Insurance terminology can be confusing. Here's what the key terms mean and how they affect your costs.
The amount you pay out-of-pocket before insurance starts covering costs. For example, with a $1,500 deductible, you pay the first $1,500 of treatment costs.
Example:
If treatment costs $10,000 and your deductible is $1,500, you pay $1,500 first, then insurance covers a percentage of the remaining $8,500.
A fixed amount you pay for each service or visit. This is typically a flat fee regardless of the total cost.
Example:
A $50 copay means you pay $50 for each therapy session, regardless of whether the session actually costs $150 or $300.
The percentage of costs you pay after meeting your deductible. Common splits are 80/20 or 70/30 (insurance/you).
Example:
With 20% coinsurance, if a $10,000 treatment costs $8,500 after your deductible, you pay $1,700 (20%) and insurance pays $6,800 (80%).
The most you'll pay in a year. Once reached, insurance covers 100% of remaining costs.
Example:
With a $5,000 out-of-pocket max, once you've paid $5,000 total (deductible + copays + coinsurance), insurance covers everything else that year.
In-network providers have agreements with your insurance for lower rates. Out-of-network providers cost more.
Example:
An in-network rehab may cost you $2,000 out-of-pocket, while the same treatment out-of-network could cost $8,000.
Approval required from your insurance before certain treatments. Without it, coverage may be denied.
Example:
Your insurance may require pre-approval for residential treatment lasting more than 7 days.
Types of Insurance Plans
Different plan types have different rules for rehab coverage. Understanding yours helps set realistic expectations.
Advantages
- • Greater flexibility in choosing providers
- • No referrals needed for specialists
- • Out-of-network coverage available
Considerations
- • Higher premiums
- • Higher out-of-pocket costs for out-of-network care
Best For
Those who want flexibility and can afford higher premiums
Advantages
- • Lower premiums and out-of-pocket costs
- • Predictable copays
- • Coordinated care through PCP
Considerations
- • Must use in-network providers only
- • Referrals required for specialists
- • Less flexibility
Best For
Those prioritizing lower costs with in-network treatment
Advantages
- • No referrals needed
- • Lower premiums than PPO
- • Simpler network rules
Considerations
- • No out-of-network coverage except emergencies
- • Limited provider choices
Best For
Those comfortable with network restrictions
Advantages
- • Covers detox and rehab
- • Part A covers inpatient
- • Part B covers outpatient
- • Part D covers medications
Considerations
- • May have coverage limits
- • Requires Medicare-certified facilities
- • Possible gaps in coverage
Best For
Adults 65+ or those with qualifying disabilities
Advantages
- • Low or no cost coverage
- • Covers essential addiction services
- • Available in all states
Considerations
- • Limited provider networks
- • Varies significantly by state
- • May require prior authorization
Best For
Low-income individuals and families
No Insurance? You Still Have Options
Lack of insurance shouldn't prevent you from getting help. Here are alternatives to make treatment affordable.
Many facilities adjust fees based on your income. Treatment costs are calculated as a percentage of what you can afford, making care accessible regardless of financial situation.
Most treatment centers offer monthly payment plans with low or no interest. This spreads the cost over time, making comprehensive treatment manageable.
Some facilities offer scholarships for those who qualify. SAMHSA also provides grants for treatment. Ask about financial assistance when contacting facilities.
Every state has programs for uninsured individuals. These are typically free or low-cost and provide quality care. Contact your state's health department for options.
Many nonprofit rehabs prioritize accessibility over profit. They often accept patients regardless of ability to pay and may offer free treatment beds.
If you're uninsured and low-income, you may qualify for Medicaid, which covers addiction treatment. Enrollment can often be completed quickly, even same-day.
Not sure what options are available to you?
Our team can help identify financial assistance programs and facilities that work with your budget.
Discuss Payment Options: (844) 834-5681Frequently Asked Questions
Get answers to common questions about insurance coverage for addiction treatment.
Ready to Verify Your Coverage?
Don't let insurance questions delay your recovery. Our specialists can verify your benefits in minutes and help you understand your options—completely free and confidential.
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