Does Insurance Cover the Cost of Alcohol Rehab? What You Need to Know

Author: Thomas Roth

Insurance often covers the cost of alcohol rehab, but it is contingent on the specifics of an individual’s insurance policy. It’s also dependent on the insurance company, the specific type of treatment, and the severity of the person’s alcoholism. While some insurance policies cover alcohol rehab fully, others may cover a portion of the cost.

We’ll help you determine if your insurance provider covers the cost of alcohol rehab and how much of the treatment it will cover. In doing so, we’ll also take you through the cost of alcohol rehab and some government benefits that can help you. Read on to learn more.

Does Insurance Cover Alcohol Rehab?

Most insurance plans, especially those compliant with the Affordable Care Act, include some coverage for mental health and substance use disorder services, including alcohol rehab. However, the extent of coverage varies widely. Ultimately, it depends on several laws in your state and the type of health insurance you have. For example, some health plans may only cover parts of alcohol rehab and not the full thing. 

Additionally, you might have a disability or government insurance. In these cases, how much rehab is covered by insurance depends on your unique plan. Age also plays a factor with plans like Medicare; these plans are only available for people over 65.

Does Insurance Cover Medical Detox for Alcoholism?

Yes, most types of insurance cover medical detox for alcoholism. Medical detox is often an essential first step in alcohol addiction treatment, and it is generally covered by most insurance plans. However, as with other forms of treatment, the extent of coverage can vary depending on the insurance plan and the specific detox program.

Does Insurance Cover Inpatient Alcohol Rehab?

Yes, most insurance plans do cover inpatient alcohol rehab, as it’s typically part of the broader behavioral health services that are required to be covered under the Affordable Care Act. However, the exact coverage can vary significantly depending on the specifics of the individual’s insurance plan, the state in which they live, and the specific inpatient facility.

Does Insurance Cover Outpatient Alcohol Rehab?

Similar to inpatient rehab, most insurance plans also cover outpatient alcohol rehab. Again, the extent of coverage can depend on the specifics of the insurance plan, the state, and the treatment provider. Outpatient rehab can often be more affordable and is generally more flexible, making it a preferred option for many individuals.

Does Insurance Cover Sober Living?

No, insurance doesn’t typically cover sober living programs. Insurance coverage for sober living homes can vary more significantly than for inpatient or outpatient treatment. Some insurance plans may cover sober living, but it’s less consistently covered compared to other forms of treatment. It’s important to review your specific insurance policy or consult with your insurance provider to understand the coverage for sober living homes.

Does Insurance Cover Partial Hospitalization?

Yes, partial hospitalization programs (PHPs) are generally covered by insurance. PHPs are a type of outpatient treatment where individuals participate in treatment services for several hours a day but live at home. Coverage will vary by insurance plan and program specifics.

Does Insurance Cover Intensive Outpatient Programs? 

Yes, insurance covers intensive outpatient programs (IOPs). As always, the specifics of coverage can vary depending on the insurance plan and the details of the IOP. Intensive outpatient programs are more extensive than traditional outpatient programs, so the extent of coverage varies.

Does Insurance cover Aftercare for Alcoholism?

Yes, insurance will cover aftercare programs for alcoholism. Aftercare, such as ongoing therapy or support group participation, is an essential part of maintaining sobriety after treatment. Insurance coverage for aftercare can vary widely. While many insurance plans do cover some aftercare services, the specifics will depend on the particular insurance policy.

Does Insurance Cover Residential Inpatient Programs?

Yes, insurance covers residential inpatient alcohol rehab. Residential inpatient programs, which require individuals to live full-time at a treatment facility, are typically covered by insurance. However, the extent of coverage can vary based on the insurance plan, the specifics of the residential program, and state regulations.

How Much Alcohol Rehab Does Insurance Cover? 

Some insurance providers will cover 100% of alcohol rehab costs, while others will only cover a few days of inpatient treatment. The amount of alcohol rehab insurance coverage depends on the individual’s specific insurance plan and the state in which they live. Coverage can range from a set number of days in inpatient or outpatient treatment, to a certain dollar amount, or a percentage of the overall cost.

Does Insurance Cover Medications for Alcoholism?

Yes, most health insurance plans do cover medications for alcoholism, often referred to as medication-assisted treatment (MAT). Under the Mental Health Parity and Addiction Equity Act (MHPAEA), health insurance plans are required to provide coverage for substance use disorders comparable to coverage for other medical conditions, which includes medications for alcoholism.

There are several FDA-approved medications for the treatment of alcohol addiction, including:

• Disulfiram (Antabuse): This medication produces unpleasant side effects like nausea and flushing of the skin when alcohol is consumed. It is intended to deter individuals from drinking.
• Naltrexone (Revia, Vivitrol): This medication blocks the euphoric effects and feelings of intoxication, allowing individuals to reduce their drinking behaviors without experiencing the alcohol “high” that can trigger a relapse.
• Acamprosate (Campral): This medication helps restore the balance of certain chemicals in the brain of a person who has recently quit drinking.

