Does Insurance Pay for Addiction Treatment?

Rehab and Insurance

Treating an addiction is worth the expense because it ultimately saves money on an annual basis. The National Institute on Drug Abuse estimates that every dollar that is spent in addiction treatment will provide a return of $4 to $7. A return of 400 percent to 700 percent is a significant reduction in medical costs, lost work productivity and other expenses related to substance abuse.

The problem that may occur when it comes to investing in treatment is the ability to pay for appropriate services. Public programs may not offer enough care for long-term addictions, so an in-patient program may be necessary to take the first steps into recovery.

Although every insurance company is different, some health insurance providers will offer assistance to pay for in-patient and out-patient treatment programs.

Identifying Coverage

HelpGuide.org states that health insurance providers may offer assistance to pay for rehabilitation, but the exact details of any plan will vary. Before seeking a treatment program, call the current insurance provider and inquire about coverage.

Although many insurance providers will offer assistance to pay for drug rehabilitation services, the amount of coverage and the options will vary. For example, one company may pay for 80 percent of a 30 day program while another will only pay 60 or 70 percent.

Ask about the current coverage to find out if rehabilitation is covered and how much is covered under the plan. Discuss deductibles and co-pay amounts to calculate how much is a personal responsibility and how much of the treatment is covered under the plan.

Organize Other Variables

Even when health insurance offers coverage for a rehab program, coverage may have exceptions or additional variables before the company will pay for the treatment.

A common variable to consider is referrals. Depending on the insurance provider and the coverage plan, it may be necessary to get a referral from a personal family doctor before the company will pay for the rehabilitation program. Go to the family doctor and ask for a referral to an appropriate treatment program.

Although referrals are a possible variable to consider, some insurance providers may also have a list of rehab programs that they cover and a list that are not covered. It may be necessary to look for a program that is in the insurance provider’s network to have the full benefit of coverage. Out-of-Network programs may cost more because the insurance provider might not give the same coverage benefits.

Since insurance plans will often provide some coverage to help pay for addiction treatment, it is possible that the actual cost of a program will be affordable for a personal budget.