By: Ava
June 17, 2021

Does Insurance Cover Outpatient Rehab?

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Acknowledging that you need professional treatment for your addiction is a huge victory in its own right. It’s a signal that you’re serious about investing in yourself and reaping the eventual benefits of a clean life.

Once you’ve cleared that hurdle and settled on outpatient treatment as what you think would give you the best shot at lasting recovery, the next questions become; how do you pay for it, and does insurance cover outpatient rehab?

It, unfortunately, goes with the territory.

Nonetheless, understanding the costs associated with treatment is critical to making sure it fits within your means. Ultimately that boils down to knowing what your particular insurance policy covers.

What Is Outpatient Rehab?

Cost aside for a moment, let’s explore what exactly outpatient rehab is, to begin with.

In general, treatment for addiction falls under two main categories: inpatient and outpatient.

To put the distinction in the most basic of terms, inpatient rehab is where you would live at the treatment center. It’s 24/7 supervision, support, care, and guidance meant for those with the most severe substance use disorders and, therefore, an elevated risk for relapse.

Outpatient care, on the other hand, doesn’t require you to live in. You would come to your scheduled sessions, leave when they’re finished, and carry on with your day-to-day life.

The National Institute on Drug Abuse (NIDA) has this to say about them, “outpatient treatment varies in the types and intensity of services offered. Such treatment costs less than residential or inpatient treatment and often is more suitable for people with jobs or extensive social support. It should be noted, however, that low-intensity programs may offer little more than drug education. Other outpatient models, such as intensive day treatment, can be comparable to residential programs in services and effectiveness, depending on the individual patient’s characteristics and needs. In many outpatient programs, group counseling can be a major component. Some outpatient programs are also designed to treat patients with medical or other mental health problems in addition to their drug disorders”.

As you can see then, there is quite a bit of choice even within the silo of outpatient care. At Multi Concept Recovery, for example, we offer traditional outpatient treatment, partial day rehab, and intensive outpatient care.

The specific type of program you embark on is designed exclusively for you to fit your unique needs and requirements.

Does Insurance Cover Outpatient Rehab?

In a word, yes.

Generally speaking, insurance will very likely cover at least some portion of outpatient rehab, if not all of it. There may be limits like a certain number of sessions or days but there is very common coverage for it.

The scope and amount of coverage you have depend a lot on your insurance provider and your precise policy so it’s crucial to gain a thorough understanding of what costs they’ll handle. Another big factor in how much coverage you have is how much you pay in monthly premiums; the higher the premium, the more of the cost that’s covered.

You can verify your insurance benefits here.

Also, it’s important to inquire with the rehab center you choose as not all addiction treatment facilities accept all insurance. 

Setting aside the question of cost and insurance, look at it from the flipside. The cost of not getting treatment is far greater and includes:

  • The cost of addiction itself, i.e., the money wasted on drinking and drugs
  • Lost wages and missed opportunities
  • Legal fees related to crimes committed, DUI, etc.
  • Compounding health problems from substance abuse that can lead to medical bills later, ER visits due to overdose, etc.

Getting the help you require is vital and there are ways to make it affordable, if you need clarity on your insurance coverage, give us a call today and we’ll help you sort it out.