Does Insurance Cover Inpatient Treatment Programs?

Does Insurance Cover Inpatient Treatment Programs?

Deciding to seek addiction treatment is often accompanied by several concerns and questions. One of the first that most people think of is usually, “how can I (or my family) afford to pay for rehab”? The total cost of addiction treatment depends on your unique treatment needs and goals; however, there are affordable treatment options for everyone, regardless of income. It can be challenging to commit to a costly rehab program. Still, it is essential to remember that seeking and completing addiction treatment is an investment in your mental health and physical recovery from addiction. With the passage of the Affordable Care Act, the ability to pay for therapy using personal, employer-sponsored, or federally funded insurance plans opened doors to treatment once closed to many.


What are the Benefits of Inpatient Rehab?

Many different levels of care are available across the country for people seeking substance abuse treatment. There are outpatient care programs, intensive outpatient programs, partial hospitalization programs, inpatient hospitalization programs, retreats, and residential care. It’s easy to see how making the best choice for you could be overwhelming. 


So why choose Orange County inpatient treatment over another treatment option? Although people choose inpatient (residential) for several reasons, there are particular treatment needs that are best served in the residential environment. These include lack of adequate support at home, severe addiction, having tried lower levels of care previously without success, experiencing a relapse, and addiction to specific substances from which detox can be dangerous.


Although each inpatient program differs from others in some way, there are common benefits of inpatient rehab that make this level of care the most effective treatment environment. Typical examples of the benefits of inpatient care include:

  • Medically supported detox and withdrawal
  • MAT treatment
  • Individual therapies (such as cognitive-behavioral therapy (CBT) and other forms of therapeutic counseling)
  • Family or couples counseling
  • 24-hour support
  • Structure and routine
  • Nutrition counseling
  • Alternative therapy options
  • Comprehensive aftercare planning


Does Insurance Cover Inpatient Treatment Programs?

In 2010, the Affordable Care Act (ACA) was signed into law. One significant benefit to the act is expanding treatment options for those covered by Medicare and Medicaid. Additionally, it required insurance companies, including private pay and employer-sponsored programs, to include addiction and mental health treatment options as part of their standard health insurance coverage. These pivotal changes to how insurance companies paid for addiction treatment helped millions more Americans to gain access to potentially life-saving addiction and mental health treatment services.


The Health Insurance Marketplace offers Affordable Care Act-sponsored insurance programs that provide addiction treatment benefits. These plans must provide financial coverage for addiction treatment services like any other medical procedure. Covered services also include inpatient (residential) and outpatient treatment options. 


Affordable Care plans assist with treatment services at all levels of care, including therapy, medically assisted detox, MAT medications, nutritional counseling, and aftercare services such as medical appointments, drug and alcohol testing, and clinic visits. ACA insurance plans are available to anyone who needs private medical insurance. 


It is essential to remember that the amount of coverage available for treatment services depends on a few factors, including (most importantly) the level of coverage purchased. In most cases, insurance will cover between sixty and ninety percent of inpatient or outpatient treatment expenses.


How to Find In-Network Rehabs in Southern California

Most health insurance plans provide coverage for addiction treatment for drug and alcohol addiction. After the passage of the Affordable Care Act, access to substance abuse, addiction, and mental health treatment services increased for people across the nation. Depending on the type of plan one has, coverage options and duration of coverage will vary. Some insurance plans may require a rehab to be “in-network” for treatment services to be covered. Choosing an in-network rehab in Southern California helps to ensure you receive the best coverage possible using your insurance benefits to help pay for treatment costs.


If you are unsure about your insurance benefits or want to learn more about coverage options, our admissions team is here to help. Contact our admissions team today if you want to learn more about insurance coverage for addiction treatment and finding an in-network provider in Southern California.