Do Residential Inpatient Rehab Centers Take Insurance?
Inpatient rehabilitation treatment is frequently covered by health insurance. However, the amount to which insurance will pay for residential treatment varies according to many factors, including the specific behavioral health benefits your policy provides, the rehab facility, and your unique needs. Below are all the answers you’re looking for to the question, “Does health insurance cover inpatient rehab?”
What is Residential Inpatient Treatment?
Residential inpatient treatment is a type of mental health, substance abuse, or addiction treatment program that provides 24-hour care in a live-in facility. It is designed to help individuals with severe mental health or substance use disorders requiring intensive care and structured treatment.
During residential inpatient treatment, individuals live at the treatment facility for a designated period, typically from a few weeks to several months. They receive individual and group therapy, participate in educational and therapeutic activities, and receive psychiatric and medical care as needed.
Residential treatment aims to provide individuals with a safe and supportive environment to focus on their recovery and develop the skills and strategies needed to manage their mental health or addiction challenges. It can be a highly effective form of treatment for those who need a more intensive level of care than outpatient treatment can provide.
Check Your Insurance for Inpatient Addiction Treatment
Our admissions coordinators will interact directly with your insurance provider on your behalf, removing from your shoulders the burden of figuring out if your insurance will pay for your addiction treatment.
What is Rehab Insurance Coverage?
Rehab or addiction treatment insurance coverage refers to how much an insurance policy covers the cost of addiction treatment or rehab services. Many health insurance policies provide some level of coverage for addiction treatment, although the specifics of that coverage can vary widely.
Typically, rehab insurance coverage includes some or all of the cost of outpatient and inpatient addiction rehab and mental health care, such as detoxification, individual and group therapy, medication-assisted treatment, and aftercare services. However, the amount of coverage and the specific benefits can vary depending on the insured’s policy and the location of the treatment facility, among many other factors.
Does Insurance Cover Inpatient Rehab?
Many health insurance policies provide coverage for inpatient care, although the specific details of inpatient insurance coverage can vary. Some insurance providers may cover the entire cost of inpatient rehab, while others may only cover a portion. It is important to verify insurance specifics of your policy to determine your benefits and out-of-pocket expenses.
In general, insurance plans that cover inpatient rehab will typically cover the cost of a room, meals, medical care, and therapy or other treatment services provided during the stay. However, some plans may have limitations or exclusions on the types and duration of treatment covered.
Additionally, some insurance plans may require pre-authorization or a referral from a healthcare provider to receive coverage for in-house care. Therefore, understanding any requirements or restrictions on coverage before beginning treatment to avoid unexpected expenses or denied claims is important.
Inpatient Rehab Centers That Take Insurance
Virtue Recovery Center has been supporting individuals on their journey to recovery from substance abuse for years with treatment locations in multiple states. Our addiction treatment specialists have created the most reliable and accredited residential treatment programs, including inpatient detoxification, sober living options, aftercare, and more.
Below you’ll find links to all of Virtue Recovery Center’s residential treatment facilities:
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Does Virtue Recovery Center Take Insurance for Inpatient Rehab?
Yes, Virtue Recovery Center accepts insurance for inpatient rehab services from most major health insurance providers. Virtue Recovery Center is also in-network with many insurance providers in Arizona, Nevada, Oregon and Texas. Some of these insurance providers include but not limited to:
Aetna, a reputable insurance provider, offers coverage for rehabilitation services related to drug and alcohol addiction under many of its health plans. However, the extent and specifics of this coverage can vary greatly and depend on factors such as the details of an individual’s Aetna health plan and the specific addiction treatment provider they choose. Aetna works closely with its policyholders to help them find appropriate nearby treatment options for their substance addictions. Although Aetna’s rehab insurance provides addiction treatment coverage in all 50 states, it’s important to directly contact Aetna for the most accurate information regarding coverage specifics and potential changes to premiums post-treatment. For those seeking luxury treatment centers, there are several options that accept Aetna. Additionally, Aetna offers a specific program for alcohol screening, intervention, and referral as part of its commitment to comprehensive patient care.
