Affordable drug rehab is necessary because none of us have unlimited budgets, and choosing how to spend our resources wisely is a decision we continuously face. Unfortunately, many people who need treatment for drug or alcohol abuse don’t receive it, and sometimes that’s because they’re concerned about the fees.
The Substance Abuse and Mental Health Services Administration (SAMHSA) reports that in 2016, among people who recognized their need for help, 27% didn’t receive or seek it for financial reasons. They weren’t aware of or couldn’t access affordable addiction treatment options.
Sources of Funding for Addiction Treatment
Understandably, you might be anxious about the cost of rehab programs. As with other types of medical services, however, you may have financial help available to you.
A primary source of funding for many people is their health insurance plan. When the Affordable Care Act (also known as the ACA or Obamacare) became law, it mandated that all health insurance plans offered through the ACA Marketplace must cover a set of essential health benefits. Treatment for substance use disorders is on the list. Many non-Marketplace plans have followed suit and offer addiction treatment coverage.
Other laws govern health insurance coverage, such as parity laws that state that if a plan covers mental health and substance abuse treatment, they can’t be covered at a lower rate than other services. This provision initially applied to group plans, such as those offered through an employer, but now applies to individual policies, too.
You may have a high-deductible health insurance plan that you’ve paired with a health savings account (HSA), and if so, you can use the HSA for addiction treatment costs. They can be used for qualified medical expenses as defined by the Internal Revenue Service and includes drug and alcohol abuse treatment.
If you don’t have a private health insurance plan, you aren’t out of luck. Public health care plans (Medicaid and Medicare) also cover substance abuse treatment. Medicaid is the largest source of funding for behavioral health, including addiction treatment; this was true even before the passage of the ACA, which expanded Medicaid coverage in many states.
There are also non-insurance sources of financial help. Does your workplace offer an Employee Assistance Program (EAP)? EAPs are common among large companies and are offered by an increasing number of smaller ones.
An EAP provides counseling to employees and refers them to treatment providers when necessary. Details vary among programs, but it’s common for a certain degree of help to be free and for additional services to be discounted.
Insurance Provisions
Health insurance plans differ widely in how they cover addiction treatment. You can learn your policy’s details by reading the Summary Plan Description and Evidence of Coverage sections if you have access to them. A quality addiction treatment facility can also check your coverage for you. Factors that affect coverage include the following:
- Network considerations – Your insurance plan may be part of a Preferred Provider Organization (PPO), Health Maintenance Organization (HMO), or an Exclusive Provider Organization (EPO). If you have a PPO, you can access care from providers who are either in your network of preferred providers or outside of it, but you’ll pay a higher amount for out-of-network care. If you have an HMO or EPO, out-of-network care is not covered.
- Whether you need a referral – Some plans, primarily HMOs, require patients to get a referral from their primary care provider before they cover the cost of specialty care.
- Whether medically managed detox is covered – Detox is the first stage of addiction treatment, and some policies cover the expenses for specific substances, but not others.
- Residential versus outpatient care – It’s possible to have a policy that covers outpatient treatment but not a residential program.
- Amount of treatment time covered – Sometimes, a plan will cap the number of treatment days, particularly for residential treatment, or require that treatment providers give periodic reports of continuing need.
How to Choose a Treatment Program
When looking for a treatment provider, you’ll want one that offers quality, cost-effective treatment. Here are some questions to ask:
- Will they work with my insurance company? You’ll want to find a program that accepts your health insurance plan and will help you determine what is and isn’t covered so you can avoid uncovered expenses as much as possible.
- Is there a range of services to fit varying budgets? It’s best to make treatment decisions based on personal therapeutic needs, but the reality is that financial factors also come into play. A program that offers both residential and outpatient programs can give you the flexibility you need.
Inpatient treatment programs provide a complete break from the distractions and temptations of normal life and allow you to focus your full attention on recovery. Because the cost includes room and board, however, they’re logically more expensive than outpatient programs.
Outpatient programs are less costly and are a good choice for many people. They often allow you to maintain other aspects of your life, such as going to work, attending classes, or taking care of your children. Outpatient programs can meet in person or online.
- Are there payment plan options? Some programs will allow you to pay over time for any expenses that aren’t covered by insurance.
- What services are provided, and do they meet your personal needs? Do you need a program that addresses co-occurring conditions like depression or PTSD? Would a men’s only or women’s only group be a good fit for you? Would you like family therapy? It’s likely, when you’re starting your recovery journey that you don’t exactly know what your needs are, so a program with many options is a wise choice.
- Are the treatments evidence-based? Some treatments, such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), have been used and studied extensively and are known to be effective. Other treatments haven’t been around long enough to have the same degree of research behind them but may prove beneficial to you. You might want a program that offers both tried and true treatments like CBT and DBT and newer therapy approaches.
- Does treatment length vary with personal needs? A one-size-fits-all program isn’t likely to be the most efficient use of funds. Ideally, you’ll spend the amount of time in treatment you need, no more and no less, and the cost will correspond to the time spent.
- Is aftercare included? The recovery journey isn’t over when patients finish their treatment programs. Participating in aftercare can reduce your relapse risk and support you while you work on applying the skills you’ve learned in treatment. Whether you’ll be charged extra for it is important to know.
Treating Addiction is a Good Investment
When trying to decide the true cost of treatment, you need to factor in the savings that are likely to come from it. Treating addiction is a good investment because addiction itself has many associated costs, treatment is effective, and there’s a considerable savings-to-cost ratio.
The costs associated with addiction aren’t all easy to quantify. They include broken relationships, ruined reputations and lost opportunities. Of course, you should consider the more quantifiable, direct financial costs of drugs and alcohol. There may also be healthcare costs, legal fees and lost wages.
Paying for addiction treatment will come to an end, but the costs of addiction are ongoing. They tend to grow over time because the nature of addiction is that people find themselves using ever-increasing amounts of drugs or alcohol.
No one wants to pay for something that doesn’t work, but research shows that addiction treatment is effective. The National Institute on Drug Abuse (NIDA) says this: “According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment stop using drugs, decrease their criminal activity, and improve their occupational, social, and psychological functioning.”
Factoring in all expenses, the savings-to-cost ratio of rehab programs is substantial. NIDA reports that with healthcare costs included, they can be as much as 12 to 1.
We Can Help You Get the Treatment You Need at a Price You Can Afford
We at The Right Step Hill Country don’t want to see anyone who needs addiction help go without it, which is why we provide high quality, cost-effective treatment. We accept Medicaid and most major insurance plans, and we’ll help you figure out what coverage you have. A payment plan may also be an option for you.
The Right Step offers options for varying budgets, including residential treatment, partial hospitalization programs, intensive outpatient programs and virtual outpatient treatment. Aftercare is also included in your treatment plan.
We provide proven, evidence-based therapy, treat co-occurring conditions like PTSD, depression, and anxiety, and offer family therapy and gender-based programs. At The Right Step, we don’t have a one-size-fits-all approach. We individualize your care, so you pay for what you need and no more.
Cost doesn’t have to keep you from getting the substance abuse treatment you deserve. We can help you navigate finances if you or your loved one seeks care. Call us at 844.675.1628 to speak with our experienced admissions specialists to find the right option for you, and start your journey of healing today.