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Is Inpatient Rehab Covered By Insurance?

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 8 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 8 minutes

Everything you need to know about insurance coverage for inpatient drug rehab programs.

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Let’s say you identify with the millions of Americans who struggle with addiction and wish they could break their cycle. If that’s the case, you may wonder how to afford rehab.

You may find it comforting to realize that insurance covers detox and addiction treatment, often fully or partially. Millions of people of all ages in the United States might benefit from intensive addiction therapy. But do insurance plans cover inpatient treatments too?

Table of Contents

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Levels of Care
Popular Topics
Families & Addiction

Understanding the Basics of Inpatient Rehab

What is Inpatient Treatment?

Inpatient addiction treatment programs are usually based in a hospital or other specialized facility where the program offers round-the-clock supervision. There are often fewer clients per staff member than in outpatient programs.

The plan can be short or long-term, depending on what you need. For some, it’s a matter of weeks; for others, it’s months or years. And while inpatient treatment is typically more expensive than outpatient therapy, it often yields far more successful results.

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Key Benefits of Choosing Inpatient Rehab

Which Advantages Does Inpatient Rehabilitation Offer?

Detoxification and addiction treatment programs often include inpatient or residential rehabilitation as one of the primary choices. Staying in the facility where therapy is being administered is a requirement of inpatient programs.

Detoxing from drugs or alcohol may be challenging, but professional medical and mental health care is readily available at any time at an inpatient drug and alcohol rehab facility. If you choose inpatient treatment, you may go through detox and the rest of your therapy sessions in one convenient location.

Both medical detox and long-term residential treatment are standard features of today’s rehabilitation centers. The duration of such courses typically falls between 30 and 90 days. How long you will need to remain in rehab is determined by the degree of your addiction and how long you have been abusing substances.

An inpatient program may be the best choice if you have a severe addiction that persisted despite attempts at outpatient care or had sought treatment before and relapsed.

Inpatient care often provides a higher level of care and comfort but comes at a higher price. Every inpatient facility offers a unique experience. However, several consistent aspects of inpatient therapy make it so beneficial, irrespective of the specifics of the planning.

Following is a brief overview of some of the main characteristics:

  • Detoxification and withdrawal treatment with medical assistance.

  • Care for the elderly includes medical intervention for the upkeep.

  • Sessions with a therapist, once a week or more often, to work on specific issues or discuss broader issues, such as depression or anxiety.

  • Therapists who work with families or couples.

  • 24/7 Availability.

  • Organization and regularity.

  • A haven away from sources of stress and temptation.

  • Aftercare planning and support.

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Most Major Insurance Will Help Cover the Cost of Treatment
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Navigating Insurance Coverage

Does Health Insurance Cover Inpatient Rehab?

After the enactment of the Affordable Care Act in 2010, insurance companies changed the way they handled payment for drug and alcohol treatment in several ways. Before the Affordable Care Act (also known as Obamacare), commercial, government-financed, and employer-sponsored insurance plans may decide whether or not to cover a particular medical service.

In addition, they may severely reduce insurers’ access to yearly or lifelong insurance for mental health or substance abuse therapy activities. In many cases, the statements buried deep within the policies made any addiction or mental health care coverage considered a pre-existing diagnosis, drastically reducing the amount of money expected of them. 

Subsequently, in 2010, many unjustified regulations and prohibitions on insurance reimbursement for addiction treatment were lifted.

Alcohol and drug treatment options for those with private insurance, Medicare, Medicaid U.S., or other government programs have been considerably increased thanks to the Affordable Care Act (ACA).

According to the ACA, insurance providers must provide insurance for addiction treatment in all plans. These modifications altered the extent to which corporations would fund addiction and mental health care, allowing millions more people to get the help they needed that had previously been unavailable due to lifetime therapy caps or out-of-pocket costs.

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Making the right decision

Tips for Choosing an Inpatient Rehabilitation Facility

Because everyone needing addiction therapy is unique, many options are available. To determine which treatment option is ideal, it is crucial to ask the relevant questions.

Consider the following questions while deciding on a rehabilitation center:

Which Kinds Of Drug And Alcohol Abuse Do This Program Address?

Look for a facility with expertise in dealing with your particular addiction and any associated mental health issues. Be careful to inquire about the facility’s experience treating your specific condition since each drug’s psychological and physical consequences are unique.

What Kind Of Counseling Services Are Available?

Treatment centers often include both group and individual therapy. Additionally, there are several conventional and alternative treatment options to choose from. For example, perhaps you feel strongly about the value of family therapy or alternative treatments like yoga, art, music, or equine therapy. Choose a treatment facility that fits your needs by researching your possibilities.

Do They Have Any Sober Living Or Aftercare Programs?

Many rehabs help you prepare for life outside of the facility. However, staying sober requires a structured aftercare plan. Determine whether the facility you’re considering offers an aftercare plan or can assist you in finding one.

In What Ways Is This Establishment Validated And Authorized?

Check whether the clinical personnel and the institution have received appropriate certification since you want access to qualified individuals. It’s crucial to keep this in mind since low-quality services may not only be ineffective in meeting your needs but may also cost you a lot of money.

What Are The Peer-Group Options Provided?

The 12-step method, as used by groups like Alcoholics Anonymous and Narcotics Anonymous, is used by many treatment facilities. In some instances, clients might choose between a 12-step program and another option offered by the same facility.

What Are The Payment Options?

The first thing you should do when trying to figure out how to pay for therapy is contact the facility to see whether they take your insurance. If you do not have health insurance, you should inquire about the availability of grants or other forms of in-house funding at the treatment facility. 

Asking yourself these types of questions can help you focus on a therapeutic plan that works best for you and reduce the stress associated with the search for that plan.

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Conclusion

We hope this article is helpful. Remember, understanding your insurance coverage for inpatient rehab is an important step for anyone ready to treat their addiction. Thanks to the Affordable Care Act, more people than ever have access to the treatment they need, with most insurance plans now required to cover addiction services.

This change means that whether you’re on a private plan, Medicare, or Medicaid, you’re likely eligible for some level of support for detox, therapy, and aftercare. It’s important to dive into the details of your insurance plan to grasp what’s covered and to what extent.

When choosing a rehab facility, consider not just the financials but also the types of treatments offered, the availability of aftercare, and the facility’s overall approach to recovery to ensure it aligns with your needs and goals.

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Written By:

Dr. Saman Aftab, Ph.D.

Dr. Saman Aftab, Mental Health write at Rolling Hills
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Dr. Saman is a mental health writer with over six years of experience in freelance writing, editing, and proofreading. She is a practicing healthcare professional holding a doctorate in physical therapy at DOW University of Health Sciences. Dr. Saman started content writing to blend her passion for writing and medicine with her extensive clinical experience.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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