Blue Cross Blue Shield Insurance
Blue Cross Blue Shield (BCBS), a major insurance provider, offers coverage for rehabilitation services related to drug and alcohol addiction. This coverage is accepted at many addiction treatment facilities, including Virtue Recovery Center. However, the extent and specifics of this coverage can differ greatly depending on factors such as the individual’s specific BCBS health plan and the chosen addiction treatment provider. BCBS provides treatment for those struggling with alcohol addiction and substance use disorders. It’s important to note that while BCBS covers some, if not all, of the costs associated with drug and alcohol rehab, the exact details will depend on the plan and the level of care needed.
Cigna, a well-known insurance provider, offers coverage for drug and alcohol rehabilitation services. It appears that Cigna has partnerships with numerous addiction rehab facilities throughout the country, providing members with a wide range of options for treatment. Coverage usually includes detox, inpatient rehabilitation, and outpatient treatment, although specifics may vary based on the individual’s plan and circumstances. Notably, Cigna covers Intensive Outpatient Programs (IOP), which are structured treatments that educate about addiction and recovery. However, prior authorization might be required for certain services like outpatient rehab, IOP, Partial Hospitalization Program (PHP), and inpatient/residential rehab services. Additionally, Cigna may cover the cost of as many rehab stays as deemed medically necessary by your primary care physician or an addiction specialist. For most accurate information, it is always recommended to directly contact Cigna or the chosen rehab center.
HealthSmart, an established insurance provider, offers coverage for rehabilitation services, including those related to drug and alcohol addiction. This coverage is typically extended to both inpatient and outpatient treatments. However, the specifics of this coverage can differ based on the individual’s HealthSmart plan and the treatment required. Certain treatments may need prior authorization or may not be included in the coverage. Additionally, HealthSmart covers mental health treatments, which include substance abuse treatments.
TriWest is not an insurance plan, but a network that works with the Department of Veterans Affairs (VA) to offer healthcare. It provides behavioral healthcare coverage, including treatment options for substance addiction. The specifics of this coverage can vary based on individual needs and the treatments required. Beneficiaries of TriWest can generally receive coverage for multiple rounds of rehab treatment, provided each round is deemed medically necessary. To understand how much of your treatment will be covered by TriWest, it’s recommended to contact them directly for benefit verification. It’s important to note that TriWest only serves the health care needs of the military and veteran communities.
United HealthCare Insurance
United Healthcare, a reputable insurance provider, typically covers drug and alcohol rehab services, along with other substance abuse treatment programs. The specifics of this coverage can differ based on the individual’s United Healthcare plan and the type of treatment required. Many United Healthcare plans provide assistance for drug and alcohol treatment services, potentially covering up to 100% of addiction treatment costs at approved facilities.
Furthermore, United Healthcare offers a free, confidential alcohol and drug addiction helpline available 24/7 for those concerned about themselves or a loved one. It’s important to verify your benefits directly with United Healthcare to understand the extent of your coverage for addiction treatment. United Healthcare policies are accepted at many rehab centers, including luxury treatment centers, offering high-quality care.
How Much Does Inpatient Rehab Cost With Insurance?
The cost of inpatient addiction rehab with insurance will depend on factors such as the length of stay, the type of treatment, the location, and the specifics of your insurance policy. Out-of-pocket expenses such as deductibles and copays may also impact the overall cost of treatment. However, the cost of a 30-day program typically ranges from $5,000 to $20,000.1
How To Check My Insurance Coverage Levels for Inpatient Rehab Treatment
Contacting your insurance carrier can be a daunting task. Easily verify insurance details by filling out our no-obligation online form. One of our highly qualified staff members will contact your health insurance provider to confirm your inpatient insurance coverage levels for rehab treatment. Then, we'll contact you as soon as possible to review your policy and discuss the next steps.
Since Virtue Recovery Centers accept most major insurance plans, we take care of the hassles and wait periods involved in calling your insurance company. Furthermore, we guarantee that any information you provide or discuss is confidential.
