Rehab Insurance & Cost Guide

The biggest factor in the cost of addiction treatment is the level of care you need. Here is how each level typically compares. Select a level to browse facilities that offer it.

Two people at the same facility can pay very different amounts. These factors have the biggest impact on your final bill:

• Level of care and how long you stay
• Location and state (costs vary by region)
• In-network vs. out-of-network status with your insurer
• Your deductible, copays, coinsurance, and out-of-pocket maximum
• Medical services such as detox monitoring, psychiatry, or medication
• Treatment for co-occurring mental health conditions
• Private rooms, amenities, and specialty programming

• Most major insurance plans include behavioral health and substance use disorder coverage.
• Coverage depends on your plan, diagnosis, medical necessity, and level of care.
• Federal parity law (MHPAEA) requires many plans to cover mental health and substance use care on terms no more restrictive than medical and surgical care.
• In-network facilities usually cost you less. Out-of-network benefits may be available on PPO plans.
• Insurers often approve treatment in stages and review progress to continue coverage.

Key terms to know: your deductible is what you pay before coverage starts, a copay or coinsurance is your share of each service, and the out-of-pocket maximum is the most you will pay in a plan year for covered in-network care.

Verifying benefits before admission prevents surprise bills. The easiest way is to call the facility you want to attend. Their admissions team will check your coverage with your insurer for you, so you don't have to call your insurance company yourself.

1. 1Pick the facility you want to attend and find its admissions phone number on its listing.
2. 2Have your insurance card ready: the policyholder's name and date of birth, member ID, and group number.
3. 3Call the admissions team and share your insurance information. Most facilities run a free, confidential benefits check and tell you whether they accept your plan.
4. 4Ask them what your plan covers for the level of care you need, whether they are in-network, and whether pre-authorization is required. Most facilities will handle it for you.
5. 5Ask for your estimated out-of-pocket costs, including your deductible, copay or coinsurance, and out-of-pocket maximum.

No. A facility's cannabis policy is a clinical approach, not a billing category. Insurance covers the treatment program based on your diagnosis, medical necessity, and level of care, so a cannabis-friendly program is billed the same way as a traditional recovery program.

Medical cannabis itself is generally not covered by insurance and, when part of a patient's care, is managed separately from the treatment program. Learn what each policy means in our Cannabis Policy Guide, or follow our step-by-step guide on how to find a cannabis-friendly rehab.

• Private insurance (PPO, HMO, EPO, POS)
• Out-of-network benefits
• Medicaid or Medicare (at facilities that accept them)
• Self-pay / private pay
• Payment plans or healthcare financing
• Sliding scale fees or financial assistance offered by some facilities
• Employee assistance programs (EAP)
• State-funded or grant-funded treatment programs

1. 1Do you accept my insurance plan?
2. 2Are you in-network or out-of-network with my provider?
3. 3Will you verify my benefits before admission, and is there a fee for that?
4. 4Is pre-authorization required, and will you handle it?
5. 5What will my estimated out-of-pocket costs be?
6. 6What's included in the cost of the program (medications, labs, therapy, housing)?
7. 7Are there additional costs I should know about?
8. 8Do you offer payment plans or financial assistance?
9. 9What happens if my insurance stops covering my stay?