When looking for addiction treatment, you will want to consider the particulars of your health insurance policy, including what it covers.
Before you commit to a treatment program, spend some time estimating your out-of-pocket costs. To help you, we have information on common out-of-pocket addiction treatment costs below.
Common Out-Of-Pocket Addiction Treatment Costs
An out-of-pocket healthcare expense is anything that you pay for yourself, without the help of insurance coverage or government funding.
Here are some common out-of-pocket costs you may be faced with when paying for addiction treatment.
With many insurance plans, a copay is required for particular treatment services, such as a doctor appointment or therapy session, and prescriptions.
Copays typically range in cost from $15 to $50 per service or prescription, but your policy will generally have its own set copay structure.
Government-funded insurance programs also have copays. Depending on the state, Medicaid may have small copays ranging from a couple of dollars to $10.
Copays can change depending on whether or not the treatment center is an in-network provider with the insurance company. There are generally higher copays for out-of-network providers.
The deductible for your insurance policy is the portion that you owe before your insurance begins to pay for your healthcare services.
For example, if you have a $500 deductible, you would pay that amount first and then your coinsurance would kick in.
Some insurance plans have small deductibles, like $500, and some have high deductibles, like $7,500. Contact your insurance company to learn how much your deductible is.
Coinsurance represents what you will owe after your insurance policy begins to cover your care costs. Generally, once your insurance begins paying for treatment, you also share some of that cost.
The amount that you are responsible for is usually based on a percentage. For example, after you meet your deductible, your insurance company may pay for 80% of the remaining treatment, leaving you to pay for 20% of it.
However, insurance companies also put a cap on the maximum amount of out-of-pocket expenses that you will pay.
Be sure to contact your insurance company to learn what your coinsurance and maximum out-of-pocket expenses are.
Uncovered Treatment Services
Other out-of-pocket costs could include any treatment services that are not covered by your insurance company.
Holistic therapy options, for example, often are not covered by insurance.
Holistic treatment services may include:
- mindfulness training
- art therapy
Due to their exclusion of evidence-based treatment, some faith-based treatment centers may not be covered by your insurance.
However, faith-based treatment centers that offer both evidence-based treatment and faith-based services, such as biblical counseling, Bible study groups, or worship services, may be covered.
Long-Term Addiction Treatment
Finally, some long-term addiction treatment programs may not be covered by your insurance. Or your plan may only cover residential treatment up to an allotted amount of time.
Some insurance companies may require prior authorization for long-term treatment, so be sure to find out where your policy stands if you are considering long-term treatment.
Find Addiction Treatment Today
Are you or a loved one looking for addiction treatment? Contact AddictionResource.net today for info about addiction recovery options, the treatment process, and how to get started.
Published on September 25, 2023
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- HealthCare.gov - Health benefits & coverage
- HealthCare.gov - Coinsurance