How To Get My Insurance To Pay For Residential Rehab Treatment
Suppose you are seeking residential rehab treatment for intensive care or hospitalization for acute care and would like your insurance to cover the cost. In that case, there are several steps you can take to help ensure that your claims are approved:
- Review your insurance policy: Thoroughly review your insurance policy to understand what is covered and the limitations or exclusions for addiction treatment.
- Obtain pre-authorization: Many insurance plans require pre-authorization or a referral from a healthcare provider to receive inpatient insurance coverage. Find out what is needed for pre-authorization.
- Choose an in-network provider: Attending an inpatient facility that is in-network with your provider can help ensure that your claim is approved and that you receive the maximum amount of coverage available under your policy.
- Submit a claim: After receiving treatment, submit a claim to your insurance provider as soon as possible. Include all necessary documentation, such as treatment records and receipts. The treatment facility will likely submit claims on your behalf. Verify this before choosing a treatment provider.
- Follow up with your insurance provider: Don't give up if your claim is denied. Instead, follow up with your insurance provider to determine why the claim was rejected and the steps you may take to appeal the decision.
- Consider working with an advocate: If you are having trouble getting your insurance to cover the cost of residential rehab treatment, consider working with an insurance advocate or addiction treatment specialist who can help you navigate the process and advocate on your behalf. Virtue Recovery Center’s admissions coordinators are ready and willing to assist.
How Many Times Will Insurance Pay For Inpatient Rehab?
The number of times that insurance will cover inpatient rehab can vary depending on the specific insurance policy and your treatment needs, among other factors. Reviewing the details of your insurance policy to thoroughly understand the coverage limitations and any potential out-of-pocket expenses you may incur is essential. Most insurance policies will generally cover multiple rounds of inpatient rehab treatment.
However, some insurance policies may limit the number of stays to one per year or have a lifetime cap on the number of covered stays. Other policies may have no limit as long as the treatment is deemed medically necessary.
Additionally, remember that the number of times insurance will pay for inpatient rehab may depend on your unique treatment needs and progress. Insurance adjusters may review on a case-by-case basis to determine the medical necessity of additional rounds of inpatient rehab treatment.
Can You Go to Inpatient Residential Rehab Without Insurance?
Going to inpatient residential rehab without insurance is possible, but it can be quite expensive. Residential treatment is often one of the most costly types of addiction treatment, and without insurance, the cost can be prohibitive for many people. However, there are some options for individuals who do not have insurance and need inpatient care.
Some rehabilitation facilities offer sliding scale fees based on income or may provide financial assistance programs to help individuals pay for treatment. Some government-funded programs, such as state-funded rehab and community health centers, also provide free or low-cost addiction treatment.
If you are considering inpatient residential rehab but do not have insurance, research and explore all your options for financing your treatment. Speak with the rehab facility to learn more about their payment options and financial assistance programs. Also, consider reaching out to local government agencies or non-profit organizations that may be able to help you access affordable addiction treatment.
Additionally, the cost of addiction treatment shouldn't stop you from seeking appropriate therapies or recovery programs. Virtue Recovery Center wants to make sure you or a loved one receives the finest treatment available if you or they are considering getting treatment for a drug or alcohol addiction. We'll work with you to create an affordable payment plan for unforeseen costs.
Inpatient Rehab Statistics
- In 2019, 1.5% (4.2 million) of Americans aged 12 and older got some type of drug use treatment, and 1% (2.6 million) received such treatment at a specialty facility.1
- In 2019, 1 million individuals aged 12 and older got inpatient rehabilitation therapy.
- From 0.7% (or 1.5 million individuals) in 2002 to 1% (or 2.4 million people) in 2019, more adults aged 18 and older got inpatient mental health care.
- On March 31, 2020, 54% of patients were receiving treatment for drug addiction alone, 32% were receiving treatment for both alcohol and drug abuse, and 14% were receiving treatment for alcohol abuse only.2
- The proportion of patients receiving treatment for co-occurring mental health and substance use disorders rose from 41% in 2011 to 49% in 2020.
- In 2020, 3.7% (or 301,000 persons) of the 8.2 million young adults (18–25) who needed substance abuse treatment in the previous year received it at a specialty facility, such as an inpatient facility.3
- In 2019, 1.5% of adolescents with a past-year substance use disorder who did not undergo treatment at a specialized institution felt like they needed treatment.
