Does Insurance Cover Rehab?

With addiction rates on the rise, the need for health insurance for rehab coverage continues to rise with it. This is because, thanks to the Affordable Care Act of 2010, health insurance plans are now required to cover mental health issues. Because of this act, most individual, state, or federal marketplace insurance plans are required to cover:

  • Behavioral and cognitive therapy
  • Substance abuse treatment
  • Inpatient Care at full-service mental facilities

This is honestly a blessing, as, before this act, many health insurance plans were not required to provide mental health coverage, so for many people who were struggling with substance abuse and addiction, treatment could only take place at state-run facilities or throughout of pocket payment.

Types of Insurance

While yes, insurance plans are now required to provide mental health coverage, that doesn’t mean they are all built the same. Many people have many different plans, and some pay more than others for substance abuse treatment.

For this reason, it is always smart to get in contact with your insurance agent to find out exactly what your insurance covers for rehab before entering. Here are some questions that might help you figure that out:

  • In what situations will your insurance plan be covering rehab?
  • What is the length of stay that your insurance plan will cover?
  • Can you use your insurance for rehab if you have been to a substance abuse or mental health rehabilitation before?
  • What aspects of your treatment plan will be covered?

It is very important to look through your insurance coverage paperwork beforehand, as many workplaces that offer insurance company DO have the option to deny coverage for mental health. In the United States most, employer-offered insurance plans do cover mental health, about 91%.

In addition, it is important to find out if you are covered by the parity law, meaning, that your mental health care is covered at the same level as medical care. Most health plans do require this, however, certain types of employer-offered health plans are exempt from this rule such as:

  • Employer Plans that have less than 50 employees
  • Medicare
  • And State Government Employees (teachers and university employees)

Certain Stipulations

With the influx of addiction rates and dual diagnosis occurrences, many insurance companies have started to understand the dire need for substance abuse or mental health treatment. Similarly, insurance companies are beginning to realize that untreated addictions can often lead, or be the cause of, other physical and mental ailments.

However, there are still certain stipulations regarding what your coverage from insurance for rehab will look like. For example, some plans require that a referral from a primary physician be submitted before using insurance for rehab coverage.

Another stipulation, is that whole, in-network, out of network thing. Some plans will only cover certain facilities, in certain areas. So if your coverage of insurance for rehab is mandated to it being only in-network facilities, it is usually helpful to go online, look up in network facilities on your health insurances web site, and look up reviews for those facilities.


How much rehab programs cost depends largely on a variety of different factors. These can include, the length of the program, the type of program, and the amenities included in that program.

Primarily speaking, most treatment facilities that are considered good quality and reasonably priced average anywhere from $20,000 to $40,000 per month. Luxury programs cost considerably more.

Sometimes, it is required that a patient will have to change facilities during treatment, either to a higher or lower level of care. It is important to ask your insurance provider if a change in the facility would be covered. This is actually a very common occurrence, as many people will discover that a certain treatment facility may not meet their required needs, or that they may be greater benefited by a different treatment modality or program.

For those who find that their coverage from insurance for rehab may not be enough to cover the cost, there are other payment options that can ensure each person gets the help they need, despite their budget. For example, many treatment facilities offer payment plans.

Other facilities offer scholarships for people who require treatment but cannot afford it. These scholarships come from charitable donations or sponsored partners and can offer either a free ride or a greatly reduced payment amount for those who qualify.

There are also many faith-based organizations, that are primarily funded by charitable donations and by church donations that people can seek out if they do not have the ability to utilize insurance for rehab.

The Addiction Blog

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