The 5 things you need to know about paying for addiction treatment

Unfortunately, accessing care for addiction, also known as substance use disorder, isn’t as straightforward as it should be. Many people assume they will have to use their life savings to pay for rehab, but that doesn’t have to be the case.

Here are some key points every person should know about paying for treatment:

 

Use your insurance

If you have employer-based insurance, you have addiction treatment coverage. Under the Affordable Care Act, also known as Obamacare, substance use disorder treatment is one of 10 benefits insurers must provide. Learn more about your benefits under your behavioral health plan by talking with your insurance provider or human resources department.

 

Look beyond your deductible

While you may know how much your deductible is, dive into the details of what it actually means. Look into the type and length of treatment covered and find out if your treatment needs to be deemed a “medical necessity” to be covered.

If you don’t understand something, call your member benefits representative and have them walk you through the fine print.

 

Know the difference between residential and outpatient treatment

Cost of care begins with an estimate of how long you will receive care. The length of treatment is determined by your individual needs and the progress you make along the way.

Residential treatment is similar to a hospital stay — most people stay in it for 30 to 90 days. For outpatient treatment, you will pay per visit as you would at a doctor's office.

 

Check your maximum

Find out your out-of-pocket maximum for the year. This is the amount that must be spent before your benefits cover 100% of essential services. This information will give you a good idea of your worst-case scenario with regard to costs.

 

Start with an assessment

Because everyone has different needs, the best way to find out the cost of care is to find out what level of treatment you will need.

At Phoenix House, for example, the clinical team establishes your or your loved one's path of treatment. After discussing the path with you, a team of admissions experts will provide a pre-certification assessment to your insurance company and explain the level of care to them. They will advocate for you to your insurance provider and work with them to ensure you have access to the treatment you or your loved one needs.

Beyond living a healthy life free from addiction, recovery has a good return on investment. Not only can living a healthier life increase your earning power and save money on future health care costs, it can make you feel like yourself again.

 

Phoenix House is a nonprofit drug and alcohol rehabilitation organization with over 120 programs in 10 states, serving 18,000 adults and teens each year.