Addiction Recovery - Treatment Professional

Cost of Rehab: How Insurance Can Help You Pay for Drug Rehab

The cost of rehab: There's ways to make drug rehab more affordable, including insurance. Learn more about the cost of rehab in our blog.

Cost of Rehab: How Much Does Rehab Cost & How Do You Pay For It?

Table of Contents

Written by

Brian MooreBrian Moore

Content Writer

Reviewed by

Jeremy ArztJeremy Arzt

Chief Clinical Officer

October 31, 2023

The Edge Treatment Center

It's a question everybody asks before a big purchase:

How much is this going to cost me?

It's normal to have concerns before you sign a check, even if it's an investment in yourself or a loved one. Paying for drug rehab is no exception. It can be a daunting task, but there are resources available to help make it more manageable.

Drug Abuse by the Numbers:

As reported by the National Center for Drug Abuse Statistics, 9.49 million Americans aged 12 and older misuse opioids at least once over 12 months.

Understanding the Cost of Rehab

Drug rehab can range from a few thousand dollars for outpatient treatment to hundreds of thousands of dollars for luxury inpatient facilities. The total cost will depend on several factors including:

  • Type of treatment program (inpatient, outpatient, etc.)

  • Length of stay

  • Location

  • Amenities and services provided

  • The level of medical care needed

It's important to understand that rehab is an investment in your health and well-being. It may seem like a large expense upfront, but the long-term benefits of sobriety far outweigh the cost. Additionally, there are ways to make rehab more affordable through insurance coverage.

Costs Involved in Enrolling in a Drug Rehab

Several factors can influence the cost of rehab for a person. Although determining the exact cost of drug rehab in a city or county may be difficult, you should get more familiar with the factors that typically influence the costs. 

To get a better estimate of the cost of drug rehab, you must remember the following:

  • Several local rehab centers may offer pricing quotes for similar treatment programs or facilities.

  • Regional patterns in healthcare prices frequently impact the price; for example, some parts of the state can have more expensive treatment options.

  • Any health insurance plan's coverage level may vary and impact the patient's out-of-pocket expenses. 

  • Some health plans may only cover one try at recovery year or offer very little or no coverage.

  • It is also challenging to estimate the general cost of drug rehab because it differs from program to program. 

Insurance Coverage for Drug Rehab

Many people are surprised to learn that their insurance may cover some or all of the cost of drug rehab. Under the Affordable Care Act, all health insurance plans must provide coverage for mental health and substance abuse treatment. This means that if you have health insurance, you likely have some level of coverage for drug rehab. However, the amount of coverage will vary depending on your specific plan and insurance provider.

Types of Insurance Coverage for Rehab

  • HMO Plans: These plans typically have more restrictions and may require you to get referrals from a primary care physician before seeking treatment at a rehab facility. However, they may also offer lower out-of-pocket costs.

  • PPO Plans: PPO plans allow you to visit any healthcare provider within your network without a referral. They often have higher premiums and deductibles, but offer more flexibility in choosing a rehab facility.

  • EPO Plans: These plans are a mix of HMO and PPO plans, offering some flexibility in choosing providers while still having lower out-of-pocket costs.

  • POS Plans: Similar to an HMO plan, you may need a referral from your primary care physician for drug rehab treatment. However, they also offer options to see providers outside of the network at a higher cost.

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Costs Involved in Enrolling In a Drug Rehab

Several factors can influence the cost of rehab for a person. And although determining the exact cost of drug rehab in a city or county may be difficult, you should get more familiar with the factors that typically influence the costs. 

To get a better estimate of the cost of drug rehab, you must remember the following:

  • Several local rehab centers may offer pricing quotes for similar treatment programs or facilities.

  • Regional patterns in healthcare prices frequently impact the price; for example, some parts of the state can have more expensive treatment options.

  • Any health insurance plan's coverage level may vary and impact the patient's out-of-pocket expenses. 

  • Some health plans may only cover one try at recovery year or offer very little or no coverage.

  • It is also challenging to estimate the general cost of drug rehab because it differs from program to program. 

