Insurance Coverage for Drug and Alcohol Rehab

While over 40 million people in the United States reported struggling with a substance use disorder in 2020, many will not receive treatment for the disorder.¹ The reasons for this are many, but a major one may be a fear of or inability to pay the cost of treatment. Luckily, due to sweeping healthcare reform implemented in the past few decades, many may be able to use this public or private insurance plans to cover some or all of the cost of addiction treatment. While coverage may vary, understanding what your insurance covers, how to use your insurance at rehab centers, and where to find rehab centers that accept your insurance can help you get started in achieving recovery.

Does Health Insurance Cover Rehab?

Under the Affordable Care Act (ACA), signed into law in 2010, almost all health plans are required to provide coverage in some capacity for 10 essential health benefits, one of which is treatment for behavioral and mental health services.^{3, 4} This law means that almost all health plans, including public and private insurance plans, must provide some level of coverage for the treatment of substance use disorders, provided those services are deemed medically necessary. In addition to this, the Mental Health Parity and Addiction Equity Act (MHPEAEA) ensures that plans cannot be more restrictive in covering mental health and substance use disorder services than they are for medical and surgical services.⁵

While these legal protection do a great deal to help people in need access vital addiction treatment services, this doesn’t mean that insurance will cover all the costs of treatment. There are various factors that may result in an insurance plan only offering partial coverage, or perhaps no coverage at all. Where you attend treatment, whether a rehab is in-network or out-of-network with your insurance plan, how intense the treatment is, how long the treatment lasts, and what accommodations and amenities are provided are all factors that can result in your coverage varying. It’s important to reach out to your insurance provider to check your coverage before committing to treatment.

Types of Addiction Treatment Covered by Insurance

The types of addiction treatment that your health insurance plan may cover will vary. However, some common addiction treatment types may include:

• Detox: Many treatment programs involve a patient completing medical detox (also referred to as medically managed withdrawal), which is the medically supervised process of ridding the body of substances.⁶
• Inpatient rehab: In an inpatient rehab program, a patient will stay at a facility round-the-clock for a predetermined amount of time to receive 24/7 medical supervision and care.⁷ This type of program can last for days, weeks, or months.⁷
• Outpatient rehab: At an outpatient rehab program, patients attend various treatment sessions like drug education or group counseling, but they don’t stay overnight at the facility.⁶
• Aftercare: An aftercare program is known as any type of follow-up or continuing care that is rendered after a patient completes their initial rehabilitation.⁷

How to Check Your Rehab Insurance Coverage

There are various ways that you can check your rehab insurance coverage. First, you can call the number on the back of your insurance card to speak with your insurance company’s customer service member. You can also access your coverage details by signing on to your insurance company’s website or member portal. Finally, you can usually call the rehab center directly and have them check your benefits and coverage for you.

 How to Use Your Insurance Benefits For Rehab

The exact steps you need to follow to use your insurance benefits for rehab will depend on your plan, so it’s important to check with your insurance provider before seeking care whenever possible. Usually, you’ll start by finding a facility that accepts your insurance plan. Then, you can verify coverage with both the rehab center and the insurance carrier. The facility itself and your insurer can help you determine whether you need to gather any necessary documentation, including pre-authorization or referrals. You’ll want to save any communications or receipts to help facilitate a smooth claims process.

Using Private Insurance for Rehab

Private health insurance is a type of insurance plan provided by a private corporation.⁸ A private health plan could be offered by a non-government employer or purchased directly from an insurer, depending on your circumstance.⁸ There could be various types of plans to choose from, including a high deductible health plan, preferred provider organization, health maintenance organization, exclusive provider organizations, or point-of-sale plans.⁹

Depending on your plan, you may be limited to where you receive care (e.g., plan network) if you want to obtain coverage for eligible services. Most private insurance plans are subject to the ACA’s EHB mandate for mental and substance abuse services, including rehab, which means you can likely use your private insurance to cover some of the cost of medically-necessary substance use disorder treatment.

Using Public Insurance for Rehab

Using public health insurance programs like Medicare or Medicaid, eligible individuals can help pay for rehab programs.⁸ These government-sponsored programs can offer low-cost or free health insurance benefits to eligible individuals or families (e.g., elderly individuals, those with disabilities, low-income individuals, etc.).⁸ Eligibility requirements may vary, and not every cost may be covered. Enrollees may be subject to networks and cost-sharing requirements, similar to private insurance plan coverage.⁸

How Much Does Rehab Cost With Insurance?

The cost for rehab can vary greatly. Factors such as the type and length of care needed, the treatment setting and provider, the amenities provided, and the insurance coverage you have will affect the overall cost of your rehab treatment. You may be able to ask your rehab facility for an estimated quote of services to get an idea of what the cost of getting treatment may entail for you under your plan details.

How to Go to Rehab Without Insurance

Those without insurance don’t need to delay or forgo care. There are many low-cost or free rehabs available through some public medical insurance programs. These programs can help take off some of the high costs often associated with attending rehab for those who don’t have private insurance options.

Finding a Rehab Center That Accepts Medical Insurance

If you’re ready to take the next step toward recovery, you’re likely wondering how to find a rehab center that accepts either private or public medical insurance. You can start the process by visiting your primary care doctor, using SAMHSA’s treatment locator tool, or calling the number on the back of your insurance card.

Once you find a treatment center, you’ll want to double-check that it is a covered facility under your insurance plan before committing to treatment. Doing so can help you avoid surprise medical bills after receiving care.

Finding a covered facility can be overwhelming, but it doesn’t have to be. Call the American Addiction Centers (AAC) addiction helpline at or you can text us for help determining the extent of your insurance coverage today.