Due to the high cost of addiction recovery programs, adequate health insurance is often necessary to be able to afford treatment.
Depending on the details of the insurance plan, people may be able to get some or all of the cost of their drug rehab program covered.
People can acquire insurance through employer-based private insurance providers or by enrolling in a government-run program such as Medicaid, Medicare, or Tricare.
How To Use Health Insurance For Substance Use Treatment
The process of using health insurance for addiction treatment can be stressful, but help is available for people who need assistance navigating the specific details of their plan.
In order to use their insurance for addiction recovery, people should first contact a representative with the insurance company and ask a few key questions.
Questions to ask before enrolling in a drug rehab program include:
- Do I need to obtain prior authorization or precertification from a healthcare provider before I can enter the treatment program?
- What are my deductibles and copays going to cost?
- Are there levels of care that aren’t covered by my insurance plan?
- Is there a limit to how long I can spend in an inpatient rehab program?
- Do I have an HMO (health maintenance organization), PPO (preferred provider organization), or point-of-service plan?
- Will my pre-existing condition affect my health insurance coverage?
Once the insurance provider has been contacted, they will help guide clients through the process of finding an in-network addiction treatment provider that they can afford.
What Types Of Insurance Cover Drug And Alcohol Rehab Programs?
People with full-time jobs typically have the option of paying for insurance coverage through their employer, who may also contribute a certain amount monthly to the cost of the plan.
Government-run insurance plans through Medicaid, Medicare, Tricare, or the Department of Veterans Affairs (VA) are funded through tax dollars and will require little to no money (premiums) from the insured person.
The following are some of the most common insurance programs in the U.S. that may be used to cover addiction treatment programs.
Aetna insurance plans are accepted at many rehab centers throughout the country, and Aetna is one of the leading providers of mental health coverage among private insurers.
Learn more about using Aetna insurance for addiction treatment.
Ambetter insurance plans are designed specifically for the Affordable Care Act’s Health Insurance Marketplace (HIM).
Ambetter provides treatment through three-tiered plans, each covering different health care services. Out-of-pocket costs will vary based on which plan a person has.
Read more about using Ambetter health insurance for a drug rehab program.
Amerigroup is designed to offer insurance coverage to disabled people and families with fewer financial means.
Amerigroup insurance covers addiction recovery programs as part of its many essential health benefits.
Learn about using Amerigroup insurance for drug addiction treatment.
Anthem insurance is a part of the Blue Cross Blue Shield Association. People with a plan through Anthem may be eligible to get between 60 and 90 percent of their treatments covered.
Read about using Anthem insurance for drug and alcohol treatment.
Blue Cross Blue Shield (BCBS)
BCBS is one of the largest providers of health insurance plans in the country. People can receive partial or full coverage of their costs at a rehab center when using BCBS insurance.
Read more about using Blue Cross Blue Shield insurance for addiction recovery.
Cambia Health Solutions
People can use Cambia Health Solutions to pay for addiction recovery services. The amount of coverage will vary based on the location of the treatment facility and the detais of the plan.
Learn about using Cambia Health Solutions insurance for addiction treatment.
Carefirst insurance will pay for a large portion of drug rehab programs after the policyholder has met their deductible.
Carefirst offers both HMO and PPO insurance plans.
Read more about using Carefirst insurance for drug and alcohol rehab programs.
Insurance plans through Centene will cover the cost of prescription medications and any transitional living accommodations needed after the initial treatment program is finished.
Policyholders may need a referral from a medical professional to qualify for coverage under Centene insurance.
Learn more about using Centene insurance for drug and alcohol treatment.
Health insurance through Cigna will cover many healthcare needs, including addiction treatment. The amount of coverage will depend on the individual insurance policy.
Read about using Cigna insurance for addiction recovery services.
COBRA is a transitional insurance program for people who have recently lost their jobs or faced other changes in their employment status.
People can use COBRA for addiction treatment if their employer-based plan also covered drug rehab programs.
Learn about using COBRA insurance for substance use treatment.
ConnectiCare insurance will cover both inpatient and outpatient treatment programs for substance abuse.
ConnectiCare sets coverage limitations for in-network and out-of-network treatment providers.
Read about ConnectiCare insurance for addiction treatment.
Coventry Health Care Insurance
Coventry insurance plans will cover a large portion of addiction recovery services. People may be able to use health savings accounts (HSAs) to cover any copays for their treatment.
Learn more about using Coventry insurance for a drug rehab program.
Health New England
Health New England offers health insurance to people in need of behavioral health services. This insurance company provides services to people in Connecticut, Vermont, and Massachusetts.
Read more about using Health New England insurance for substance abuse treatment.
Highmark is a nonprofit organization affiliated with Blue Cross Blue Shield. Insurance coverage through Highmark will help pay for a drug and alcohol rehab program.
Learn more about using Highmark insurance for addiction treatment.
People can use Humana insurance to cover a substantial portion of addiction treatment. Out-of-pocket expenses will be higher when treatment is sought with an out-of-network provider.
Read about using Humana insurance for a drug rehab program.
Kaiser Permanente health insurance plans cover addiction recovery and mental health services. Coverage for substance abuse treatment will vary by plan.
Learn more about using Kaiser Permanente for addiction treatment.
Lifetime Healthcare Insurance
Lifetime Healthcare insurance is a nonprofit entity that funds health services through their affiliate insurance companies, keeping costs lower for their policyholders.
