Affording Addiction Treatment

There are many barriers that you may encounter when seeking help for addiction, but the cost of treatment is one barrier that can make recovery seem almost impossible.

However, this doesn’t have to be the case, and there are many options available to help deal with the potential costs of rehabilitation.

Because of the Affordable Care Act (ACA) recognizing that addiction is a chronic illness that requires specialized treatment, private insurance will include coverage for at least some form of addiction treatment.  

Even without insurance, there are different avenues of financial aid and support that can make treatment possible. Affording addiction treatment should never be out of reach and it does not have to be if you know where to look for help.

Cost of Treatment: Breaking It Down

Before attempting to defray the cost of addiction treatment, it is important to understand how different treatments can affect costs. Many people are unaware of how price correlates to treatment, so having a breakdown can be useful.

It’s also important to know that when you attempt to get an estimate on the cost of addiction treatment, it is usually going to be very general, as each person’s needs are going to be a bit different.

To get a more accurate picture of what the cost of your treatment will be, you need to have an idea of what your needs might be:

• Acute treatment
• Inpatient or outpatient treatment
• Medication-Assisted Treatment (MAT)
• Length of your treatment
• Residential treatment
• If you will be treated at a hospital
• If you will be treated at a government-funded facility
• If you will be treated at a private facility
• Post-treatment recovery services

Depending on the needs of a given individual, there can be fairly significant differences in the cost. Someone who requires residential treatment with MAT is going to be facing higher cost than someone with a less severe circumstances who needs only minimal support from an outpatient clinic.

Treatment facility and duration length are two of the biggest factors in play when determining costs, but they are significant when it comes to recovery.

A private addiction recovery facility is going to be more expensive and potentially less likely to be fully covered by someone’s insurance policy. However, it will be able to provide a broader range of specialized treatment options, a higher level of individualized care, and more comfortable amenities.

Similarly, not all plans will provide coverage for someone’s entire length of stay, and the amount of time covered will vary from one insurance to another. However, according to the National Institute on Drug Abuse (NIDA), effective addiction treatment length has been proven by research to be at least 90 days. If the duration is less than that, and there is a strong chance of relapse, this likely would result in more time spent in treatment.

What Does My Insurance Cover?

The specifics on what your insurance covers when it comes to addiction treatment will vary based on your insurance policy. Typically, however, you will most likely be eligible for coverage for the following services:

• Medical detoxification
• Inpatient, outpatient or residential (in-network care)
• Dual diagnosis treatment for co-occurring disorders
• Post-treatment counseling and services

However, coverage eligibility is much less likely if:

• The facility is out-of-network
• The facility is located out-of-state
• Services are mainly holistic or nontraditional
• Facility uses medications not generally covered

If you are unsure what is covered under your insurance plan, we recommended that you speak with your insurance provider to find out, and get answers to questions like:

• Do I need a referral from my primary care physician?
• Am I required to have any copayments ready?
• Will expenses apply to my deductible?

Affording Treatment Without Insurance

If you do not have private insurance or a public plan through the ACA, there are options available to you that can cut the cost of addiction treatment. If you are a veteran, in most cases the complete cost is covered by the completely covered by the U.S. Department of Veterans Affairs.

Medicaid and Medicare are also possible options. Medicare is a federal program that provides coverage to those who either have a major disability, are 65 years of age or older or both, no matter their income. So those with Medicare are typically covered for the full continuum of addiction recovery services.

Medicaid is a federal and state program that can provide coverage to those of low income, but both addiction treatment coverage and eligibility are going to differ from state to state. You also may be eligible for certain government-funded scholarships or grants that can be used to cover the costs.

In many cases, treatment centers will work with you to create a custom payment plan, as well as offer a sliding scale of costs depending on your income level and what you can afford.

This can be helpful even if you do have insurance but need help bridging the gap between what your policy will cover and what you must pay out of pocket.

There are the options of taking out a loan to finance treatment as well as asking for financial help from family and friends. While the latter can be hard on someone’s pride, getting help is more important, and chances are, the people you care about will both want you to see you recover and live a better life and be willing to help make that a reality