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How to Pay for
Drug Rehab & Treatment

How to Pay for
Drug Rehab & Treatment

There are about 12,000 substance abuse treatment centers in the United States, yet only a small fraction of people who need treatment actually receive it. There are lots of factors at work here, including social stigma, fear of losing a job, lack of information on treatment, and refusal to admit one has a problem. But perhaps the biggest barrier to addiction treatment is cost. Knowing how valuable rehab is means little if you cannot afford it.

Treatment is probably more accessible than you think. Most centers accept private insurance, Medicare, and Medicaid. When that isn’t enough one can turn to programs that offer scholarships, low-cost loans, and other types of financial assistance for drug rehab.

Expert

Cynthia Orta
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There are about 12,000 substance abuse treatment centers in the United States, yet only a small fraction of people who need treatment actually receive it. There are lots of factors at work here, including social stigma, fear of losing a job, lack of information on treatment, and refusal to admit one has a problem. But perhaps the biggest barrier to addiction treatment is cost. Knowing how valuable rehab is means little if you cannot afford it.

Treatment is probably more accessible than you think. Most centers accept private insurance, Medicare, and Medicaid. When that isn’t enough one can turn to programs that offer scholarships, low-cost loans, and other types of financial assistance for drug rehab.

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Did You Know?

Over 3,600 substance abuse facilities in the U.S. accept either Medicare or Medicaid. Nearly 4,000 facilities accept military insurance (such as
TRICARE).

The Affordable Care Act (aka Obamacare) mandates that all Marketplace health plans cover mental health and substance abuse treatment as “essential health benefits.” Plans cannot deny coverage as a pre-existing condition, nor can they place yearly or lifetime dollar limits on coverage.

Over 4,700 U.S. substance abuse facilities offer sliding fee scale payment options (where payment is determined by the patient’s income level and other factors).

Many states and nonprofit organizations provide grants to facilities to help pay for substance abuse treatment services costs.

Drug Rehab Financing: How Much Does Treatment Cost?

The cost of substance of abuse treatment varies widely depending on a variety of factors (type of treatment, length of treatment, private vs. public facility, luxury vs. standard amenities, etc.), but can often run anywhere from $5,000 to $50,000, sometimes more. Here’s a look at the most common costs for rehab and treatment:

  • Inpatient: Inpatient programs are those where the patient resides at the treatment facility for a period of time, typically 30 to 90 days or longer. Costs for a 30-day program can range from as little as $2,000 for the most basic facility to as much as $25,000 or more for a premium or luxury facility.
  • Detox: Inpatient detoxification programs are generally priced in to the cost of the residential program. Costs for outpatient detox programs typically range from $600 to $800 a day.
  • Outpatient: Outpatient programs allow the patient to live away from the treatment center but require on-site attendance for therapy and group meetings, typically for 10 to 12 hours a week. Costs for a 30-day program commonly range from $3,000 for standard facilities to $10,000 for premium or luxury facilities.
  • Medications: Medication costs vary widely, but can total in the thousands of dollars a year.

How to Pay for Drug Rehab

The following rehab financing options can reduce or, in some cases, cover treatment costs.

Health Insurance

The short, simple answer is yes. Under several laws, such as the Affordable Care Act (ACA), insurers are required to pay for “essential health benefits,” including substance abuse treatment. But, as we all know, any time the subject of health insurance comes up things are never quite that simple. The extent of insurance coverage depends on several factors, including the type of treatment sought as well as the specific insurer and policy involved. The bottom line is that in most cases insurance will not cover the entire cost of treatment. It can, however, go a long way in making treatment affordable enough for almost everyone.

Below is a list of the most common forms of insurance available, and what to look for when it comes to coverage for rehab and treatment:

Jointly funded by the federal and state governments, Medicaid is state-administered health insurance for low-income and needy individuals, including adults, children, the elderly, and the disabled. Coverage for substance abuse treatment under Medicaid was greatly expanded under the ACA. Currently, Medicaid is required to cover all basic aspects of substance abuse treatment, including detox, inpatient and outpatient services, medication, recovery maintenance and relapse prevention services, and more. Levels of coverage vary by state, though, so be sure to check your state’s Medicaid program for more information.

