In reality, finding a detox facility is easy. Paying for drug detox services is the real challenge. Most people think that you need insurance if you hope to be able to afford drug detox service. You might be surprised to learn that even if you don’t have insurance or don’t have sufficient insurance, there are still ways to find rehab treatment. Yes, you’ll have to work a little harder to find it and in some cases, this means being placed on a waiting list.
Will Insurance Cover Drug Detox Services?
The short answer is “yes.” Our experience shows that insurance often covers drug detox services because these services involve treatment of what’s classified as a medical disease. While there are variables that must be considered consider prior to making an assessment, it pays to do some research and get informed.
CHECK YOUR INSURANCE COVERAGE
How Much Will Drug Detox Services Cost?
Understanding what drug detox services cost will mean that one must first recognize that there are wide variety of programs. Each detox facility shapes their programs a bit differently. While one drug detox center might be an inpatient facility while another might be an outpatient facility. We strongly recommend an inpatient detox facility because the chance of success in much greater if the patient is monitored closely.
There are detox services available through some non-profit health centers that may be offered for free. A luxury or celebrity-style facility that offers drug detox services would be on the other end of that spectrum could cost more than $75,000 a month. Interestingly enough, those celebrity-type detox facilities have yet to prove themselves as being any more effective than other drug detox centers.
Splitting the difference, research shows that most drug detox services cost much less, often ranging in the $3,000 to $20,000 a month, depending on the program.
As you can imagine, the broad range of costs are due to variables in the location, length of stay, and amenities. For example, a recovery center set in Malibu is simply going to cost more than one set in a suburban location.
Where Do I Start to Look for Drug Detox Services?
A great start would be to look at your state’s website to examine options for state-run, behavioral health or addiction treatment programs.
Here’s how to do that:
- Search by entering your state’s name and .gov in your search engine, for example ‘California.gov’. You should find your state’s website at the top of the list of search results.
- Once on your state’s website, search for addiction services. States use different terms for this, so try searching for ‘behavioral health’, ‘mental health’ or ‘addiction services.’
Alternatively, try this approach
Click on State Substance Abuse Agencies and then choose your state in the drop–down menu that pops up.
This will provide you with a 800 number for treatment services in your state, and in most cases, a link to your state’s substance abuse services website.
What Will My Insurance Cover Towards Drug Detox Services?
This really is the million dollar question. Some insurance coverage will cover 100 percent of the expense of drug detox services after deductibles are satisfied. Other forms of insurance will require co-payments that range from small to troublesome, which are required to be paid by the insured party.
In some plans, out-of-network treatment drug detox services can be more expensive, as the insured party often must pay a larger percentage of the treatment costs, even after their satisfying their annual deductible.
The detox process varies depending on the substance(s) being abused, and likewise, the amount of the costs covered by insurance will vary according to the process chosen and the individual’s specific plan.
Inpatient care is always more expensive, whether or not you have insurance. Your coverage will help pickup these costs at different rates for different plans.
Unfortunately, while insurance companies might be required to offer coverage for drug detox services, they don’t necessarily have to cover the cost of an inpatient program. For some insurance plans, outpatient care is the mandatory first step. If outpatient care doesn’t work, then inpatient care is often deemed to be “medically necessary” and the insurance kicks in at a higher level, depending upon your plan.
State Funded Drug Detox Services
Since Renaissance Recovery operates in the State of California, we’re adept at presenting all available options. In the worst case scenario, we can turn to the state and federal governments for assistance. There are a couple of options that MIGHT help:
Medicaid , which is a federal-and state-funded program. Originally created in 1965 to provide health insurance for those with very low income, coverage varies depending on your state and Medicaid insurance provider. However, drug detox services are typically covered, since the Affordable Care Act requires that all insurers, including Medicaid, provide some level of coverage. However, not all treatment facilities will accept Medicaid insurance coverage as payment, so we can help find a facility that does.
Medicare is another federal-and state-funded program. It was established in 1965 and provides insurance for those older than 65 or who have a severe disability, regardless of income. In some cases, people may qualify for both Medicaid and Medicare for health insurance coverage. Medicare provides coverage for substance abuse and addiction treatment in the following circumstances:
- When a doctor declares that substance abuse treatment is medically necessary or sets up the plan of care.
- When treatment is provided by a Medicare-participating facility or provider.
Digging in a little deeper, we know that drug detox services and addiction treatment is covered by Medicare Part A, and out-of-pocket costs are the same as they are for hospital stays. However, Medicare only covers up to 190 days in a psychiatric hospital per lifetime. This rule does not apply to general hospitals.
Outpatient treatment services such as counseling, pharmacological treatments administered at a doctor’s office, and patient education—are all covered under Medicare Part B at an 80%-20% rate, meaning that Medicare pays 80% and the consumer or supplemental insurance is responsible for the remaining 20%. Prescription medications are covered under Part D. However, Part D will not cover methadone or buprenorphine for treating addiction. Methadone may be covered under Part A, but only if it is administered at a hospital.
There’s an Easier Way
By now, you’re head is probably spinning as you try to navigate the complex landscape of insurance options for drug detox services.
There’s an easier way: Call a drug detox facility. No one knows the local laws and complexities of insurance coverage better than they do. They deal with private insurance, state insurance and non-profit groups on a daily basis. They can help you navigate the waters quickly and successfully.