There are plenty of hurdles to overcoming addiction. One of the most persistent is inaccurate information and preconceptions about insurance and cost. Given the high cost of rehab, it’s not surprising that so many people who don’t understand their options fail to seek treatment for a drug or alcohol addiction. According to a survey by the Substance Abuse and Mental Health Services Administration (SAMHSA), about 22 million people need treatment for addiction every year, yet 89 percent never receive the help they need.
That’s unfortunate because, in most cases, insurance covers rehab, which is classified as treatment for a recognized medical disease, but coverage depends on one’s policy and the nature of the treatment involved. For example, the cost of rehab may vary considerably according to factors such as the treatment facility itself, whether treatment is on an inpatient or outpatient basis, and length of stay, to name a few. On average, the cost of rehab in drug treatment centers can vary widely, falling anywhere from $2,000 and $25,000 a month. Private facilities are the priciest, with costs running anywhere from $20,000 to $60,000, while publicly-funded treatment facilities range between $1,500 and $8,000. Any way you look at it, rehab is a costly proposition if you lack insurance.
Residential care typically takes place in a non-hospital setting with on-site medical staff. It’s round-the-clock care with treatment taking anywhere from 6 months to a year (short-term treatment takes about a month), it includes personal and vocational training, and it can be customized based on a patient’s need. Patients who must report to a job every day generally require outpatient treatment. Outpatient facilities offer group counseling, treatment for co-occurring disorders, and programs to meet individual needs. However, it may not offer the full-scale recovery planning that residential facilities provide.
Cost according to care standards:
- Outpatient – Rehab patients undergo treatment at a facility about 5 days a week, including counseling and prescribed medications.
- Cost: $1,000 to $10,000
- Intensive outpatient – A stepped-up version of outpatient treatment, intensive outpatient care requires patients to undergo treatment several days a week.
- Cost: $3,500 to $11,000
- Residential – Inpatient care is a full-time commitment, combining treatment with an introduction to healthy habits like diet and exercise. Residential treatment costs vary greatly.
- Cost: upwards of $25,000
- Partial hospitalization – Involves at least 3 days a week in a treatment center for therapy, which includes learning coping skills.
- Cost: $7,000 to $20,000
It’s important to factor in ancillary costs when assessing the cost of rehab treatment. Some facilities charge an admission fee, which can cost several thousand dollars. There is often a fee for detox, the initial part of the recovery process, which can be as high as $800 a day, though this cost may increase substantially if emergency detox is necessary. There may also be additional fees associated with aftercare, such as the need for an extended stay.
Insurance coverage and costs
The coverage one receives for rehab treatment depends on your plan — insurers commonly cover at least a portion of treatment, but check the details of your policy carefully to determine what treatment services are covered under your plan, how long you’re covered, and what your financial responsibilities will be. Private insurance is generally the most expensive option, since it offers the most treatment options. Typical out-of-pocket costs for rehab include copays and/or coinsurance of 10 to 50 percent of total cost, though there are some plans that cover up to 100 percent for treatment once the deductible has been met.
As of 2017, the average individual health insurance premium was $393, and $1,021 for an average family premium. Patients with an HMO pay 100 percent of the bill for out-of-network visits, which is also the case with exclusive provider organizations (EPOs). Patients in preferred provider organization (PPO) plans pay the difference once the insurer has covered its share.
Other forms of coverage
More than 3,600 substance abuse facilities take either Medicare or Medicaid, while approximately 4,000 accept military insurance. More than 4,700 US treatment centers offer patients a sliding fee scale option, in which payment is based on the patient’s income and general ability to pay.
The cost of rehab is fluid and depends on many factors, but it’s very expensive no matter how you look at it. Insurance covers rehab treatment, but to what extent varies widely based on your insurance plan. If you have insurance, study the details of your policy very carefully, because even if you have good coverage, you can expect to have out-of-pocket costs. If you lack insurance, many treatment facilities will help you work out a payment schedule based on your means and ability to pay.
Other references used but not included in copy (competitors to RehabSolutions):