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Addiction Center Treatment: Is It Covered Under Insurance?


Addiction Center Treatment: Is It Covered Under Insurance?

Policy Scout
Policy Scout

Addiction center treatment makes a big difference in helping people get back on track with their life. However, paying for it out of pocket is not within the means of every person seeking help. Health insurance policies that meet the requirements of the Affordable Care Act may provide you with coverage for several important parts of the recovery process. If you don't have access to this, then you have a few other options.

Types of Addiction Treatment

There are several types of treatment options that may fall under your health insurance. When you're looking into the availability of these services, you'll want to see how long treatment is covered and the providers that are available as part of your network. Your plan will have out of pocket limits and may have a deductible that you're responsible for before the health insurance covers your costs. Additionally, a co-pay may be required after the deductible is met.

Inpatient Care

You are admitted into an addiction treatment center for inpatient care, which means that you stay at the facility during this process. The treatment plan may require weeks or months to help you through your addiction. This option is used in situations where the addiction has been challenging or impossible to get through on your own, or where relapsing is a strong possibility. Since you receive 24/7, hands-on care, you're able to get the support necessary to get past the worst of it.

Outpatient Care

You receive care at an addiction treatment center or a medical provider experienced in these matters, but you only go there for your appointments. The providers specialize in addiction treatment and may even be the same ones that cover inpatient care, but the plans and methods may be different since you'll be in your home environment.

Medical Detox

Certain types of substances, such as alcohol, cause severe withdrawal symptoms in people addicted to it. You may need medical assistance to get through the detoxification process and the side effects that are related to it. This type of care may be part of an inpatient treatment plan. By getting medical assistance during this process, you improve your chances of avoiding life-threatening reactions and staying on track with recovery.

Related Mental Health Treatment

Addiction may lead to other mental illnesses occurring, such as depression and anxiety. Psychiatrists, psychologists and other mental health professionals help you address these conditions through specialized treatment methods.

Follow-up Counseling

Addiction treatment isn't a one-and-done process, especially if you are getting treatment for a long-term addiction or one that is particularly severe. Follow-up counseling can help you stay away from temptation and remain on-track with your success plan.

Ongoing Addiction Treatment Medication

In some cases, you need medication for addiction treatment or a related mental illness. Ongoing medication management will adjust the prescriptions and the dosages as needed to maintain their efficiencies.

What to Do If Addiction Center Treatment is Not Covered by Your Insurance

Unfortunately, some health insurance plans may not cover the type of addiction center treatment that you need. Your deductible could be too high or it may not have the providers necessary for your medical care. Here are a few resources to tap into if you find yourself in this unfortunate situation.

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Change Health Insurance Plans

Look for health insurance that does cover addiction center treatment, if possible. You may not have that option if you rely on healthcare through your employer or if it's the wrong time of the year to sign up on the marketplace.


Reach out to your social circle for help with the costs associated with the addiction center treatment plans. Your friends, family members, and community may be able to help in your time of need.

Sliding Scale Facilities

You may be able to find treatment centers that offer payment plans or sliding scale payments, which adjust the expenses based on your income. These needs-based facilities could have long waiting lists, so be prepared for that possibility when you start your search.

Nonprofit Organizations

Some nonprofit organizations offer grants, sponsorships, and other opportunities to people who are struggling with addiction. The Substance Abuse and Mental Health Services Administration is an excellent starting point for getting directed to resources that are available within your community. You can also dial 211 to connect with social services that may help.

Government Programs

State and local governments may have addiction treatment programs in place for your area. They typically have a list of eligibility criteria to qualify for these services. State-funded treatment centers are available in many parts of the country and focus on drug and alcohol abuse. The characteristics that these programs look for in qualifications include legal residence in the United States, how long and severe your addiction is, proof of income and proof of residence.

Getting help with an addiction can be difficult, especially when it’s been a long-term fixture in your life. Many health insurance plans make it possible to get the specialized care that you need to break free of the addition and start living a normal life again. Even if it’s not covered under your health insurance plan, you have options for accessing the necessary level of care.


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