drug & alcohol treatment in Ohio

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How Does Health Insurance Work To Pay For Drug & Alcohol Rehab

If you suffer from drug or alcohol addiction, deciding to receive treatment is likely the most important decision that you’ll ever make. People who receive professional treatment for substance use disorder have the highest likelihood of both achieving sobriety and maintaining it. Sadly, however, one of the biggest barriers to addiction treatment is its cost. Many consumers and their families are unable to cover the entire costs of either inpatient or outpatient treatment programs despite having a desperate need for this support. The good news is that your health insurance company may cover some or all of your drug addiction treatment costs. With this help, those who are ready to reclaim their freedom and overall health can enroll in quality treatment programs that have impressive success rates.

With the implementation of the Affordable Care Act, private health insurers are now required to provide coverage for substance abuse treatment in some form. Under the Affordable Care Act, treatment for substance abuse is legally recognized as an essential health benefit. As such, private health insurance companies are no longer able to outright deny coverage for substance use disorder and the medical services it requires. It’s important to note, however, that the level and amount of available coverage can vary significantly from one private insurance company and plan type to another. Factors affecting the level of coverage that’s currently available to you include:

  • The state in which your benefits were purchased
  • Whether you have an HMO plan or a PPO plan
  • Whether your chosen drug treatment facility is in-network
  • The type of substance abuse treatment that you’re seeking

In many instances, patients can expect to cover some portion of their own treatment costs even when coverage from a private health insurance company is available. In these cases, plan deductibles and co-payments are virtually guaranteed to remain as out-of-pocket costs. Moreover, those who rely on their health coverage for substance addiction treatment must additionally remain current with their plan premiums.


How To Plan For The Costs Of Drug Addiction Treatment


In years past, private insurance companies were legally able to refuse coverage for substance use disorder and for those policyholders with comorbidity or co-occurring disorders. These refusals were based on insurers’ ability to determine these issues as being pre-existing conditions. This, however, is another protection that the Affordable Care Act now provides. Thus, if you’ve been dealing with addiction for quite some time, you may be eligible to receive financial support for treatment from your current insurer, irrespective of past attempts at treatment or any prior documentation of your illness.

One of the first steps in determining how much your health insurance policy will cover is by speaking with your insurer directly. Many health insurance companies maintain constantly updated lists of recognized or in-network providers and treatment facilities. Moreover, their customer care representatives can easily and quickly assess individual health insurance plans to get a better understanding of the benefits that are offered. With the information that they share, you can determine which treatment types, facilities, and additional support services are available to you.

The Affordable Care Act also mandates that private insurance companies provide coverage for the treatment of mental health disorders. Many people who suffer from drug or alcohol addiction have co-occurring disorders. In these cases, the emotional pain and other discomfort caused by undiagnosed and untreated mental health issues have caused them to turn to drugs or alcohol for relief. With co-occurring disorders or comorbidity, success in addiction treatment typically requires that all underlying mental health issues be properly and professionally treated as well. Coverage for someone with comorbidity can include therapy, any necessary medications, and time spent in inpatient or residential rehab facilities.

People with private health insurance are no longer required to cover the entire costs of their substance abuse treatment on their own. This has made essential medical services available to those in desperate need of them. Whether partial or full coverage is available to you, the addition of this financial support can both make treatment more accessible and open up a much broader and far more diverse range of treatment options. If you want to find a rehab facility, an outpatient program, or an inpatient treatment center that perfectly aligns with your treatment needs and budget, we can help. Call us today at 833-820-3812.


There is no one-size-fits-all when it comes to addiction. Every person is unique and deserves the proper placement in the right program to best avoid potential relapse. Our “Phase Back to Life” outpatient programs combine the love, care, compassion and structure of a traditional rehabilitation center – along with a real life recovery program. We know you just want your loved one back and some peace of mind. That’s exactly how we designed our program. Call us today to learn more.

Our well-appointed facilities will ensure that your loved one is comfortable and safe.  We have taken great care to ensure that each individual feels at home from the start, so they are ready to engage in a life of recovery.  We have thought of everything to make sure it’s all taken care of.

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