Many factors go into the costs of addiction treatment, so the price tag will vary widely from one rehab to the next. Plus, because addiction treatment plans are highly personalized, the price may vary from person to person. Considering the many variables that must be reviewed, treatment could cause anywhere from a few thousand dollars to several hundred thousand dollars. But why is there such a wide range of potential costs?
What Contributes to the Cost of Rehab?
Here are some factors that can influence the cost of your treatment in rehab:
- The level of care you need. There are four major levels of care in addiction treatment, and the biggest difference between them is their level of intensity. In medical detox, you’ll need 24-hour care from medical professionals. In outpatient treatment, you’ll spend fewer than nine hours per week in treatment. The costs associated with these levels can widely vary. However, someone with high-level needs can’t be effectively treated in low levels of care. So, levels like detox and inpatient services are sometimes expensive but very important.
- The time you spend in treatment. Addiction is a complex disease that affects your brain’s reward center and how you subconsciously react to stress, triggers, and other factors. It takes time to learn effective coping strategies to help achieve and maintain sobriety. According to the National Institute on Drug Abuse (NIDA), 90 days has shown to be the optimal minimum amount of time in rehab. That 90 days could span inpatient and outpatient treatment, and a good portion could be spent in outpatient care. But it will ultimately depend on your needs.
- The type of rehab center. There are many different types of rehab centers. Some are high-end treatment facilities, while others are more clinical. Both can be effective when it comes to treating addiction, but many higher-end rehab centers offer many amenities that lead to higher costs. Resort-style amenities may help some people engage in treatment and feel more comfortable, but clinical or hospital-style treatment may be all you need. Many rehab centers strike a balance between creating a comfortable and professional environment.
- Federal versus private rehab. Most rehab centers accept private insurance plans and out-of-pocket private pay options. However, many don’t accept federal insurance options like Medicare or Medicaid. If you have a federally funded insurance plan, you still have some treatment options. These tend to be lower-cost treatment options, but it can take longer for you to get treatment through these providers.
- Your specific treatment plan. Addiction and the people it affects are complicated. There are many potential co-occurring problems and underlying issues that could be associated with a substance use problem. Some people struggle with anxiety, some have past traumas, and others have chronic pain issues. All of these things represent issues that need to be addressed in addiction treatment. There are also many different medication and therapy options that you may go through depending on your needs. There is no one treatment plan that works for every person that needs addiction treatment, so there is no singular price tag for addiction treatment.
Does Insurance Cover Rehab?
Addiction treatment is a form of health care, and insurance providers are required to offer coverage for addiction treatment and mental health services. Since the Affordable Healthcare Act of 2010, all plans in the U.S. Health Insurance Marketplace must offer coverage for behavioral health treatment, mental and behavioral health inpatient services, and substance use disorder treatment.
The specific of how much coverage you will receive and what particular treatments will be covered will depend on your specific insurance plan and provider. When you’re seeking a rehab program, your insurance provider can answer specific questions about coverage. You can also talk to the rehab center you are interested in. Many addiction treatment programs can help with insurance verification.
What Does Insurance Cover?
Your insurance provider may offer coverage for many of the medications and services you need while in addictiontreatment. Insurance companies also offer coverage for multiple levels of care in addiction treatment, including inpatient and outpatient treatment. Psychotherapies like individual counseling, group therapy, and behavioral therapies are also routinely covered.
Insurance companies prefer evidence-based approaches to treatment. That refers to medications and therapy options that have been scientifically tested and shown to be effective in a significant number of cases. That means they may not offer coverage for alternative treatments like yoga, acupuncture, equine therapy, and brand-new therapies that haven’t been proven effective in scientific research.
Why Don’t Some Rehab Centers Accept Federal Insurance?
Some addiction rehabs do accept patients and clients with Medicare or Medicaid, but many don’t, just like many private doctor’s offices and medical practices. Federal insurance options like Medicaid require more paperwork than a typical insurance company, which can increase the administrative burden on a treatment center. On top of the extra work and costs that are required to accept Medicaid, the programs are often slow to provide payment for the covered services and provide smaller payouts.
The difference is either passed on to the client or the healthcare provider. For that reason, many private healthcare providers, including rehab centers, avoid federally funded insurance programs. Still, the insurance marketplace and healthcare are always changing, and more treatment centers may accept federal insurance in the future.
Can I Pay Privately?
Yes, if you have the money or if you’re able to raise the money on your own, many rehab centers will accept private past options. However, many rehab centers prefer to work with insurance companies in their network. Still, if you need addiction treatment and you don’t have or need an insurance company to help you pay for it, you can usually find a treatment program that will allow you to pay out of pocket.
Are There Low-Cost Options?
Yes, there are several low-cost options available. Even though your options are more limited than someone with private insurance, there are ways for you to get help without insurance or enough out-of-pocket money to cover it. Many private addiction treatment centers offer a few free beds to people that need them. However, these programs are usually reserved for people with significant medical, physiological, behavioral, and financial needs. They’re also very limited. If you do qualify, it may be difficult to find an opening.
You can also go through federally funded addiction treatment resources. The Substance Abuse and Mental Health Services Administration (SAMHSA) may be able to connect you to addiction treatment options that are low-cost. The major drawback to these programs is the time it takes to get treatment. Private rehab centers try to get you into a program as soon as possible after you decide you need treatment, often within 24 hours.
If you’re a veteran or a military service member, you may be able to get addiction treatment through the U.S. Department of Veterans Affairs. Treatment costs for veterans are often much lower than it is for private citizens and civilians.
Is Addiction Treatment Worth the Cost?
Addiction is often difficult to overcome, and some people achieve sobriety and then relapse, which is a common occurrence. The relapse rate for substance use disorders is between 40% and 60%. However, when you consider that other chronic illnesses such as diabetes, hypertension, and asthma have similar relapse rates, it’s clear that addiction is similar to other chronic conditions. Even if your hypertension returned after you got treatment for it, you wouldn’t say it was useless.
Treatment for addiction has been shown to lower your risk for dangerous consequences of active addiction, increase your ability to find and maintain employment, and lower your use of harmful substances. A relapse doesn’t mean addiction treatment has failed. Each time you go through treatment, you learn ways to cope with addiction and the problems that are associated with it. A relapse just means you need to take another look at your treatment plan and relapse prevention strategies.
Addiction that isn’t addressed with effective treatment can threaten your health and relationships. The consequences of addiction are often associated with heavy financial costs. Addiction reorients your priorities around seeking and using drugs, which can be a drain on your finances. It can also threaten your ability to maintain employment.
Addressing an addiction problem can be expensive, but it may help deal with an issue that would otherwise damage your finances and ability to provide for yourself. Besides monetary costs, addiction can also cost you your health and relationships.
Addiction treatment is also worth the cost for communities as a whole. Substance use problems represent serious public health problems. Addiction problems in a community are associated with rising costs that involve healthcare costs. Since people in active addiction are more likely to be involved in or the victims of crimes, there are added costs associated with criminal justice. There are also costs that are involved with secondary consequences of substance misuse, like increased infectious disease rates and car accidents.
According to NIDA, addiction costs the U.S. more than $600 billion annually addiction treatment can help to lower these costs. If substance use problems in a community are addressed and prevented, there will be less of a financial burden in that community.