Using Insurance for Drug Rehab

Once you’ve made the decision to seek treatment for substance abuse, a common concern is how to pay for treatment.Some rehab facilities may give you the impression that rehabilitation centers are only for celebrities who can pay cash for their care. The truth is most facilities offer different payment options for clients from all socioeconomic backgrounds. No matter what kind of insurance you have, you may be able to use these benefits to pay for drug rehab.

What Does Insurance Pay For?

Many health insurance policies pay for drug rehabilitation services. However, the coverage for substance abuse treatment can vary.

Some policies will cover only counseling for substance abuse. Others may only cover outpatient services. Others policies will cover all or part of the costs of medically assisted inpatient detox.

In 2008, the Mental Health Parity and Addiction Equity Act (MHPAEA) went into effect. This law requires health insurance providers to expand available benefits for mental health and substance abuse disorders.[1]This means insurance carriers must cover these conditions at the same rate as other medical conditions. MHPAEA does not require companies to cover mental health treatment or drug rehab.

However, insurers who cover these services may not:

  • Charge higher copayments or deductibles for substance abuse services
  • Set more extensive network restrictions on substance abuse and psychiatric treatment
  • Set lower coverage limits for substance abuse and mental health care
  • Fail to disclose the reasons why substance abuse treatment is denied

MHPAEA changed with the start of the Affordable Care Act in 2010. As a result, the limits applied to mental health and substance abuse services can’t be more restrictive than limits applied to medical and surgical services.[2] Ultimately, the goal of the Affordable Care Act was to give the American public fair and affordable access to substance abuse treatment.

Questions to Ask Your Insurance Company

Often insurance policy documents describe the different forms of health coverage. However, some insurance jargon is hard to understand. To find out whether your provider covers substance abuse treatment and which forms of coverage are available, just follow this simple process:

  • Call the customer service number on your insurance card.Ask about your specific benefits. If you don’t have a copy of your card, ask your human resources department for the number.
  • Ask whether you will need a referral from a primary care doctor to have your expenses covered.
  • Ask about whether a copayment is due and whether the expenses will apply to a deductible.

Getting Help With Insurance Issues

If you don’t get the answers you need from your insurance provider, or you’re not able to make that call, ask for help from an addiction treatment professional.

If you’re under the influence of alcohol or drugs or going through withdrawal, making these phone calls may seem like an overwhelming task. Health insurance coverage can be difficult to understand. A counselor at The Canyon will gladly help you sort out your insurance benefits. This is one of many reasons why reaching out for help is the most important step in initiating the recovery process. Remember, you can also ask for help with payment solutions.

Your primary care doctor’s staff or your therapist’s office may be able to help you determine whether your insurance benefits will cover the services you need, such as:

  • Partially supervised outpatient care
  • Intensive inpatient rehabilitation
  • Medical detoxification
  • Residential treatment at a recovery community

Health Insurance and Privacy

When you’re weighing the pros and cons of entering treatment, you may be worried about how your employer will react. Many high-functioning alcoholics and addicts are able to continue performing their jobs, even as they struggle with substance abuse.

The Health Insurance Portability and Accountability Act (HIPAA) offers a certain amount of protection for employees concerned about the confidentiality of medical care. HIPAA privacy rules state that healthcare providers cannot disclose any information about your treatment to your employer without your written consent.

Although federal law protects records of your treatment, HIPAA does not prevent your employer from asking you to provide information. You may be asked about your condition or your care, especially when asking for leave of absence or insurance coverage.

Employers encourage employees to seek help. This helps reduce absenteeism, increases productivity, reduces the risk of workplace accidents, leads to less errors and decreases theft by employees.

Take the First Step

Don’t let the initial lack of money or information prevent you from getting the help you deserve.

Even if you have lost your job and/or your health insurance, you can still go to treatment. Many treatment centers offer sliding scale payment options. You may also qualify for assistance through government-sponsored programs.

Start your search for recovery by calling The Canyon’s helpline. Our counselors will provide a free, confidential assessment of your needs. We are glad to help you find out what forms of treatment are available. This simple phone call may be the most important thing you can do to improve your health today. Call now to secure a more stable, positive future.


[1]http://www.samhsa.gov/health-financing/implementation-mental-health-parity-addiction-equity-actImplementation of the Mental Health Parity and Addiction Equity Act (MHPAEA).

[2]https://www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/ Mental health & substance abuse coverage.


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