Cost Shouldn’t Keep You from Getting Help: Paying for Addiction Treatment

December 26, 2014 Updated: April 23, 2016

When it comes time to seek help for an addiction, getting the patient to commit to a recovery program is often the most significant barrier to overcome. Once you or your loved one agrees to get help, though, there is often another hurdle to overcome: paying for treatment. Inpatient treatment bills can run into the tens of thousands of dollars, and for some patients, that may seem to be an insurmountable obstacle. As a result, they may try to handle their problem on their own, or feel discouraged and keeping abusing.

It doesn’t have to be that way, though. There is a wide array of options when it comes to paying for addiction treatment, making it possible for even the most financially strapped patient to get the treatment he or she deserves.

Private Insurance

When it comes to paying for treatment, most patients plan on using insurance for drug rehab in Arizona or their home state. Most private health insurance plans include coverage for inpatient or outpatient addiction treatment, but there are usually some restrictions. In most cases, it depends on whether the plan falls under Employee Retirement and Income Security Act (ERISA) guidelines or not.

If you have an ERISA plan, you may not have coverage for substance abuse treatment, since the law does not require these plans to offer that type of coverage. If you have a non-ERISA group plan, though, you’re entitled to up to seven days of detox admission, 30 days of non-hospital inpatient services (up to 90 days total, lifetime maximum), and up to 30 days per year of partial hospitalization or outpatient treatment.

In addition, under the rules of the Affordable Care Act, health insurers are now required to treat addiction as any other chronic disease, meaning that most plans offer expanded coverage for rehab treatment. Individual plans vary, and you may have to meet deductibles and make copayments, but private health insurance will usually cover the majority of your rehab bills, as long as the center accepts your insurance.

 

Government Assistance

For those without health insurance, or in need of additional financial aid, federal and state agencies do offer recovery assistance to qualified individuals. Older or disabled adults with Medicare can generally use those plans to pay for treatment, provided the facility accepts Medicare. Medicare Part A covers some of the costs of treatment received in a hospital, while Part B covers outpatient treatment, lab tests, and some services by alcohol and drug counselors. However, Medicare won’t cover all costs, and you will still have to pay some co-payments and deductibles.

If you fall within certain income guidelines, you may qualify for Medicaid, or government-funded health insurance. State programs vary, but in general, all cover some type of substance abuse treatment. Again, you will need to find a center that accepts Medicaid payments, but if you don’t have any other options, this assistance can help you get back on track.

Scholarships and Sliding Scales

Most recovery centers offer some type of financial assistance program to patients to help increase access to treatment. Some facilities offer scholarships or one-time assistance plans to reduce the overall cost of treatment; qualifications for such programs vary and depend on the individual center and its policies.

Another common form of assistance is a sliding payment scale. Patients who are paying out of pocket, or who have inadequate insurance coverage, may be able to pay based on their income. The facility will compare your household income and size against the federal poverty guidelines to determine how much you have to pay for treatment; in some cases, your household income could qualify you for a significant discount and open the doors to treatment options you didn’t think were possible.

In some cases, patients seeking rehab assistance have been advised to take out loans, make withdrawals from retirement accounts, or drain personal savings to help pay for treatment for themselves or a loved one. With so many other assistance options available, borrowing money should always be a last resort. Someone completing rehab is trying to make a fresh start, and facing significant debt is not always conducive to getting off to a great start after treatment. The best thing to do is to talk directly with the recovery center you want to go to, and explain your financial situation. Chances are there is an assistance program available that will help you get the treatment you need without falling deep into debt.