Modified: 22nd Jul 2019

Even when an addiction sufferer is ready to get help, they still face challenges. One of those challenges is figuring out how to pay for rehab. In a perfect world, the cost of treatment would be affordable for people from all walks of life. Unfortunately, we don’t live in a perfect world, and the cost of rehab is something addiction sufferers have to take into account.

Addiction Treatment Payment Options

If a prospective addiction treatment client doesn’t have access to healthcare, they will need to get creative to pay for rehab. In some cases, the individual might have the financial resources to handle the costs without it affecting their financial standing. Realistically, there are not many people who would fall into that category.

Here’s a list of potential ways an addiction sufferer might be able to pay for rehab should they not have access to healthcare insurance:

  • Personal Savings – If someone has been saving money for retirement or a rainy day, dealing with an addiction qualifies as a big storm
  • Personal Loans – It’s never a good thing to borrow (unsecured loan, credit cards) to pay for rehab, but saving one’s life make the cost of borrowing worth enduring
  • Facility – Rehab facilities are quite aware that many clients are struggling financially. Top facilities will typically offer a way to finance the cost of treatment
  • Endowments or Scholarships – Top rehab facilities have a lot of grateful former clients who donate money to be used to treat less fortunate clients

Healthcare Insurance and the Affordable Care Act of 2009

In 2009, President Barack Obama signed the Affordable Care Act (ACA) into law. The provisions of the new law had a profound effect on the addiction treatment industry.

There are two provisions in particular that work in favor of an addiction sufferer. First, the ACA forces insurance companies to cover preexisting conditions. That’s great news for drug users because the very presence of an addiction is a clear indication it’s a preexisting condition.

The other provision makes clear that healthcare insurance providers are required to cover addiction treatment costs the same as they would treat for any other medical condition. The only caveat is the ACA does not dictate the extent of coverage that the insurance company has to provide.

Addiction Treatment Coverage Under Anthem Insurance

If you are fortunate enough to have healthcare insurance through Anthem, you are entitled to coverage for your addiction treatment costs. However, it might not be clear to what extent you have coverage.

There are several things you can do to find out about the level of addiction treatment coverage your healthcare insurance policy affords you. The first thing you can do is check the policy summary you should have received from your employer or insurance agent. If you don’t have access to the summary page, you always have the right to contact the insurance company’s customer service department and make the inquiry.

Of course, you are dealing with a significant physical problem due to your addiction issues. If you don’t feel up to checking on your insurance yourself, there is another option. Most reputable addiction treatment centers employ an administrator whose job it is to handle the verification of payment resources. In most cases, that administrator is going to have access to a support staff member at Anthem Insurance. This individual will be able to tell your advocate exactly what the insurance company will be able to pay based on the terms of your coverage. This is a great option because it takes the pressure off you.

The Services Covered

Given the insurance company has some flexibility regarding the extent of coverage, they are not likely to cover 100% of all costs. For a better understanding of what your insurance company is required to cover per the ACA, take a look at the following information. Remember, the coverage of these items might be partial coverage.

1 Addiction Treatment Medications – This would include medications needed during the detox process, plus any medications a doctor might prescribe as part of a recovery maintenance program.

2. Inpatient Care – Anthem Insurance is going to have to cover at least a portion of inpatient care. However, that only applies to standard addiction treatment options, meaning holistic and some evidence-based therapies might not be included.

3. Outpatient Care – This is one treatment option that insurance companies will usually cover up to 100%. That’s designed to encourage the client to pursue this option because it’s far cheaper than inpatient care.

4. Aftercare – The last thing insurance wants is to cover rehab a second time due to relapse. It’s far more cost effective to cover sober living or outpatient counselling to prevent relapses.

Making Your Insurance Count

It’s not possible to endure years of living life with an addiction. Eventually, it’s going to lead you to insanity, prison or even death. If you are lucky and smart enough to have healthcare insurance with Anthem or any other top insurance company, you need to recognize the fact you have access to addiction treatment without hurting yourself financially.

There could be a lot of reasons why you feel the need to self-medicate away your worries. With that said, there’s no glory in abusing harmful substances. You have so much more to offer the world, which is exactly why the government and insurance companies want to make sure you can pay for treatment.

This is a decision you have to make on your own. You need to be committed to the process enough to be open and honest about what’s going on in your life. If you can do that much, you can arrest your addiction. At the end of the day, you’ll never regret finding your way to recovery. It’s something your insurance company is going to be able to help you accomplish.

Article Reviewed by Dr. Keerthy Sunder, MD, DFAPA

Dr. Keerthy Sunder, MD, DFAPADr. Keerthy Sunder, MD is an accomplished and internationally recognized expert in the field of addiction. He has earned diplomates from the American Board of Psychiatry and Neurology, the American Board of Addiction Medicine, and the Royal College of Obstetricians and Gynecologists.