I. The Basics of Paying for Rehab

Rehab services for addiction are expensive. This isn’t surprising when you consider the intensive medical and therapeutic attention people need during their first difficult days of sobriety. Addiction medicine specialists are generally medical doctors, while M.D. and Ph.D. psychiatrists and psychologists often invest hours each day in patient care at most facilities. Also, the costs of room and board, emergency care, medication, and many other miscellaneous expenses add to the bill a rehab center must charge its residents.

Not all treatment plans are alike, however. Outpatient rehab is significantly cheaper than a live-in residential treatment plan. Attending a day program for 90 days may cost just $5,000 to $10,000, though this isn’t an appropriate choice for every person struggling to get sober. Before you can know for sure what your costs are, it’s helpful to evaluate your specific needs and look for the most affordable options you think can cover them. As a rule, the earlier you start planning to go into rehab, the more affordable it should be.

II. Step 1: Assess Your Needs

The first step in paying for rehab is to assess your needs. Different substance addictions call for different treatment approaches. Some detox, for example, can be done at home with little supervision, while coming off of some other substances can be medically dangerous. In the former case, you might be able to stop using at home and attend a day program, while detoxing from some of the more physically dependent substances can only safely be done under direct medical supervision in a well-equipped facility. It’s a good idea to talk with a doctor about detox and early sobriety options for your particular use history.

Social needs also have to be addressed before you decide on a treatment plan. If you can keep sober in your home environment, it may be possible to opt for a less expensive outpatient program that you attend every day for a month rather than paying for an inpatient program that isolates you from the outside world. If, on the other hand, you feel you’re likely to use on the outside, inpatient care may be the only appropriate or helpful option. In that case, the extra cost is worth paying for lasting sobriety.

III. Step 2: Review Treatment Options

Nearly 14,000 facilities offer substance abuse treatment in the United States. While they all have some things in common, they also have their differences, and those can be important to both your odds of success and the final cost of treatment. Some programs follow a 12-step model, for instance, which leans heavily on peer counseling and community sponsorship for addicts in recovery. These support groups operate at no cost, and people getting treatment this way are not expected to pay for group sessions.

Other approaches, such as moderated intake and clinical maintenance options, like methadone support, cost money on a continuing basis. It would be wrong to choose an approach based solely on the price rather than on how well it works for treating your addiction, but the cost varies between methods, and this has to be factored in.

IV. Step 3: Look Into Payment Methods

Whatever approach you eventually settle on, the subject of payment is inevitable. Fortunately, you may have a lot of options for covering the costs of rehab, since even most insurance companies recognize that treating addiction disorders is less expensive than a lifetime of emergency care. Options most people have to pay for rehab include:

Medicare

Medicare is the federal health insurance program for seniors and adults with certain disabilities. There’s no specific payment plan option for substance abuse treatment under Medicare, though the services are often paid for as part of normal Medicare coverage. Inpatient care, for example, generally falls under Medicare Part A coverage, while outpatient services are covered under Part B. Medicare Part D (or a Medicare Advantage plan with prescription coverage) can often pay for medications, though some drugs also fall under Part B. It’s best to discuss your plans to get help with a Medicare caseworker who may be able to help you find payment resources within the program.

Medicaid

Medicaid is the low-income health insurance program jointly administered by federal and state governments. Under the 2010 Affordable Care Act, also known as Obamacare, Medicaid must cover all of the basic costs of substance abuse rehab for insured individuals. This includes inpatient care and various medical expenses associated with sober living. Not all providers take Medicaid, however, so your access to treatment may be limited by availability in your area.

Private Insurance Coverage

Since 2010, private insurance companies in the United States have been required to offer coverage options for substance abuse rehab treatment. While coverage amounts and premiums vary, most insurance providers either publish information about their plans for new enrollees or have customer service workers who can explain coverage limits over the phone. Common items covered under private insurance plans include:

  • Preliminary screenings
  • Intervention services
  • Prescription maintenance medications, such as methadone
  • Family and group counseling sessions
  • Inpatient treatment
  • Long-term residential treatment in a skilled nursing or post-acute setting
  • Medically supervised detox
  • Outpatient medical appointments, both before and after inpatient care
  • Miscellaneous mental health services

Employer Assistance Programs

Many employers offer eligible employees various kinds of assistance with drug and alcohol dependency programs. Group insurance plans provided by employers often cover these programs, though they are sometimes managed as separate standalone programs by the business. High-risk, high-stress professions, such as police, fire, and emergency medicine, commonly have preferred provider networks and a designated supervisory employee who can make the necessary arrangements for employees who need help. Some employee assistance programs are anonymous, while others are not. Each assistance plan varies in its details, and it’s helpful to speak with an HR manager who can guarantee confidentiality for you.

V. Additional Resources and How to Get Help

  • Medicare accepts applications for eligible seniors, and it provides multiple payment options for the various services it covers. You can find a plan online, sign up for coverage, or switch between plans during the annual open enrollment period.
  • The federal Medicaid program offers low- and no-cost health insurance for seniors, pregnant women, disabled adults, and people with limited income. Eligible citizens can sign up for Medicaid online, through the national website, or their state’s healthcare exchange. Local and county departments of social services can also typically handle Medicaid applications, where applicants can ask an intake worker about coverage limits.
  • American Addiction Centers offer online and phone referrals for people looking for inpatient rehab care for their substance abuse issues. In addition to the service’s toll-free helpline, (800) 774-5796, the nonprofit also operates the Free Rehab Centers website, which lists over 1,000 centers that offer no-cost treatment services for people struggling with addiction.
  • The Substance Abuse and Mental Health Services Administration operates a free, confidential 24-hour helpline that can be reached at (800) 662-HELP (4357). The administration doesn’t provide therapy or other direct services, though it does offer a free referral service to licensed inpatient treatment centers.