- The following reasons were often given by those aged 12 or older with a prior year substance abuse problem who did not obtain treatment at a specialty facility but felt they needed therapy:
- 9% were not ready to stop using
- 8% didn’t know where to go for treatment
- 9% didn’t have health insurance and were unable to afford the cost of treatment
- More adolescents between the ages of 12 and 17 got mental health treatment in a specialty mental health facility, from 11.8% (or 2.9 million individuals) in 2002 to 16.7% (or 4.1 million people) in 2019.
- Studies have shown that individuals who complete an inpatient rehab program are more likely to achieve and maintain long-term sobriety than those who do not receive treatment or receive outpatient treatment only.
- In a survey of 164 opioid addicts (80% of whom had previously undergone detox), 27% reported relapsing on the day they were released from their short-term detoxification program, and 65% reported relapsing within 30 days.
- This is one reason patients are strongly advised to complete at least 90 days of treatment, ideally with at least 30 days in an inpatient care setting.4
Check Your Insurance Coverage With Virtue Recovery Center
If you’re committed to recovery, submit a request to one of our professional admission coordinators today using the form below. Before discussing the next steps, a coordinator will address any inquiries regarding our programs, including interacting directly with your insurance provider on your behalf to check your insurance coverage levels for drug or alcohol addiction rehab.
Using your Health Insurance Card, fill out all of the fields on the confidential form.
A member of our staff will contact your insurer to verify if your policy will cover your treatment
We will contact you promptly with the results of the verification and discuss the next steps
*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note that this is only a quote of benefits and/or authorization. We cannot guarantee that payment or verification eligibility will be accurate and complete as conveyed by your health insurance provider. Payment of benefits is subject to all terms, conditions, limitations, and exclusions of the member’s contract at the time of service. Your health insurance company will only pay for services it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. Suppose your health insurance company determines that a particular service is not reasonable and necessary or that a specific service is not covered under your plan. In that case, your insurer will deny payment for that service, and it will become your responsibility.
*Insurance Disclaimer: Virtue Recovery Center will attempt to verify your health insurance benefits and/or necessary authorizations on your behalf. Please note, this is only a quote of benefits and/or authorization. We cannot guarantee payment or verification eligibility as conveyed by your health insurance provider will be accurate and complete. Payment of benefits are subject to all terms, conditions, limitations, and exclusions of the member’s contract at time of service. Your health insurance company will only pay for services that it determines to be “reasonable and necessary.” Virtue Recovery Center will make every effort to have all services preauthorized by your health insurance company. If your health insurance company determines that a particular service is not reasonable and necessary, or that a particular service is not covered under your plan, your insurer will deny payment for that service and it will become your responsibility.
- Stilkind, Joseph. “Average Cost of Drug Rehab : By Type, State and More.” NCDAS, 1 Jan. 2023, drugabusestatistics.org/cost-of-rehab
- “Key Substance Use and Mental Health Indicators in the United States: Results From the 2019 National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration (SAMHSA), 2019, www.samhsa.gov/data/sites/default/files/reports/rpt29393/2019NSDUHFFRPDFWHTML/2019NSDUHFFR090120.htm.
- “National Survey of Substance Abuse Treatment Services (N-SSATS): 2020: Data on Substance Abuse Treatment Facilities.” Substance Abuse and Mental Health Services Administration (SAMHSA), 2020, www.samhsa.gov/data/sites/default/files/reports/rpt35313/2020_NSSATS_FINAL.pdf.
- “Key Substance Use and Mental Health Indicators in the United States: Results From the 2020 National Survey on Drug Use and Health.” Substance Abuse and Mental Health Services Administration (SAMHSA), 2021, www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf.
- Bailey, Genie L., et al. “Perceived Relapse Risk and Desire for Medication Assisted Treatment Among Persons Seeking Inpatient Opiate Detoxification.” Journal of Substance Abuse Treatment, vol. 45, no. 3, Elsevier BV, Sept. 2013, pp. 302–05. https://doi.org/10.1016/j.jsat.2013.04.002.
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