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Does Health Insurance Cover Drug Rehab?


One factor many families and individuals worry about when seeking treatment for addiction is how much it will cost. Financial concerns should never stop you from seeking help with drug or alcohol addiction. Admissions counselors and other professionals are trained to offer a variety of options and help you find ways to cover the cost of treatment, and many programs work with individuals to create payment plans. Plus, the Affordable Care Act mandated that insurance providers that sell plans through the various marketplaces provide benefits for behavioral health — including benefits for chemical dependency issues.

Is Rehab Covered by Insurance?

Whether or not your rehab services will be covered by insurance depends on a few factors. First, you obviously have to have a health insurance policy like Beacon Health Options in force at the time you seek treatment. If your insurance policy has lapsed because premiums weren’t paid or you’ve changed employers, then a treatment provider can’t successfully bill claims to it.

Second, you must have a policy that includes benefits for chemical dependency treatment. Medicare, Medicaid and most private insurers do include these benefits.


Finally, your providers must diagnose you with a substance abuse disorder that is relevant to those benefits and bill for services following claims billing requirements.

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cigna
valueoptions
aetna
amerihealth
ghihip
unitedhealth
magellan
oxford
ins_0011_Geha
qualcare
ins_0000_Coventry
1sthealth
ins_0013_ComPsych
ins_0017_Health-Choice
ins_0012_Humana
upmc

Most Major Insurance Accepted

Many insurance plans provide coverage for drug rehab and alcohol treatment at a licensed addiction treatment center. Transitions Recovery addiction treatment center accepts most major insurance plans. All or part of the costs of drug rehab, alcohol treatment, and dual diagnosis related services may be covered by your insurance.

We work closely with your insurance providers to provide high-quality services. We can check your insurance benefits to help you determine coverage, assist in pre-certification, perform utilization reviews, and bill the insurance company. Please call our treatment center at (800) 626-1980 if you would like to have one of our insurance specialists check your benefits and eligibility for our drug rehab or alcohol treatment programs.

If you do not have insurance or if your insurance does not cover addiction treatment, we offer other viable options. Learn more about the costs and payment for addiction treatment. Give us a call today at 800-298-1783 to talk with a friendly representative at our treatment center. Transitions is contracted with Cigna, Aetna, Value Options, Humana, Mental Health Network and many others. We also accept most private PPO policies.

cigna
valueoptions
aetna
amerihealth
ghihip
unitedhealth
magellan
oxford
ins_0011_Geha
qualcare
ins_0000_Coventry
1sthealth
ins_0013_ComPsych
ins_0017_Health-Choice
ins_0012_Humana
upmc

How Much Does Rehab Cost With Insurance?

The total cost of rehab and the amount you have to pay out-of-pocket is often very different. The total amount  you must pay depends on factors that include:

  • Your deductible. This is the portion of your healthcare expenses that you must pay out-of-pocket each year before your insurance company will pay for services.

  • Your co-insurance. This is the portion of your healthcare expenses you may continue to pay even after meeting  your deductible.

  • Your maximum out-of-pocket. This is the amount your insurance sets as the cap for the total expenses you’ll pay each year.

  • The cost of the rehab. The amount your provider charges for its services impacts how much you may have to pay.

  • The insurance write-off. Insurance companies rarely consider the total amount for a bill. They typically set aside a percentage, often as much as 20 to 30 percent, as an unallowed or UCR portion, which the provider writes off. (For this reason, patients who are paying cash without the involvement of an insurance company can often negotiate a sizeable discount on the total bill.)

Depending on all these factors, the total out-of-pocket costs for inpatient rehab with insurance could range from $0 to $12,000 or more. The higher dollar amount would indicate that a deductible and out-of-pocket max was not yet met that year.

Don’t Let Money Keep You From Seeking Help With Addiction

There are many ways to approach a bill from inpatient rehab, so don’t let today’s financial concerns stop you from seeking treatment for addiction. When you speak to professionals about rehab options, be honest about your money situation. They may be able to help. Admissions counselors can advise you about financial programs and Medicaid options, and facilities will often work with you on paying your bill after you’re done with treatment, even if you need to make payment arrangements.


If you’re struggling with addiction and want to find out more about your options, contact us today.