How To Pay For Addiction Treatment

The two biggest obstacles to receiving addiction treatment are making the decision to seek help and figuring out how to pay for addiction treatment. Fortunately, for those who need help paying for drug rehab, many options exist besides health insurance and personal, out-of-pocket contributions.

How To Pay For Addiction Treatment

Paying For Drug And Alcohol Rehab

Realizing that you need to pay for addiction treatment that may last weeks or months can discourage people from pursuing the help that they need. Especially when someone needs to enter treatment immediately, having to create a financial plan overnight can be daunting.

This guide will provide you with the information you need to minimize your out-of-pocket obligations.

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Health Insurance

Health insurance plans acquired through an employer or the Health Insurance Marketplace must comply with the Mental Health Parity and Addiction Equity Act. This law requires that policies providing coverage for behavioral health benefits, such as mental health care and addiction treatment, do so at rates similar to other medical procedures. These types of insurance policies are also governed by the Affordable Care Act, which requires most health insurance plans to cover addiction treatment.

A great health insurance policy may cover 90 to 95 percent of the cost of treatment. Coverage benefits, copays and deductibles will vary between plans, and treatment centers are often only in network with a small portion of available insurance plans. To learn the coverage details of a specific policy, call the number on the back of the insurance card or contact the admissions team of an addiction treatment center for verification of benefits.

Click the following link to see our comprehensive list of health insurance providers commonly accepted at drug and alcohol rehab centers throughout the US: Insurance Coverage & Providers

Health Maintenance Organization (HMO)

HMO plans rely on a primary care physician to oversee patients’ needs and typically require a referral for any specialized care or services. Out-of-network treatment typically is not covered, so patients must restrict their choices to providers who are in-network.

Preferred Provider Organization (PPO)

PPO plans offer more flexibility and do not require a referral to see a specialist. If the provider the patient wants to use is out of network, a lower level of coverage is usually available.

Questions To Ask Your Insurance Provider:

  • To learn how to get insurance to pay for drug rehab, start with the following questions:
  • What levels of addiction treatment does my insurance policy cover? Detox, inpatient treatment, outpatient treatment?
  • What are my coverage limits and out-of-pocket maximums? How many days of treatment or individual therapy visits are covered?
  • Do I have to demonstrate medical necessity in order to qualify for treatment benefits?
  • Are prescriptions covered, such as those used in detox and medication-assisted treatment plans to prevent withdrawal and discourage relapse?
  • What are my deductible and copay amounts?

Most addiction treatment centers offer an admissions hotline where trained specialists can research insurance coverage on behalf of patients at no cost.


State Health Insurance Programs

Each state participates in Medicare and Medicaid benefit programs, both of which are federal and state collaborations to provide healthcare for citizens who meet certain qualifications. Coverage limits and treatment requirements vary between states, and not all addiction treatment providers accept Medicare or Medicaid.

Medicare

Medicare is available to United States citizens age 65 or older who have paid Medicare taxes for at least 10 years. Medicare is also available to those under the age of 65 who have been eligible for Social Security disability benefits for 24 months or who meet other disability-related qualifications.

Medicare coverage for addiction treatment is broken into three parts:

  • Medicare Part A: Covers hospital stays and inpatient services such as residential addiction treatment for up to 60 days.
  • Medicare Part B: Covers outpatient, medically necessary services such as outpatient drug rehab.
  • Medicare Part D: Prescriptions used in addiction treatment, such as those used in medication-assisted treatment plans, are included in Part D.

State Health Insurance Plan assistance centers provide state-specific information on Medicare and can be accessed at SHIP National Technical Assistance Center.

Medicaid

Medicaid provides health care coverage for low-income families, as well as pregnant women and those who receive Supplemental Security Income. Copays for addiction treatment services vary from state to state. Learn more at Medicaid.gov.


Military Health Insurance

TRICARE

TRICARE provides health insurance for active-duty personnel, retirees and reservists called to active duty, as well as some family members. TRICARE covers many levels of addiction treatment care such as detox, inpatient treatment, outpatient treatment and medication-assisted treatment.

Veterans Health Administration

The Veterans Health Administration offers coverage for substance use disorders and medication-assisted treatment programs to all eligible veterans. Most veterans receive this healthcare free of charge, but some are required to pay copays.


