Does Insurance Cover Addiction Rehab?

Taking the big step and going for rehabilitation to overcome an alcohol or drug addiction can be difficult. If you managed to take this step, you should be happy with yourself. When you choose a reputable facility that offers an effective treatment plan that meets your needs, you will find out that your recovery will be smooth and fast-paced. But what if you found the right facility but can’t afford the charges. Can insurance cover these expenses?

The answer to that question is yes, but it all depends on your health insurance coverage and the firm you choose for this. Since the introduction of the affordable care act in the year 2010, many insurance providers were compelled to offer healthcare policy that covers substance and drug abuse treatment. However, the amount this policy covers varies based on the provider.

For this reason, it is wise to check the rehab coverage of any provider you have in mind before working with them. This will save you a lot of money and time. To help you understand how insurance covers rehabilitation, this article will discuss some important terminologies in the health policy, how to use your insurance coverage, and what to do if you find out you don’t have coverage. 

What does the Insurance Policy Cover?

This policy can be comprehensive or severely limited. It could cover all your healthcare expenses or might only pay for a form of rehab services. Sometimes, the insurance provider will limit the centers that they cover. They might only extend the policy coverage to facilities that are under their network. So, when you go to a treatment facility that is not under them, they might decline it.

Payment for treatment could also be limited based on the type of rehab and the length of the treatment. If you would like to know more about how the type and duration of treatment can affect the cost, you can read this article.

Some Important Terminologies in Addiction Rehab Insurance Policy

To understand how insurance providers work when it comes to addiction rehab, there are some specific terminologies to understand. They help to describe the requirements for alcohol or drug insurance coverage. Here are some of them:


The premium is the payment madeto have access to this health insurance coverage i.e. the rehabilitation. It can also be considered as the subscription fee. This money can be paid every month, twice a year, or once a year. This depends on your provider’s plan and what works best for you.


A deductible is money that you will have to pay towards your healthcare costs every year before your health insurance provider helps out. So, if a person needs to go to drug rehab, he or she would have to pay this deductible before the service provider starts paying to cover the remaining expenses. As a result, it is said that the lower the deductible you pay, the higher the premium, and vice versa.

Out-of-Pocket Expenses

Aside from the deductible, there are several out-of-the-pocket expenses that are involved in drug rehabilitation costs. For instance, there might be a provision for a copay to balance the payment for residential rehab stays, medications, and therapy sessions. There might also be a co-insurance policy that is similar to the copay. When the coinsurance and copay payments are low, the premium is always higher. 

Most insurance providers will offer an out-of-pocket plan limit to the patient, once that amount is reached, the provider will pay the remaining balance. If you would like to understand how out-of-pocket works, check here:

How to Use Your Addiction Rehab Insurance Policy

There are several steps you should take before you can use this coverage. These include the following:

Contactthe Healthcare Insurance Company

You shouldn’t assume that your provider will automatically offer you indemnity to any rehabilitation center you choose. You need to confirm whether it has any specific facilities that are registered under its network. If there are any, ask the provider whether there are any forms to fill or steps to take in order to get enrolled into a rehab program.

FindOut the Type of Programs it Covers

There are different types of treatment programs that a rehab facility could offer. It could be an inpatient or an outpatient program. Outpatient treatment involves visiting the clinic for therapy, counseling, and other forms of care. It is generally much more affordable than the inpatient one. Many healthcare insurance policies can cover the outpatient program. Make sure you confirm if your provider’s policy covers both types of programs.

Find Out the Type of Care or Treatment that is Included

Not all providers will cover all forms of rehab treatment. Some focus on detoxification, others might cover therapy and medication expenses. Ensure that you ask the company about the limits of its policy coverage. Are certain treatments restricted or would it cover all expenses? You need to know this information.

Ask Whether Location Matters

If your provider doesn’t have specific recovery facilities under its network, then you might be free to choose any facility of your choice. But, would the company accept any center even if it is in a particular state? You need to confirm this with the insurance company. If you need to confirm this, you can check out Regence Blue Shield of Washington State drug rehab insurance coverage review for help.

What if You Don’t Have Addiction Rehab Insurance Policy

If you don’t have this coverage, there are other options to consider:

Talk to Your Boss

Depending on where you work, your employer might be able to offer health insurance coverage to you. Some businesses willingly give their staff extended leave, so they wouldn’t lose their job after the treatment. It can be devastating to lose one’s job after paying for a rehab program. Reach out to your employment HR to see if there is any aid or assistance your employer offers to its employees.

Talk to the Recovery Center

Many centers offer flexible payment plans that allow patients to pay based on their financial capabilities. Patients can pay monthly or bi-monthly. This will allow you to start rehab as soon as possible without the fear of money holding you back.


Insurance can cover your substance recovery expenses, but it all depends on the provider you choose for your healthcare plan. Before you use this policy, remember to keep the pointers mentioned in this article in mind so that the entire process will go on smoothly.


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