If you are researching addiction treatment for yourself or a loved one, one of the first questions you have will be: how much is it going to cost to get the care that I need?
The overall cost of drug rehab will depend on the type of treatment, whether you are living at the center (inpatient) or coming in for sessions (outpatient), length of care, and your insurance coverage.
Key points:
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- The average cost of rehab centers can vary widely, and the total cost is based on several factors such as the program type and your insurance coverage.
- There are several treatment options available if one option feels out of reach.
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- Insurance coverage is often confusing. Speaking to the right people can help you understand your coverage.
What Does Rehab Actually Cost?
The cost of addiction treatment varies widely based on which treatment program you are interested in.
Intensive outpatient programs tend to cost less than partial hospitalization programs, which in turn cost less than residential treatment programs.
It is important to keep in mind that going for the cheapest option may not end up saving you the most money in the long run.
Going to a program that is not structured enough for the severity of what you are facing can increase the chances that you have to return to treatment again.
Outpatient programs (OP or IOP)
Intensive outpatient programs are generally the least expensive option.
IOP generally includes 9-12 hours of treatment a week and last for 8-12 weeks. However, this can change depending on who you are seeing for care.
If you were to pay this completely out of pocket, each session can cost several hundred dollars, and the total out-of-pocket cost can reach several thousand dollars.
Due to the Affordable Care Act, all insurance plans cover mental and behavioral health care, including substance abuse services.
This means that if you have insurance, you will likely not pay the full out-of-pocket cost.
Partial Hospitalization Programs (PHP or Day Treatment)
Partial hospitalization programs (PHP) are similar to IOP programs in that they are also outpatient. However, day treatment sessions usually run longer, often the entire day.
Since PHP includes a more structured program, greater supervision, and longer, more intensive days, it costs more than IOP at most treatment centers.
That added time and support can be especially helpful for people who are at higher risk of relapse or need more stability to begin making progress.
PHP also gives people more time each week to build coping skills, work through challenges, and stay engaged in treatment.
While it may be tempting to choose fewer hours to lower the cost, not getting enough support can make recovery harder and create setbacks that cost more in the long run.
Residential and inpatient treatment
Residential treatment and inpatient rehab programs provide 24/7 care and support where you live at the residential treatment center.
These programs are different from an inpatient detox program, which you often need to complete before entering rehab facilities, and can sometimes all be done at one treatment center.
Residential and inpatient programs are for those with a more severe substance use disorder, such as serious alcohol addiction or drug abuse.
They are also helpful for clients who require more than outpatient treatment and who need a safe and supportive living environment.
Luxury rehab options exist, and often cost more due to greater amenities.
Detox programs
Detox programs are often the first step in drug addiction treatment and can help you safely navigate withdrawals with close medical supervision.
Detox will typically last shorter than the intensive outpatient options and residential treatment.
While they are shorter, they also require more medical staff and medical supervision. Again, cost varies greatly due to insurance coverage. However, out-of-pocket costs can be several thousand to tens of thousands for care.
Does Insurance Cover Rehab? It Covers More Than You Might Think.
All Marketplace insurance plans are required to cover mental health and substance abuse services as they are considered essential health services.
While your health insurance might not cover the entire cost, it often significantly reduces out-of-pocket costs.
What insurance typically does (and doesn’t) cover
Most insurance plans cover:
- Rehab facilities
- Detox
- Outpatient services
- Therapy and counseling
- Medication-assisted treatment (e.g., methadone for opioid-use disorder)
- Residential treatment
Cost will depend on whether you have met your deductible for the year, whether you have a high-deductible plan or pay a coinsurance rate, any applicable co-pays, and whether the treatment center is in-network.
What the Mental Health Parity and Addiction Equity Act means for your family
The Mental Health Parity and Addiction Equity Act ensures that insurance plans cover mental health and substance use disorders “no more restrictively than medical or surgical care”.
Generally, this means that for your mental health treatment plans, things like copays, visit limits, and approval requirements must be comparable to those for health issues or medical or surgical conditions like heart disease.
However, it does not guarantee that every type of treatment is covered. What it does do is ensure that if coverage exists (for example, if your plan already offers mental health coverage), then it must be offered fairly.
How to find out what your plan covers quickly
Ways to find out what your plan covers quickly include:
- Calling your insurance provider
- Asking to speak to a behavioral health advocate through your insurance (many plans have staff who specialize in connecting clients with mental health services)
- Asking treatment centers to verify your insurance plan and help explain coverage options.
Treatment centers can typically show how much of your deductible you have already used and provide a breakdown of the estimated cost.
At Sandstone, we have an instant insurance verification tool, and you can call or chat with us during business hours to ask our staff any questions you might have about insurance coverage and cost. Give us a call at (888) 850-1890.
What if my insurance doesn’t cover everything?
Even with insurance coverage, many clients experience out-of-pocket expenses. However, typically you have options to help you pay for rehab treatment.
Many treatment centers offer payment plans, and some hospitals or larger programs may also have grants, scholarships, or charity care to help lower the cost.
There may also be other ways to make care more manageable. Some people use HSA or FSA funds for qualified medical expenses. Others may qualify for free or low-cost services through health centers, state behavioral health agencies, or support groups.
Sliding scale fees and income-based options
Many rehab and treatment centers offer sliding scale pricing based on your income as a form of financial assistance.