Employee Assistance Programs

Employers may offer an employee assistance program as part of their benefits package. EAPs provide resources to help employees successfully handle personal and workplace issues that may arise. These resources may include services such as financial or legal counseling, workplace conflict resolution, family therapy, counseling, workplace training and short-term assistance for substance use disorders.

Which specific services are available to employees will depend on what the employer has chosen, but details can generally be found through the company’s human resources department. EAPs are typically paid for entirely by the employer, and the benefits extend to other members of the household such as spouses, live-in partners and children.


Scholarships And Grants

If a person in need of addiction treatment is wondering how to pay for drug rehab without insurance, there are other options.

10,000 Beds

10,000 Beds is a non-profit organization that collects scholarships from addiction treatment centers and awards them to qualified applicants. Applicants must fill out a questionnaire and commit to a minimum of 30 days of treatment. 10,000 Beds does not offer immediate placement, and applications close when all available scholarships have been awarded. Learn more at 10000beds.org/scholarship/.

Substance Abuse And Mental Health Services Administration

Through SAMHSA, the federal government provides financial assistance to citizens and organizations for a variety of purposes, including addiction treatment. Many programs are focused on reaching vulnerable populations, such as pregnant women, veterans and IV drug users, but grants exist for a wide range of qualified applicants.

Access To Recovery

Access to Recovery is a SAMHSA grant program intended to expand access to treatment and allow patients to choose which treatment center they would like to attend. Funds are awarded to state governmental agencies to apply to addiction treatment efforts in their respective states.

Substance Abuse And Prevention Block Grant

The Substance Abuse and Prevention Block Grant is a federal program administered through SAMHSA. This grant program provides funds to each state and community organizations within each state that are dedicated to preventing and treating substance use disorders. The grant allows treatment centers to offer low-cost or no-cost therapy to low-income individuals or those without insurance or other resources.

To search for addiction treatment grants by state, find the point of contact for each state at: https://www.samhsa.gov/sites/default/files/ssa-directory.pdf.

It may be reassuring to know that if or when insurance stops paying for drug rehab, many addiction treatment centers will step in to allow the patient to stay in treatment. Drug and alcohol rehab centers may offer scholarships and financing to those who cannot afford the cost of treatment.


Financing Options

If a person needs help paying for drug rehab without insurance, medical loans, medical credit cards and personal loans are available through banking institutions to those who qualify.

Medical Credit Card

CareCredit is a financing option for medical procedures and wellness care not covered by insurance. This credit account offers short-term repayment options of six to 24 months, interest-free if the balance is paid in full and on time. CareCredit also offers long-term financing up to 60 months with interest. Learn more at CareCredit.com.

Medical Loans

A personal medical loan can bridge the gap between scholarships, insurance and out-of-pocket expenses. Applied for through a person’s bank or other specialized financial institution, personal medical loans can potentially cover the remaining balance for an addiction treatment program after scholarships and insurance.

LightStream

One such medical loan is LightStream, offered by SunTrust Bank. Currently advertising interest rates as low as 5.49, this financial product features a simple way to calculate the loan’s interest rate and a simplified application process that can be completed on a cell phone. Loans are available in amounts from $5,000 to $100,000, and loan repayment terms range from 24 months to seven years. Learn more at LightStream.com.

My Treatment Lender

My Treatment Lender provides loans for addiction treatment, offering a variety of packages with varying terms for different credit ratings. Featuring same-day loan payouts and advertising some of the lowest interest rates in the industry, My Treatment Lender helps thousands of patients finance treatment each year.

Prosper Healthcare Lending

Prosper Healthcare Lending offers loans to pay for healthcare services, including drug rehab. Loan amounts go up to $35,000 with repayment terms of up to 60 months. Applicants receive a response within two minutes of completing the online questionnaire to determine creditworthiness.

Non-Medical Personal Loan

Many banks offer a personal loan option that can be used to pay for addiction treatment. Based on a person’s credit score and general creditworthiness, personal loans provide upfront funds to finance personal expenses and are repaid over time.

Loans When You Have A Low Credit Score

Those with a lower credit score may still qualify for a personal loan, but generally the terms will be less desirable, with a higher interest rate and shorter repayment timeline. However, making the payments on time for the life of the loan can go a long way toward improving a person’s credit score.