Policyholders can get both inpatient and outpatient treatment services covered through Lifetime.
Read more about using Lifetime Healthcare insurance for substance use disorder treatment.
Magellan Health Insurance
Magellan health insurance has a lengthy background in behavioral health treatment coverage and will help people with drug or alcohol addiction get the care they need.
Most Magellan plans will pay for residential, outpatient, and aftercare services.
Learn more about using Magellan insurance for addiction treatment programs.
Medicaid is a government-run insurance program that covers disabled people, pregnant women, and people with lower financial means.
People with Medicaid insurance plans can get most if not all of their costs covered at a drug and alcohol rehab program.
Read more about using Medicaid insurance for substance use treatment.
Medical Mutual covers the vast majority of drug treatment services. For full benefits, clients must attend a rehab center that accepts Medical Mutual insurance.
Learn more about using Medical Mutual for drug rehab programs.
Medicare is a health insurance program available through the federal government that provides coverage for mental and behavioral healthcare services.
Insurance through Medicare will pay for some if not all of the treatment plans for alcohol use disorders and drug addiction.
Molina Healthcare Insurance
The Molina Healthcare company was designed to help patients lacking the financial means to pay for medical care. Molina offers both Medicaid and Medicare-backed insurance plans.
Learn more about using Molina Healthcare for substance use treatment.
There are several insurance plans through Optima that can help cover a large portion of addiction treatment costs. While Optima has an extensive network, it does not cover all rehab facilities.
Read more about using Optima insurance for drug and alcohol treatment.
Tricare is a health insurance plan for active-duty military members, dependents, and other eligible veterans. Plans through Tricare provide treatment coverage for addiction.
Learn about using Tricare insurance for substance abuse treatment.
People with insurance policies through UnitedHealthcare can get a portion of their rehab program costs covered. Rates of coverage will vary according to the individual plan.
Read about using UnitedHealthcare insurance for drug and alcohol addiction treatment.
VA Health Insurance
Veterans or eligible dependents covered by the VA may receive inpatient and outpatient treatment at little to no cost.
People can apply for VA benefits at their local VA clinic or medical center.
Learn more about using VA health insurance for drug rehab programs.
WellPoint insurance plans range in coverage level based on the amount people want to pay for copays, deductibles, and monthly premiums.
The highest-tier plan covers up to 90 percent of treatment services at a rehab center.
Read more about using WellPoint insurance for substance abuse treatment.
How Do Deductibles And Copays Affect Rehab Program Costs And Coverage?
Most private insurance plans will require customers to provide copayments or deductibles before the insurance provider can begin covering treatment costs.
A deductible is the amount of money paid each year for eligible medical services or medications before the health plan begins to share the cost.
For example, if the yearly deductible is $1,000, clients will have to pay the first $1,000 in treatment costs before the insurance plan will cover the rest.
Going to a rehab program before your deductible is met could mean a higher out-of-pocket cost overall.
However, once the deductible is met, even if this occurs during treatment, your out-of-pocket costs will be lower.
To learn how deductibles will affect your overall treatment costs, speak to your insurance adjuster.
Copays are a flat fee paid each time a person goes to the doctor or fills a prescription. The copayment is typically printed on the health plan ID card.
Not all insurance plans use copays to share in the cost of expenses, and some behavioral health services may be covered at no out-of-pocket cost.
Types Of Substance Abuse Treatment Programs Covered By Insurance Plans
Insurance providers will fully or partially cover an array of evidence-based and holistic therapies for addiction.
Treatment options covered by insurance include:
- medication-assisted treatment (MAT)
- medical detox
- intensive outpatient programs (IOP)
- cognitive behavioral therapy (CBT)
- mental health treatment
- dialectical behavior therapy (DBT)
- family, individual, or group therapy
- 12-step programs such as Alcoholics Anonymous
- partial hospitalization programs (PHP)
- dual diagnosis treatment for co-occurring disorders
- support groups for people with opioid addiction
- long-term or short-term inpatient treatment
Available treatments will vary by rehab facility and medical necessity. The level of care received will typically be determined after a full assessment from a healthcare provider.
Are There Behavioral Health Services That Aren’t Covered By Health Insurance?
Most insurance companies will pay for medically necessary treatments for drug and alcohol addiction.
Medical necessity is determined by getting prior authorization or precertification from a doctor or treatment specialist.
After an official diagnosis has been made, people still may be restricted in what kinds of addiction treatments they receive.
For example, some insurance plans may only cover rehab programs that offer science-backed services as opposed to holistic therapies.
Other Ways To Pay For Addiction Treatment If You Don’t Have Insurance
If you or your loved ones cannot afford private health insurance or don’t qualify for a government program, there are other resources to help cover the cost of addiction treatment.
Financial assistance for substance abuse treatment may include:
- state-funded grants for substance use treatment
- sliding fee scales based on income and family size
- payment plans
Find A Substance Abuse Treatment Center Today
For more information about health insurance programs for drug abuse treatment, call our helpline today. Our team can help you find a recovery center that works for you.
Addiction Resource aims to provide only the most current, accurate information in regards to addiction and addiction treatment, which means we only reference the most credible sources available.
These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.
- National Institute of Health (NIH)
- National Institute of Health (NIH)
- Substance Abuse and Mental Health Services Administration (SAMHSA)