Each of these medications can be an important part of a comprehensive treatment plan that includes counseling and participation in social support programs.

However, just as with other types of treatment for alcoholism, coverage can vary by insurer and policy. Patients should check with their individual insurance provider to confirm coverage details for these medications.

Are There Free Alcohol Rehab Options? 

Yes, there are free or low-cost alcohol rehab options available. These typically come in the form of state-funded programs or non-profit organizations. However, the resources for these programs can be limited and there may be waiting lists. That said, there are also support groups like Alcoholics Anonymous (A.A.). These groups meet weekly or monthly and provide you with a sponsor to help you maintain sobriety. Still, it’s not the same as inpatient or outpatient rehab, so it doesn’t work for everyone.

It’s also possible to get help through books, movies, YouTube videos, and documentaries. These are some free online resources you can use for alcohol rehab.

How Much Does Alcohol Rehab Cost?

The cost of alcohol rehab varies widely depending on the specifics of the program and location. On average, outpatient programs, where the patient does not live at the facility but visits for treatment, can cost anywhere from $5,000 to $10,000 for a three-month program. In contrast, inpatient programs, where the patient resides at the facility for a period of time, can be significantly more expensive. A 30-day program can range from $6,000 to $20,000, and luxury or high-end programs can cost as much as $60,000 or more. Please note that these are estimates and actual costs can vary. Additionally, there may be other associated costs such as medications, ongoing counseling, and follow-up care.

Knowing about the costs of alcohol rehab and whether or not it’s covered by your insurance can help you find the best program for your needs.

What Types of Insurance Cover Alcohol Rehab?

Many types of insurance cover alcohol rehab, including private health insurance, employer-sponsored insurance, and government programs such as Medicaid and Medicare. The amount of alcohol rehab that’s covered is usually what differentiates each insurance provider. We’ll take you through some of the most common insurance companies and how they’re useful for alcoholism treatment.

Does TRICARE Insurance Cover Alcohol Rehab? 

Yes, TRICARE insurance does cover alcohol rehab. It includes coverage for inpatient services, partial hospitalization, and intensive outpatient programs. When it comes to coverage, TRICARE usually covers most of the alcohol rehab treatment. Still, it depends on your specific plan and where the treatment is being administered.

Does BlueCross BlueShield Insurance Cover Alcohol Rehab? 

BlueCross BlueShield does typically cover alcohol rehab. The level of coverage depends on the individual plan and the state in which the policyholder resides. There are dozens of BlueCross BlueShield programs, so reach out to your provider for more details. If you’re having trouble, feel free to contact our helpline for more information. You can also connect the insurance agent to the alcohol rehab treatment center and have them discuss the details on your behalf.

Does Aflac Insurance Cover Alcohol Rehab? 

Aflac insurance does not directly cover alcohol rehab. Aflac provides supplemental insurance for costs not covered by your primary insurance, like lost income during treatment. In these situations, Aflac can be useful for getting some additional funding for alcoholism treatment. That said, Aflac isn’t something that can be used as your primary payment modality.

Does Humana Cover Alcohol Rehab?

Humana, like other insurance providers, typically covers a portion of both inpatient and outpatient alcohol rehab under their behavioral health benefits. The exact coverage can vary based on factors like the location, whether the treatment provider is in-network, the specifics of the treatment needed, and the particular policy’s deductibles, co-pays, and out-of-pocket maximums.

Does Aetna Insurance Cover Alcohol Rehab?

Aetna insurance typically does cover some portion of alcohol rehab costs. The extent of coverage varies by policy and location. In most cases, recovering alcoholics will have to pay a deductible or cover some of the costs in other ways. Still, it’s possible for Aetna to cover most of the treatment if you’re in the right state and have the appropriate coverage.

Does Cigna Insurance Cover Alcohol Rehab? 

Cigna insurance often covers a portion of alcohol rehab costs, although the exact amount varies based on the individual’s plan and location. There is no exact dollar amount that Cigna guarantees, so it’s based on the total cost of coverage and your plan. In some situations, you may have to pay a portion of the alcohol rehab treatment. Cigna may also stop covering alcohol rehab if you stay in facilities for longer periods than your plan approves.

Does UnitedHealthcare Insurance Cover Alcohol Rehab?

UnitedHealthcare provides coverage for alcohol rehab under many of its insurance plans. The specifics can depend on the individual plan and state law. Most UnitedHealthcare insurance plans cover a portion of alcohol rehab. Therefore, the patient still has to pay for deductibles and other expenses for alcoholism treatment. Medication is usually covered by UnitedHealthcare for alcoholism.

Does Kaiser Permanente Cover Alcohol Rehab? 

Kaiser Permanente does typically provide coverage for alcohol rehab, although coverage can vary depending on the specific plan and state regulations. It’s an integrated managed care consortium, so you have to abide by the network that Kaiser Permanente is connected to. It’s one of the preferred networks for people in the LGBTQ+ community.

