Does Health Insurance Cover Alcohol Rehab?

Excessive drinking is one of the leading causes of preventable death in the United States, and even though millions of Americans are battling a substance use disorder, only 1 in 10 receive specialty treatment.

Alcohol rehabilitation services can be expensive, but health insurance does cover them, partially or in full. Coverage depends on your plan, but chances are you have more options than you think.

If you’re in need of alcohol recovery treatment, check your health insurance policy to see what alcohol-related services are available to you.

What’s Covered?

Under the Affordable Care Act, health plans are required to cover alcohol treatment, but benefits may vary depending on your state and provider. They can also change year-to-year, so make sure you review your benefits before seeking care.

The following services should be covered by your health insurance:

• Screenings
• Intervention
• Medically-managed inpatient care
• Medical detoxification services
• Addiction treatment (e.g., addiction to medications)
• Outpatient services
• Behavioral health care, including counseling and psychotherapy
• Treatment for co-occurring disorders

Additional services may be offered, depending on your plan. These include:

• Preventative counseling
• Care management
• Peer support services 
• Risk reduction interventions
• Inpatient hospitalization for short-term care
• Intensive outpatient services (IOP)
• Partial hospitalization programs (PHP)
• Medication-assisted treatment (MAT)
• Follow-up counseling

A successful recovery, according to the American Society of Addiction Medicine, requires a continuum of care, ensuring that patients receive support as soon as they seek help and long after they’ve begun treatment.

With Medicaid or Medicare, you get access to free or low-cost alcohol addiction treatment, which includes inpatient care, long-term residential treatment, and family counseling.

When you visit FindTreatment.gov, you can find out what’s covered under your plan and available in your area. You can also submit an appeal to your insurance provider if your coverage for alcohol treatment is denied. 

What’s Not Covered?

Unfortunately, not everyone has health insurance, and even those who do may not get enough coverage to afford proper care. In addition, if a service is deemed medically unnecessary, even if it aids in your recovery process, it may not be covered.

Some services that aren’t usually covered by insurance include:

• Non-medical amenities
• Holistic care services
• Recreation programs
• Food delivery 
• Private treatment services
• Alternative therapies

Health insurance providers are not required to cover relapses, either. So if you relapse, you may need to find alternative care or payment options. However, some insurance plans will cover alcohol rehab when you relapse. If you have a care manager, they may advocate on your behalf to ensure you get the coverage you need. 

Free Resources for Alcohol Recovery

Even if your insurance covers partial treatment, you could end up facing high costs for rehab. This can be debilitating for individuals who are already cash-strapped. However, you do have options. 

Here’s what you can do:

• Secure a medical or non-medical loan
• Ask about private pay options
• Check your Employee Assistance Program (EAP) to see if substance use treatment is covered in your benefits package
• Find a local organization that offers financial assistance or grants for rehab
• Contact your state or local agency to find free or affordable services in your area
• Download an app for mental health or therapy support
• Join a support group or program, such as AA or The Tempest

If you don’t have health insurance, visit the Health Insurance Marketplace at HealthCare.gov to see if you qualify for Medicaid or other low-cost coverage plans.

If you’re not eligible at this time, visit Substance Abuse & Mental Health Services Administration (SAMHSA) to find local support groups, treatment facilities, and community-based organizations (CBOs), who may be able to provide free or affordable alcohol rehab services.

Alcohol addiction is a lifelong disease that can be costly. Contact your health care provider today to see what’s covered and for how long and take full advantage of the local resources available to you. Chances are you’ll need a combination of services in order to obtain and maintain a sober lifestyle. 

A Word From Verywell

Getting sober isn’t easy, but living a sober life can be just as difficult. Alcohol rehabilitation looks different for everyone and the path to recovery can be complicated and challenging. Not every service, treatment, or care facility will work for you, even if it’s the only option covered by your insurance. Don’t let this discourage you. If something doesn’t work, try something else.