Should Choose Inpatient or Outpatient Rehab?

The first thing to do when assessing the cost of enrolling in a drug rehab center is to understand your addiction's severity and requirements. The USA has more than enough options for people with all kinds of needs. These programs vary in intensity, structure, duration, and location.

There are different drug rehabilitation programs, each with its advantages and disadvantages. The most common types of drug rehab programs are inpatient and outpatient.

No matter what type of program you choose, remember that just because a program is expensive does not mean that it would be suitable for you. Most costly programs are not the best by default- but neither are the cheapest. So make sure you choose a rehab that perfectly balances costs and quality. 

Programs designed to provide recovery, and pave the way for a lifetime of sobriety, are usually designed as either inpatient or outpatient treatment options. All substance abuse treatment programs in the country are likely to use this basic categorization, but each option can have minor variations.

For instance, many states, like California, might offer drug rehab programs further divided into inpatient residential rehab and hospital inpatient rehab. Similarly, outpatient drug rehab might be grouped into outpatient rehab with partial hospitalization and conventional outpatient rehab.

Differences Between Drug Rehabs

Nevertheless, the dynamics of inpatient and outpatient settings remain the same, apart from some differences, such as:

Residential (Inpatient) Drug Rehab

A residential inpatient rehab setting means asking the person to stay at a facility designed like a home away from home with maximum clinical care and supervision.

Hospital Rehab

Hospital inpatient rehab has a 24/7 medically supervised environment connected to a hospital for any clinical treatment. It provides fewer lifestyle amenities than a residential program and might last for a shorter duration.

Outpatient Drug Rehab

Outpatient drug rehab programs with partial hospitalization ask the person to start the treatment, usually detox, in a clinical facility where serious withdrawal symptoms can be better managed, followed by a decreasing level of supervision, gradually giving way to a conventional outpatient treatment setting.

Conventional outpatient treatment refers to the person coming into the facility for a few days each week, where each visit lasts for a few hours without the need to stay at the facility.

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Differences Between Different Forms of Drug Rehab

Besides these fundamentals of the treatment setting, there are some more significant differences, such as:

Inpatient Rehab

  • Compulsory stay at the facility

  • Medical supervision 24/7

  • Doctors or physicians are available on call 

  • Holistic aftercare approach 

  • Greater emphasis on building skills to prevent a relapse

Outpatient Rehab

  • Weekly visits to the treatment clinic 

  • Fixed hours of rehab each week

  • Freedom to continue living at home

  • Continuation of rehab with little or no supervision

  • Encouraging involvement in social activities to stay sober

Cost of Rehab: What Rehab Is Right for Me?

After thoroughly evaluating both types of rehab, it is safe to say that outpatient rehabs are more affordable. These programs allow the patients to continue with their jobs and other responsibilities, meaning they would not have to abandon their income source to enroll in an outpatient rehab program.

Inpatient rehabs, on the other hand, take care of every aspect of a person's day-to-day life, from food and lodging to medication and therapy. Their all-inclusive nature makes them both- appropriate yet costly options. 

It is also important to acknowledge that, for some people, traveling to and from outpatient rehab can be equally, if not more, expensive than staying at an inpatient drug rehab. If the facility is far from your house, it can also demotivate you to travel a great distance daily. Additionally, some medications prescribed during treatment can interfere with your ability to drive. 

Family at home also plays a significant role when deciding the cost of rehab. If a person's family is not sympathetic to their recovery journey, it is generally advisable for them to stay at an inpatient rehab. The unaccommodating and unsupportive environment at home can easily disturb a person's recovery prospects. 

Therefore, the cost of outpatient or inpatient rehab is a matter of circumstances. Some people may be able to afford even the most expensive drug rehabs in the country, but that does not mean it would be the right step for them. Instead, they may benefit more from an outpatient setting while simultaneously working on their addiction and social skills. 

How Can Insurance Help in Covering Drug Rehab?