Does Liberty Health Share Cover Alcohol Rehab?

Liberty Health Share is a healthcare sharing ministry, and they have some limitations on covering pre-existing conditions and behaviors they consider “unbiblical,” which may impact their coverage of alcohol rehab. You’ll have the best luck with Liberty Health Share Cover when you apply to faith-based alcohol rehab programs. These programs are usually affordable and use treatment modalities like the 12-Step principles and counseling.

In the United States there are hundreds of insurance providers. To determine if your alcohol rehab is covered, it’s always best to contact your insurance provider directly for more information.

Do Government Benefits Cover Alcohol Rehab?

Yes, government benefits such as Medicaid and Medicare can cover alcohol rehab. The exact coverage can depend on the state’s regulations and the specifics of the individual’s eligibility. Always check with your benefits or agent before enrolling in alcohol rehab. Most treatment centers will tell you before you enroll if they take Medicare or Medicaid. Remember, it’s up to the alcohol Rehab’s discretion to accept these policies.

Does Medicare Cover Alcohol Rehab?

Medicare Part A can cover inpatient rehab, and Part B may cover outpatient rehab for alcohol addiction. However, coverage is dependent on the treatment being considered medically necessary. It’s also possible to get additional Medicare insurance options for supplemental coverage to fill any gaps. Medicare also has to be accepted as the facility you plan on attending. Unfortunately, alcohol rehabs aren’t obligated to accept this insurance. For this reason, you have fewer options when entering alcohol rehab programs.

Does Medicaid Cover Alcohol Rehab?

Medicaid often covers alcohol rehab, including both inpatient and outpatient treatment, but this can depend on the specific state’s Medicaid program and guidelines. When using Medicaid for alcoholism treatment you’re at the mercy of state programs that accept the insurance or government facilities. For these reasons, you don’t have as much liberty when it comes to choosing where you get treatment for alcoholism.

Does Short-Term Disability Cover Alcohol Rehab?

Short-term disability insurance may provide some income support if you need to take time off work for alcohol rehab. However, it’s important to review your specific policy or consult with a benefits advisor to understand your coverage. The insurance coverage won’t directly pay for treatment but it may provide you with enough of an income to pay for alcohol rehab. Therefore, it depends on your situation and how much disability you’re eligible for.

Is Alcohol Rehab Covered Under FMLA?

The Family and Medical Leave Act (FMLA) doesn’t directly cover the costs of alcohol rehab, but it can provide job-protected, unpaid leave for individuals seeking treatment. This can make it financially more feasible for some to seek treatment.

There are dozens of unique government benefits for alcoholism. Therefore, make sure you reach out to your healthcare provider to see if your benefits are included.

How To Find Out if Your Insurance Covers Alcohol Rehab

The best way to find out if your insurance covers alcohol rehab is to directly contact your insurance provider. Most providers have a toll-free number you can call. Be prepared to provide details about your policy, and ask specifically about what types of alcohol rehab treatments are covered, to what extent they’re covered, and if there are preferred providers you need to use.

Another option is to reach out to the rehab facility you’re considering. Most facilities have staff members who can help you understand what your insurance will cover. They often have experience navigating insurance questions and can help you understand the specifics of your policy.

When discussing your policy with your insurance provider, remember to ask about:

• The extent of your coverage for inpatient and outpatient treatment.
• Any copays or deductibles that apply.
• If there are limitations based on the length of the program or total cost.
• If your plan requires you to use certain facilities or treatment providers.

Keep in mind that under the Affordable Care Act, mental health and substance use disorder services are one of the 10 essential health benefits that most health insurance plans must cover. This includes behavioral health treatment, counseling, and psychotherapy. As a result, your insurance plan likely offers at least some coverage for alcohol rehab, but it’s important to verify the specifics of that coverage.

Remember, seeking help is the first and most crucial step in treating alcoholism. Do not let the potential cost deter you from finding the treatment you or a loved one needs.

Sources and Additional Assistance

• National Institute on Alcohol Abuse and Alcoholism (NIAAA): Offers extensive resources and research on alcoholism, including information on treatment options.
• Substance Abuse and Mental Health Services Administration (SAMHSA): Provides information on mental health and substance abuse, including coverage options and resources for locating treatment facilities.
• Centers for Medicare & Medicaid Services (CMS): A useful resource for understanding how government insurance programs cover alcohol rehab
• The Mental Health Parity and Addiction Equity Act (MHPAEA): This federal law requires group health plans and health insurance issuers to provide the same level of benefits for mental and/or substance use treatment and services that they do for medical/surgical care.
• Healthcare.gov: Provides information on what insurance plans, under the Affordable Care Act, cover.
• Official sites of Insurance Providers: Most insurance providers, like Aetna, BlueCross BlueShield, Cigna, UnitedHealthcare, etc., offer specifics on what their various plans cover.