Medicaid coverage for behavioral health and substance use treatment
Both Medicaid and Medicare may cover:
- Outpatient rehab
- Detox
- Some residential treatment
Medicaid and Medicare can both help cover behavioral health and substance use treatment, but coverage depends on the type of care you need, where you live, and the details of your plan.
Medicaid benefits can vary by state, while Medicare coverage often depends on the part of Medicare you have and whether the provider or program meets Medicare rules.
While Sandstone Care does not currently accept Medicaid or Medicare, our team can still help point you toward other treatment options that may be a better fit for your coverage and care needs.
Financial questions to ask a treatment center upfront
Good questions to ask a potential treatment center include:
- Can you please provide me with a breakdown of my estimated out-of-pocket expenses?
- Are all parts of the treatment required, or is there a way to reduce services and cost?
- Do you offer payment options?
- Are there any additional fees I should be aware of?
For example, medications may cost extra. Many treatment centers order them through a pharmacy and bill your insurance separately.
What Changes the Cost of Rehab?
Several factors impact the cost of treatment, such as your insurance, deductible, how long you stay, and how many hours you are in rehab each week.
Where you are in your insurance plan for the year
If you have already used up your deductible or reached your max out-of-pocket costs for the year, you might not pay anything at all.
Be aware of where you are in your plan year, as plans often roll over at the start of the New Year.
For example, if you start treatment in December and have reached your out-of-pocket max, you might not pay anything for that month.
However, depending on your health care plan, you could start owing much more once January rolls around if that is when your private insurance plan year changes over.
How many hours per week
In general, more hours of treatment each week means a higher cost.
For example, Partial Hospitalization Program (PHP) care usually costs more than Intensive Outpatient Program (IOP) care because it includes more treatment time and support.
At the same time, it is important not to choose fewer hours just to lower the cost if that level of care is not enough.
A program that looks less expensive upfront can end up costing more over time if it does not provide the amount of support needed to make real progress.
Length of stay
A longer stay isn’t necessarily more expensive.
A residential stay where room and board are factored into the cost often incurs greater costs. However, that doesn’t necessarily mean that you will pay more.
Ultimately, for many, a longer stay can improve outcomes and reduce relapses during their recovery journey.
Location and amenities
Things that can drive up costs include:
- Private rooms
- Specialized services
- Location
- Luxury centers with amenities
Dual diagnosis
When a client has both mental health conditions, such as anxiety, depression, or bipolar disorder, alongside a substance use disorder, it is known as a dual diagnosis.
Because each condition can affect the other, treatment needs to address both at the same time. That can make care feel more involved, but it does not always mean treatment will cost more on its own.
For most people, the biggest cost differences still come down to the level of care, length of stay, insurance coverage, and any additional services that may be needed, such as psychiatric support or medication management.
Treating both conditions together can also be important from a cost standpoint in the long run. When only one issue is addressed, setbacks, relapse, or worsening mental health symptoms can lead to more disruption and a greater need for care later on.
How Much Does Rehab Cost for Teens & Young Adults?
Sometimes programs for teens and young adults include additional services and staff that may drive up the cost.
Why adolescent and young adult programs are often structured differently
Because the brain is still developing through adolescence and young adulthood, mental health symptoms, substance use, stress, and recovery can all look different during this stage of life.
Treatment for teens and young adults is often structured differently to reflect how brain development affects emotional regulation, decision-making, relationships, and the ability to build new coping skills.
Most teens are still in school, so many treatment programs include academic support, such as a certified teacher or staff member who helps clients stay connected to school and make a plan for keeping up with their education.
Family member involvement also tends to play a bigger role in teen treatment. Parents and caregivers are often closely involved in daily support, structure, transportation, communication, and decision-making, so family therapy is often a core part of care.
Teen programs also often have stricter staffing requirements to help maintain safety and provide closer supervision. That usually means having more staff members available throughout the day.
Outpatient care options that fit around school or work
Intensive outpatient programs can often fit around school or work if you are unable to take time away.
Oftentimes, these programs also have an online option offered by the recovery center. At Sandstone, we offer both in-person and virtual IOP options, so you have the flexibility to pick a program that meets your needs.
Typically, clients find they need to take time off from work for PHP outpatient programs.
When residential treatment is the right level
Sometimes residential treatment is needed. Times when inpatient rehab is recommended may include:
- Severe dependency
- Safety concerns
- Outpatient therapy wasn’t enough
- Lack of support at home
- Need for a structured environment
How to Figure Out What You Will Actually Pay
Many treatment centers do not list exact prices on their website. This is because costs can vary widely for each person, and this usually depends on their specific insurance coverage.
Questions to ask when you first call a treatment center
Good questions to consider asking include:
- What are my estimated out-of-pocket costs?
- Do you accept my health insurance?
- What happens if I need a longer stay?
- What happens if I choose to leave early?
- Can you provide referrals to other treatment facilities if you do not accept my insurance?
What should I do next?
If you are considering a rehab program:
- Verify your insurance, or reach out to your insurance provider and ask for a list of in-network options
- Reach out to any additional centers you are interested in and ask if they take your insurance or offer other forms of financial assistance
- Compare your options
- Reach out to interested treatment centers to ask about starting the admissions process
- Also, ask about the discharge planning process and whether there is help with setting up aftercare or sober-living options, if needed.
While cost is a big part of choosing the right treatment program, it is also about finding a center that you feel supports your long-term recovery goals.