Medicare is the federal government’s health insurance program primarily for persons 65 years and older, but also provides coverage for certain younger people with disabilities and individuals suffering End-Stage Renal Disease. There is no distinct Medicare benefit category for the treatment of substance abuse. However, substance abuse disorders are generally covered under Medicare, as long as the services are deemed “reasonable and necessary.” This may include inpatient and outpatient mental health treatment, outpatient hospital services, medication-assisted treatment, medications, and more. In most cases, patients are responsible for applicable deductibles and copayment or coinsurance amounts. Again, check with your specific provider for details on what is covered under your Medicare plan.

TRICARE is the main source of health care coverage for veterans upon their retirement or separation from active duty. TRICARE substance abuse treatment benefits may include, among others, inpatient services, intensive outpatient programs, detox, medication-assisted treatment, opioid treatment programs, partial hospitalization programs, mental health therapeutic services, and residential substance use disorder treatment. Deductibles and copayments may apply. Veterans may additionally be eligible for certain inpatient substance abuse services through the Department of Veterans Affairs (VA).

The Indian Health Service (IHS) is an agency of the U.S. Department of Health and Human Services responsible for providing federal healthcare services to American Indians and Alaska Natives. ITU funds are available to pay for substance abuse treatment at over 800 facilities and programs throughout the U.S.

Private health insurance is just that: insurance not publicly subsidized. That doesn’t mean it is free from governmental regulation, however. Private health insurance is subject to many of the same federally-mandated coverage requirements as publicly-subsidized insurance programs, including coverage for substance abuse treatment. While private insurance is the most expensive form to carry upfront, it is accepted by a much greater number of treatment providers, and typically provides its customers with a much wider variety of treatment options compared to publicly-subsidized insurance. Private insurance, for example, is more likely to cover longer inpatient and outpatient treatment periods, as well as luxury facilities, higher-end amenities, and holistic treatment options.

Levels and extent of coverage vary by specific insurer and policy, so be sure to check the details of your policy carefully. Contact your insurer or the treatment programs you’re considering for more information.

Programs Offering Financial Assistance for Drug Rehab

As important as it may be, insurance rarely pays all of the costs of rehab. And, in many cases, those in the greatest need of treatment are also the most likely to lack insurance coverage of any type. Fortunately, there are a number of additional programs and options that offer help paying for rehab.

State-Funded Rehabs

State-funded rehab centers commonly provide treatment to low-income patients at a highly-discounted rate or entirely free of charge. Patients must meet specific requirements to receive treatment at a state-funded facility, such as proof of U.S. citizenship or legal residence, proof of state residence, and a demonstrated inability to pay (lack of income, insurance, etc.) for treatment elsewhere.

State-funded rehab centers typically provide much more limited services when compared to private facilities, and there are often waiting lists for in patient admittance. Nevertheless, state-run centers are often the only opportunity for treatment available to those in the greatest need.

Federal, State and Nonprofit Grants & Scholarships

Federal and state governments as well as nonprofits provide funding in the form of grants and scholarships to individuals for substance abuse prevention, treatment and recovery programs. These grants and scholarships may be offered for treatment at a specific facility or come in the form of a voucher that may be used to pay for treatment at one of several participating facilities. Grant and scholarship opportunities are commonly limited to low-income patients residing within jurisdictions designated by the specific grant or scholarship programs. Contact your state’s mental health or substance abuse agency, or the treatment facilities you are considering, for more information on grant and scholarship availability.

Sliding Fee Scales and Other Rehab Financing Programs

Many treatment providers offer their services on a sliding fee scale to patients who are unable to pay the full program price. Facilities offering this option consider a number of factors to determine a particular patient’s treatment costs, including income, personal expenses, family size and obligations, and more. In addition to sliding fee scales, treatment facilities may offer other payment assistance options, co be sure to ask each rehab program under consideration about sliding fee scale and payment assistance options.

More Drug Rehab Financing Options

Even with insurance and the other financing options discussed above, most patients will likely have to secure some level of personal funding to help pay for their treatment. For many, this will mean making difficult and sometimes painful decisions in order to raise those funds. Below are a number of common options available for financing rehab:

Credit cards are a common method used by patients and their families to help pay the upfront costs of rehab services. Credit cards provide convenient and quick access to cash that can help finance lifesaving treatment. But, as anyone who has ever used one (and who hasn’t) can tell you, credit cards come with high interest rates, making them particularly difficult to pay off. Therefore, it’s good advice to carefully consider your ability to make the necessary monthly payments before laying down your plastic to fund treatment. Tip: Consider taking out a new card with a 0% introductory rate that allows you some time before interest begins to accrue.

