Insurance Options for Rehab

Does Insurance Cover Substance Use Disorder Treatment?

The short answer: Yes. In recent years, federal legislation has expanded the rehab services that insurance policies must pay for. The Mental Health Parity and Addiction Equity Act of 2008 requires group plans covering more than 50 employees to provide mental health coverage — including substance abuse treatment — equivalent to medical condition coverage. This act does not apply to small group plans covering 50 or fewer employees nor individual insurance plans. However, some individual and small group policies do cover treatment.

Signed in 2010, the Affordable Care Act (ACA) made substance use disorder treatment one of the essential health care benefits available to Americans. As of 2014, policies sold on Health Insurance Exchanges must provide coverage for alcohol or drug rehab. This includes pre-existing conditions.

In addition to federal regulations, state laws can affect insurance coverage for addiction treatment. It’s important to check with your insurance company about the specifics of your plan or policy.<

What will insurance pay for?

Your coverage’s scope will depend on your insurance company and policy. Review your policy manual, or call your provider, to best determine what your coverage entails. Some limitations could include:
The policy may only cover certain levels of care (for example, detox and outpatient services may be covered, but not inpatient treatment).

  • The policy may cover only certain types of facilities, such as dedicated detox centers, hospitals or outpatient clinics.
  • The policy may only cover services for a certain period (a policy may be limited to 30, 60, 90 or 120 days of treatment).
  • The policy may limit treatment to a certain number of days per year or per lifetime.
  • The policy may cover only rehab facilities in its provider network (going out-of-network may require a higher copayment or services may not be covered at all).
Call your insurance company’s toll-free number, or a specific number found on your insurance card, to determine you or your loved one’s coverage. A representative should provide you with:

  • Coverage status
  • Dates that coverage is valid
  • Services that policy covers
  • Deductible or copayment amount (the portion of cost you are responsible for)

Sometimes, representatives cannot provide coverage verification over the phone.

As part of the rehab admission process, an intake counselor or insurance verification specialist can help you figure out your financial responsibilities. We can also help you request authorization for care from your provider.

Many people hesitate to seek substance use disorder treatment because of fear of repercussions. These include concerns of job demotion or termination from employers or dropping of coverage from insurance carriers if they found out. Worry no more.

The law protects the privacy of individuals seeking drug or alcohol treatment through the provisions of 42 Code of Federal Regulations (CFR). 42 CFR imposes strict sharing limits on treatment centers that receive federal funding. This guarantees that those who need rehab are not stigmatized. Any records that identify the patient as a substance user or as a participant in a rehab program can never be disclosed to an outside entity — even for payment or medical treatment — without written consent from the patient.

42 CFR applies to a many rehab programs across the country. Facilities that do not receive federal assistance may still be subject to state privacy regulations. Programs that do not comply with these privacy regulations face criminal penalties, such as fines of up to $5,000 for each offense.

Our intake specialists will take your insurance information and help you determine whether your insurer will cover care at our facilities.

Your plan type may require a deductible or a copayment for your treatment. You may also be asked to pay an additional amount for specific services, like prescription medications or specialist consultations.

Covering Your Care

The Recovery Village® will work with most insurance providers except for Medical Assistance and Medicare. With the approval of your provider, we accept insurance from: Aetna, UBH, United Healthcare, Cigna, GHI, Beacon Health Options (formerly known as Value Options), BCBS, Individual Insurance plans, Humana, etc.

Please call us for coverage verification or check with your health insurance carrier to determine covered services. All products, logos and company names are trademarksTM or registered® trademarks of their respective holders. Their usage here does not imply any affiliation with or endorsement of said companies.

Financing options are available for those without insurance.

Top insurance companies with drug rehab coverage

Call our intake coordinators to get a full list of insurance companies that we work with for rehab. You can also contact your insurance directly.

    BCBS (Blue Cross Blue Shield)
    Anthem
    Aetna
    Assurant Health
    Cigna
    United Behavioral Health
    United Healthcare
    Humana
    Kaiser
    AARP
    Molina
    Health Net
    Mutual of Omaha
    United Concordia
    Coventry Health Care
    And More

Learn about insurance options


Our Intake Coordinators Will Assist You

If your provider does not approve coverage for The Recovery Village® — do not give up hope. Our experts are here to assist with information on private pay options and, when possible, cash pay scholarships at reduced rates. We pledge to do our best to find a way to make treatment available and help you find the help you need.

When getting help for addiction to drugs such as alcohol, meth and opioids like heroin and oxycodone, payment shouldn’t be your first concern. But the reality is that drug treatment requires an investment of money, time and energy. Fortunately, many of the leading rehab centers accept insurance. To have your costs reimbursed, however, you must verify that your insurer will pay for substance abuse treatment. You must also find out which recovery services your insurance company will authorize, and whether the program you choose will be covered. For example, some plans and providers cover drugs used in treatment such as methadone and suboxone. If it seems like a lot, just give us a call. We are happy to check on your behalf to help make the process as easy as possible.

About The Recovery Village® Columbus

The Recovery Village® Columbus is a full-continuum-of-care facility for drug and alcohol addictions. In addition to any co-occurring mental health issues. Our treatment system guides patients through comprehensive, personalized health services that span all levels of care.