How to Find an Addiction Treatment Center that Accepts Your Insurance
How do I find an addiction treatment center that accepts my insurance?
That’s probably one of the first questions you ask when searching for help with substance use disorder (SUD). You want to make sure there are qualified professionals who can provide whatever level of care you need at a price you can afford.
There are many factors to consider when choosing a facility for residential or outpatient recovery including location, program length, cost, services offered, payment options, and insurance coverage. The best way to determine which option will work best for you is by researching all potential locations yourself.
Here’s what to look for in each type of facility:
In-Network/Out-Of-Network Drug Rehabs
An “in-network” facility has contracted directly with your insurance company. These facilities have agreed to accept certain specific plans as payment without additional charge. This means they don't have any incentive to raise their rates to cover costs above those negotiated with insurers. In most cases, this also includes Medicare & Medicaid patients because these programs require providers to be certified through government agencies like CCCA (Certification Commission on Certification Accreditation) or NCAHO (National Council on Alcoholism And Health Outcomes.)
As a patient, if your insurance is an HMO (health maintenance organization) or EPO (exclusive provider organization) plan you are likely restricted to in-network providers – for addiction treatment or any other healthcare services.
However, patient who have a PPO (preferred provider organization) plan can receive treatment from in-network or out-of-network providers.
Most health insurance companies offer some form of reimbursement plan, so check the benefits page under “Plan Benefits” or “Coinsurance.” Some employers may even pay 100 percent of the charges if employees choose approved centers. If you aren’t using insurance to fund therapy sessions, it might be worth asking about direct billing since most people won’t qualify unless they receive financial assistance from another source.
Be wary of facilities claiming to be "out-of-networks" but still charging more than what your insurer would normally reimburse. They're likely not participating in your network, nor are they required to follow your provider agreement. It could be considered fraud, especially if they bill outside of guidelines established by your insurance carrier. Also, if a facility says its prices are lower than other similar institutions, compare them side-by-side before making a decision.
Private Rehabilitation Centers
Private addiction treatment centers typically only accept private (commercial) insurance policies. These insurance policies are typically provided by an individuals employer or purchased through the insurance marketplace. Private rehab programs typically cannot accept Medicaid, Medicare, or other forms of insurance provided by welfare programs. Contrary to popular belief, private addiction treatment is extremely accessible to even people of modest means as a result of the affordable care act requiring that insurance companies provide some form of coverage for substance use and mental health treatment.
Commonly accepted health insurance plans include: Aetna, Cigna, United Healthcare, Optum Behavioral Health, Blue Cross Blue Shield, Ambetter, Humana, Empire, Horizon, Anthem, Moda, Tufts, Presbyterian Healthcare Services, CareFirst, UPMC Health Plan, Wellmark, PacificSource, and Molina.
State Funded Programs
The majority of publicly funded facilities serve low income populations. State funding comes via government grants and federal funds allocated for healthcare purposes. Not every person qualifies for state aid, though. For example, some states restrict eligibility based upon age, while others exclude anyone convicted of a felony violent crime within five years. Many states also deny funding to men over 65, although women aged 50 - 59 are eligible. Individuals must meet strict requirements regarding employment status, family composition, household size, and medical history in order to obtain state support. Check out SAMHSA Treatment Locator and call your state office of mental health and addictions to see if you qualify.
Many nonprofits operate alcohol and drug treatment programs specifically designed to address the needs of underserved communities. Unlike commercial rehabs, these programs vary widely in terms of offerings, staffing, and patient selection criteria. There are several ways to locate free or affordable rehabs near you. One resource is Substance Abuse and Mental Health Services Administration (SAMSHA), the primary U.S. agency responsible for developing evidence-based treatments and disseminating information related to behavioral health conditions. Another helpful site is the National Association of Drug Court Professionals (NADCP), which provides training opportunities and resources for court personnel interested in treating offenders with co-occurring disorders. Lastly, try contacting your county Department of Human Services, District Attorney’s Office, Area Agency On Aging, Adult Probation Department, Community Corrections Program, or Juvenile Justice System. Each entity should have someone available to answer general inquiries about the region. Keep in mind that paying for rehab isn't always cheaper than staying home where appropriate resources are accessible. Often times, going straight into detox or emergency rooms only makes matters worse. Talk to a counselor or therapist about your situation instead.
What's the Next Step After Finding a Rehab?
After selecting a rehab, the next step is to enroll. Once enrolled, you'll complete intake paperwork and learn about your new environment. Typically, this involves meeting staff members, reviewing contracts, signing agreements, and getting settled. Residential rehabs allow clients to stay overnight, whereas day-treatment allows them to leave earlier each morning. During your time in rehab, you'll participate in group and individual counseling, meditation classes, exercise, art, music, spiritual growth activities, educational workshops, and recreational events. Afterward, you’ll transition back to your normal life—a process called reintegration. Reintegration occurs gradually, taking anywhere from 30 days to six months depending on the severity of abuse and dependence issues. While in rehab, you'll experience increased socialization and peer pressure, both positive and negative. Since rehab doesn't happen overnight, expect to spend approximately three weeks longer inside than you did living independently.
Recovery is never easy, but knowing exactly where to start helps ensure you’re receiving quality care at a reasonable rate. Researching your options ahead of time gives you peace of mind. Remember, no matter what stage of change you’re at right now, everyone deserves access to effective therapies and medication management. Recovery is possible, but it requires patience and commitment. Take action today!
All In Solutions Counseling Center Cherry Hill is a private drug and alcohol rehabilitation center that accepts most commercial health insurance providers. If you or a loved one are interested in seeking treatment, you can go to their website for a free no-obligation online addiction treatment insurance check. A qualified admissions representative will then contact you to explain your insurance coverage to you so that you can find an addiction treatment program that accepts you insurance.
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