Personal loans are another option for those who may also qualify for a credit card. Like credit cards, personal loans are unsecured, meaning the borrower does not have to put up some form of property as collateral. Personal loans are typically offered by banks and credit unions, as well as a number of online providers, and are paid back over time, commonly in monthly installments. The main advantage of a personal loan is that it usually comes with a lower interest rate than a credit card, although not as low as a secured loan.

Sometimes the best place to turn for help to finance substance abuse treatment is one’s own family members and friends. This can be tricky, of course. Borrowing money from someone with which you have a close personal relationship can cause damage to that relationship if not handled with care. It’s good advice, therefore, to make sure that both parties clearly understand the terms the loan before it’s made. Strongly consider putting those terms in writing.

There are a few lenders that specialize in providing loans to persons specifically seeking substance abuse treatment funding. Two examples of such lenders are Prosper Healthcare Lending and My Treatment Lender.com. Advantages to special financing programs include affordable interest rates, longer payback periods, and convenient grace periods before starting repayment.

For those in a position to do so, taking out a second mortgage or home equity loan comes with a number of advantages over using credit cards or taking out an unsecured loan, most prominently a much more attractive interest rate. The downside is that such loans are secured by the home itself, meaning that if you default on the mortgage or loan, you stand to lose your home in foreclosure. So, as with all other payment methods discussed here, consider this option carefully.

Selling personal items may seem like a desperate and depressing option to help pay for treatment, but consider this: most addicts would gladly sell their personal possessions if it were necessary to pay for their next fix. If that’s the case with you, wouldn’t selling those possessions to pay for the treatment that might save your life be a much better choice?

More Help Paying for Rehab: Personal savings or retirement accounts; crowdfunding; employer assistance programs.

Q&A with Rehab Expert Cynthia Orta

About Cynthia Orta

Cynthia Orta is the President of Innova Recovery Services in Monument, Colorado. Cynthia received her business degree from State Technical Institute of Memphis and has several years of experience in the management and financial industry. After operating her own business for over 12 years, Cynthia sold her business to devote more time to her clients in recovery. Helping others through the recovery process is a passion for Cynthia due to her own family experiences with addiction.

  • What are the most common ways patients pay for treatment at Innova Recovery Services?

    It’s half and half at my facility. We have private pay and insurance clients. Insurance for us is on an out-of-network basis only, unless we can get a single-case agreement to get in-network with the insurance company, which is helpful to the client. Most of the time, the client has already come from a rehab, so their deductible and out-of-pocket have been met. The insurance normally pays a portion, and what the insurance does not pay, the patient is responsible for that portion.

  • Do you take all forms of private insurance?

    I take all forms of private insurance, but the first thing I have to do is verify the benefits. We’re strictly intensive outpatient, so if the client doesn’t have intensive outpatient coverage, then we can’t use it and the client has to private pay.

  • Do you or your patients receive any federal or state grants or scholarships to help pay for treatment?

    We don’t get any funding from grants or scholarships. For me, a scholarship basically means that I’m providing the scholarship. I make [the patient] responsible for a small amount. But that’s me eating the cost on the rest of it. So, I can’t scholarship a whole lot of people, but I’ll scholarship the ones who truly, truly want their recovery and truly need their recovery.

  • Can you speak a bit about the forms private funding commonly takes?

    Usually its credit cards or the patient pays cash after each session. Because we’re an intensive outpatient, we haven’t had anybody have to take out a loan. When I worked for an inpatient facility, where the patient came in for detox and a residential 30- to 53-day program, that could cost up to $30,000. If the patient has insurance, the inpatient programs insist that they pay their deductible before they come into the program.

  • Can you talk a little bit about how a sliding fee scale works?

    I sit down with the client. I find out how much they make per month and go through their bills, because – my son was an addict years ago, and every place that I put him broke me. I will not break the [patient’s] families. They can pay me at the end of every month, they can pay me at the end of every session. But we’ll work out a plan.

  • If you could give a potential client, or their family, one piece of advice regarding funding treatment, what would it be?

    My biggest thing that I tell all my clients, if they’re going to private pay, is not to worry. I want them to worry about their treatment. I want them to worry about their recovery. And then we’ll work on all of the money issues as they come up.