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Treatment Center Payment Plans

Addiction treatment centers may provide a direct payment plan option for patients, allowing them to repay the cost of treatment over an agreed-upon period of time. This helps a person get the treatment they need immediately, without having to wait for outside scholarships or loans to be approved.

Sliding-Scale Fees

Many drug rehab centers genuinely want to help their patients find lasting recovery through professional addiction treatment. They also understand that the financial burden of paying for treatment is a barrier for many people. To help as many people as possible access the care they need, some centers accommodate their patients’ financial limitations and adjust treatment fees according to each patient’s financial situation and income. Sliding-scale fees decrease the cost of treatment for those who can least afford it.


Crowdfunding

One often-overlooked way to pay for addiction treatment is through crowdfunding efforts on social media. Those who suffer from substance use disorders are often surrounded by people who want the best for them and are willing to pitch in financially to get them into recovery. Creating a public fundraising campaign where friends and family can donate can yield a significant amount of money to put toward addiction treatment.

Gofundme.com is one of the most widely used crowdfunding sites, featuring easy campaign setup and secure financial transactions. To start a GoFundMe campaign, create an account and tell the story behind the need, then add a photo and set a target fundraising goal. Share the campaign with family and friends on as many social media platforms as possible. Funds can be withdrawn as donations come in or after the fundraising goal has been met.

Additional crowdfunding sites that offer similar features include fundly.com, fundrazr.com and gogetfunding.com.


Addiction Treatment Program Length And Cost

Addiction treatment comes in a range of therapeutic methods and program lengths, all with varying costs. Program length is determined both by the treatment center and how each patient responds to therapy, but research has shown that 90 days or longer leads to the most positive treatment outcomes.

The cost of treatment can range from a few thousand dollars for an outpatient program to tens of thousands for a highly structured residential treatment program.

Drug And Alcohol Detox

Drug and alcohol detox provides medical support and manages withdrawal symptoms as patients’ bodies adjust to sobriety, keeping them safe and as comfortable as possible.

  • Length of Treatment: a few days to a few weeks
  • Cost: $500 to $1,000/day

Inpatient Drug Rehab

In residential addiction treatment programs, patients live onsite and attend therapy sessions each day as they work to acquire the relapse-prevention techniques necessary to maintain long-term sobriety.

  • Length of Treatment: 30 to 90 days
  • Cost: $2,000/week to $1,000/day

Intensive Outpatient Addiction Treatment

Offering more independence than an inpatient program, intensive outpatient drug rehab patients live at home while participating in therapy.

  • Length of Treatment: 30 days to 6 months
  • Cost: $2,500 to $6,000/month

Outpatient Drug And Alcohol Rehab

Increasing levels of independence and the ability to maintain work and family obligations are the hallmarks of outpatient addiction treatment.

  • Length of Treatment: 3 to 12 months
  • Cost: $2,000 to $4,000/month

Aftercare Services

Alumni programs and aftercare services allow those who have completed addiction treatment to access support services when needed.

  • Length of Treatment: 30 days to indefinitely
  • Cost: free to $150/visit

Sober Living

Sober living homes are drug- and alcohol-free communal residences where recovering individuals live with others who are working on their recovery. Addiction treatment is not typically included.

  • Length of Stay: as long as the patient needs
  • Cost: $500 to $1,500/month

How To Get Health Insurance

Those who don’t receive health insurance through an employer can purchase a private health insurance policy through the Health Insurance Marketplace. New enrollment is limited to November 1 through January 31 of each year, unless qualifying life events apply. Compare available plans and learn more at HealthCare.gov.

Finding Addiction Treatment

No one should have to go without professional drug rehab due to an inability to pay. Using a combination of insurance, scholarships and crowdfunding, even those in the most dire financial circumstances can find a way to get into a treatment program.

The money and time invested in an effective addiction treatment program is never a waste; it’s an investment in the future and the well-being of each patient.

Department of Health and Human Services - https://www.cms.gov/

Substance Abuse and Mental Health Services Administration - https://www.samhsa.gov/sites/default/files/sabg_fact_sheet_rev.pdf

Substance Abuse and Mental Health Services Administration - https://beta.sam.gov/fal/5d3d252425041bec677882473e15b7a0/view?index=cfda&sort=-relevance&page=1&keywords=substance%20use&date_filter_index=0&date_rad_selection=date

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