If you need drug and alcohol dependency treatment, you may wonder how to cover the related costs. To help you understand the types of assistance on offer, we’ve collated an overview of government funding and other forms of support. 

How much will treatment cost?

Accessing effective treatment for drug and alcohol dependency isn’t always easy. Many patients find treatment pathways difficult to navigate, particularly in states where resources are siloed and poorly organized. One of the best ways to secure effective help is to research the types of services for which you’re eligible, and ask treatment providers plenty of concise questions.

Contrary to popular belief, there are plenty of free and low-cost options available for people who want to tackle their drug and alcohol abuse. As well as accessing state funds set aside for uninsured individuals, patients can often access inexpensive treatments with Medicaid or private insurance coverage.

Does every insurer cover treatment for substance abuse?

In short, yes. According to the Mental Health Parity and Addiction Equity Act (MHPAEA), health insurance companies and group health arrangements must offer similar benefits for addressing mental health issues and addiction disorders as they do for surgical care and medical issues. In other words, it’s illegal for your insurance company not to cover substance abuse treatment.

What to do if you have insurance

If you have healthcare insurance, call your insurer for a confidential discussion about drug and alcohol treatment coverage. In all likelihood, your insurer will require a deductible – a sum of money you’ll need to pay upfront before your benefits kick in. Remember to ask your insurance provider the cost of your deductible and whether you’ve already contributed toward this expense. Any medical costs can count toward your total deductible, such as fees for checkup appointments.

Once you’ve ascertained your deductible costs, ask your insurance provider for a list of approved medical providers in your vicinity. Requesting this information will increase the likelihood of your insurer agreeing to cover the cost of your treatment.

It’s worth noting that you may have to pay a small upfront fee (also known as a co-pay) to your medical provider or rehabilitation facility. Remember to find out how much you’re expected to pay upfront and how many appointments your insurers are prepared to cover per year. 

If you need help choosing the best treatment to suit your medical requirements and budget, you should ask your insurance provider whether they hire case managers. Case managers represent licensed healthcare providers (including registered nurses and social workers) who are happy to work directly with patients. Typically, your insurance premium will cover the cost of hiring a case worker, and they’ll work closely with you to make sensible decisions and build a brighter future. Some insurance companies also allow trusted friends and family members to make decisions on behalf of clients. As such, you may wish to discuss this option before proceeding with any treatment plans.

What to do if you don’t have insurance

While it can be more difficult to access treatment without insurance, there are still several options available. Some rehabilitation facilities offer free or low-cost treatments, charging patients fees that align with their income levels. 

To access an assisted treatment placement, you’ll need to provide information such as your average yearly income and household size. Don’t fret if you work on a freelance basis or don’t have access to precise numbers – an estimate will suffice.

Please be aware that every state is apportioned funding to treat uninsured people with alcohol and drug dependency issues. Rules and regulations surrounding eligibility differ across the country, so reach out to your state agency for more information about accessing this funding. 

Uninsured individuals may also wish to purchase insurance as a matter of urgency. Purchasing coverage will usually give you access to benefits within a few weeks of signing up. However, you must enroll at a specific time of year if you want to make the most of a new insurance plan. This year, the federal open enrollment period for 2023 coverage opens on November 1, 2022, and closes on January 15, 2023. These dates can differ slightly for individual states. You may also access a new insurance deal if you experience a qualifying life event, such as getting married, attaining US citizenship, or having a child. 

In most states, you can access Medicaid at any time if your income sits within their lower and upper eligibility requirements. Get in touch with your state’s Medicaid agency for more information about eligibility and how to apply for coverage. 

Some rehabilitation facilities offer scholarships or financial relief for patients who may struggle to cover their attendance fees. Please be aware, however, that these programs are often subject to strict requirements. Typically, you’ll need to successfully complete the program for the grant to be awarded. 

Accessing mental health coverage

All insurance plans should cover mental health support and substance abuse services as standard. Behavioral and mental health provisions are classed as essential benefits. As such, all insurers must cover:

• Behavioral and mental health inpatient treatments
• Psychotherapy and counseling
• Treatment for drug and alcohol problems

The specific kinds of behavioral health benefits you receive will depend on your specific health plan and the state in which you reside. As such, it’s worth researching the marketplace before settling on a health plan.