Does Health Insurance Cover Addiction Treatment?
Health insurance in the United States does cover some of the costs of treatment for substance use disorder (drug and alcohol addiction). Under the Affordable Care Act (ACA)—a law passed in 2020 to make health insurance more accessible and affordable—treatment for substance use disorder must be at least partially covered under all health insurance policies.1,2
The ACA lists substance use disorder as one of the 10 elements of essential health benefits that insurance companies must provide. This means that coverage must be provided for the treatment of addiction and mental health disorders.1,2 Rehab and other addiction treatments fall under this mandate.
If you have health insurance, this means your policy will cover at least some of the cost of treatment for addiction. Although health insurance companies are mandated by law to cover some drug and alcohol addiction treatment, that is not a guarantee that everything will be covered. Coverage varies, based on the plan you have and which services and treatments you are receiving.
Does Recovery First Accept My Health Insurance?
Depending on which insurance plan you have, your policy may cover:
- Inpatient rehabilitation.
- Outpatient care.
- Partial hospitalization programs.
- Medical detoxification.
- Medication-assisted treatment.
- Dual diagnosis & co-occurring mental health condition treatments.
- Continuing care (e.g., individual counseling, family counseling, therapy).
- Maintenance medication to support ongoing sobriety.
You can your verify insurance coverage with Recovery First or our other American Addiction Centers facilities by completing our Submitting your information is the first step in verifying your insurance and getting started on the path to recovery.
After you submit your information, staff at Recovery First will verify your insurance for you. All you need to do is enter your name and insurance ID number in the form below. We will be in touch within 1-2 business days to discuss the next steps.
How Much Does Rehab Cost with Insurance?
Each person’s cost of addiction treatment, with or without insurance, will vary based on factors including:
- The severity of substance use disorder.
- What substances the person used.
- Which type of treatment(s).
- How much a person’s insurance covers.
- Whether the rehab facility is in-network or out-of-network with their insurance.
- The duration of time spent in treatment.
For more information on the cost of treatment, call our Admissions Navigators at . They will answer any questions you have and share information about the types of treatment you may be interested in.
Admissions Navigators will also verify your insurance and share the next steps for beginning treatment when you are ready.
Though rehab and addiction treatment services can be expensive, addiction is even more costly. Addiction affects not only the person living with substance use disorder, but their family, friends, community, and society as a whole.
More important than saving money is saving lives.
If you or your loved one are ready to make the step to getting sober and living well, now is the time.
What Parts of Addiction Treatment are Not Covered by Insurance?
In some cases, you may be responsible for paying some costs of treatment, including:
- Deductible: This is a fixed cost that you pay before insurance coverage kicks in to pay for addiction treatment. If you have a $1,000 deductible, this means you’ll pay the first $1,000 in costs and your insurance pays the rest.
- Copayment: Copayments are a fixed amount you pay for healthcare services after your deductible is reached. For example, you may have a copayment of $30 every time you visit the doctor.
- Coinsurance: The percentage of costs you pay for healthcare services after you’ve met your deductible.
Many insurance companies require your primary care physician or another qualified healthcare professional to complete pre-authorization forms before insurance coverage kicks in for addiction treatment.
Your doctor will schedule an appointment to assess your needs and concerns and can complete the required form during the appointment.
If your insurance does not cover all of your addiction treatment costs, there are other forms of assistance to help people pay for those costs not covered, which can provide financing for patients to help cover costs.
You can check your benefits now and get a response within just minutes to your email when you fill out our secure form below.
How to Pay for Drug & Alcohol Rehab without Insurance
If you don’t have health insurance but are ready to access addiction treatment, options are available to help you cover the costs of treatment. Many states offer financial assistance to people who do not have private insurance. Some states have free, state-funded rehab options. Others have state insurance policies or offer scholarships and grants to people who need treatment but don’t have insurance.
SAMHSA maintains a Directory of Single State Agencies (SSA) for Substance Abuse Services. Start here to learn who to contact to find assistance programs available in your state.
Alternatively, you can work with the rehab center you choose to pay for addiction treatment. Options to help cover the costs include:
- Loans and credit options. Many financial institutions provide loans or credit for healthcare-related costs, including substance use disorder treatment. Healthcare loans typically have lower interest rates than other loans and are flexible enough that they may cover all of the costs of addiction treatment. The amount you qualify for in a loan depends on your credit.
- Payment plans. Many treatment facilities offer financing options. This gives you the opportunity to pay back the cost of treatment over time, in small increments that work within your budget.
- Scholarships. Some treatment facilities provide scholarships to people in financial need. These scholarships may cover some or all of the costs of treatment. Some states offer government scholarships and grants to people who need help paying for treatment.
If you don’t have private insurance, you may qualify for government insurance such as Medicaid or Medicare.
Medicaid is the largest healthcare insurance program in the United States and is funded federally and at the state level.3Medicaid provides free or low-cost insurance to low-income applicants. Medicare is a federal insurance program that provides coverage for people who are over the age of 65, live with disabilities (at any age), or live with end-stage renal disease or ALS.3
Qualifying Life Events
Depending on your situation, you may be able to apply for insurance as a result of a qualifying life event. This would allow you to obtain insurance outside of the yearly open enrollment period. A qualifying life event, or a QLE include the following:
- Loss of health coverage
- Changes in household (getting married/divorced, having a baby/adopting, death in the family)
- Changes in residence (moving to a different zip code/country, moving to a shelter/transitional living home, being a seasonal worker and going to or from the place of work, a student moving to or from where they attend school)
- Other qualifying events:
- Changes in income that impacts coverage you qualify for
- Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act Corporation shareholder
- Becoming a U.S. citizen
- Leaving incarceration
- AmeriCorps members starting/ending their service.
To determine if you are experiencing a qualifying life event, call 800-318-2596 or visit Qualifying Life Events to learn how to apply.
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