Most Americans have health insurance, but not all policies are created equal. There is private insurance, and then there is government-provided health insurance. Because every insurance policy is different, it can be challenging to evaluate whether treatment for drug rehab is covered. Each policy will give a different level of coverage, whether owned by a private insurance company or the government.

Addiction treatment must be covered by any private insurance offered in the exchange marketplace due to the 2010 Affordable Care Act (ACA). To find out for sure whether your insurance policy will cover addiction rehabilitation or not, contact your insurance company. Most official websites of drug rehab centers also feature an insurance verification tool where one can check if their plan is valid in their facility or not.

The following insurance-related elements should also be discussed with your insurance provider to calculate the insurance coverage for drug rehab:

  • Deductibles

  • Copayments

  • Coinsurance

  • Out-of-pocket expense

  • The effective date of the policy

Private insurance for drug rehab is typically the most costly choice, but it also offers the widest range of options, allowing you to choose the treatment that most closely matches your needs. Most rehabs are also very open to taking such insurance coverages. Private insurance will also give you the most possibilities if you seek insurance options for drug or alcohol rehab. People who cannot afford private insurance can look for public insurance policies to enroll in affordable drug rehab. 

The US Department of Veterans Affairs (VA) can assist you in locating VA services nearby if the person in need of care is a veteran or is covered by health benefits for veterans. 

Nonprofit and State-Funded Drug Rehabs

Some patients are eligible for low-income rehabilitation, which nonprofit groups typically provide. Rehab for people with low incomes is free or significantly discounted. People can access these services to receive the assistance they need, irrespective of their financial situation.

These clinics may be granted funding from the federal government, states, or reimbursements from public health initiatives like Medicaid, among other sources. However, since many candidates are vying for a limited number of program slots, eligibility requirements for state-funded substance abuse programs are generally strict. And these criteria might be different for drug rehab in different states.

For example, in some cities, the authorities might be lenient and ask only for proof of income and inquire about your health insurance coverage. In others, you can be asked for information and documentation on your citizenship, residency in the state where you seek treatment, income source, and health insurance (or lack thereof). 

Options for People with Low Incomes or No Insurance 

Some people may not be able to afford drug rehab because of their low or no income status or because they do not have health insurance. But this does not mean that such individuals do not deserve to have a chance of recovering. Here are a few things you can try if you cannot afford rehab on your own:

Check to see if you qualify for Medicaid, which offers health insurance to those without other resources. For example, Medicaid will typically pay for some addiction therapy.

Talk to the Human Resources Department at your place of employment. They may have policies to help their employees recover from substance use disorders. They can also offer to hold your position while you are in rehab, which is a huge deal in and of itself. 

You can also get in touch with your local health treatment centers. They can help you contact state agencies that provide substance abuse services to people in low-income groups 

Talk to the administrators of the drug rehab you have selected. Often, some reputed rehab centers have reservations for people who cannot pay. Additionally, they may also try to set up some payment plans for you to be able to pay the rehab fees in installments. 

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Other Ways to Pay for Rehab

If you do not have health insurance or your policy does not cover the full cost of rehab, there are other options available. These include:

  • Private financing: Some treatment facilities offer payment plans or financing options to help make the cost more manageable.

  • Grants and scholarships: Some organizations and foundations offer grants or scholarships for individuals seeking drug rehab treatment. You can search for these opportunities online or contact your chosen rehab facility to inquire about any available options.

  • Crowdfunding: With the rise of crowdfunding platforms, many people have successfully raised funds for their rehab treatment through donations from friends and family.

  • Sliding scale fees: Some facilities may offer reduced rates based on your income or ability to pay.

The Edge Treatment Center Will Help You Find Every Resource for the Cost of Rehab

At The Edge Treatment Center, we understand the financial concerns that may come with seeking drug rehab treatment. Our team of experts will work with you to explore all available options and help make the cost of rehab more manageable. We believe that everyone deserves access to quality addiction treatment, regardless of their financial situation.

Contact us today to learn more about our programs and how we can help you on your journey to recovery. Together, we can overcome any barriers and find a way for you to get the treatment you need and deserve. Let's start your journey towards a healthier, happier life today.

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