The costs associated with medical services, including therapy for substance use disorders, can be high. The National Institute on Drug Abuse estimates that the average cost for a full year of methadone maintenance treatment is close to $5,000. This does not include and counseling or therapy and other medical services that may be needed, such as medications for mental health disorders, other medical conditions, etc. While it is easy to speculate that getting treatment for a serious substance use disorder is much less costly than continuing to live with the complications that are associated with having such a disorder, paying for the treatment is still an issue for many. There are several options that individuals can use to assist them in paying for treatment for a substance use disorder. The bottom line is: yes, you can afford treatment.
Individuals who have insurance will have an advantage when it comes to affording treatment for substance use disorders compared to individuals who do not. Individuals who have any type of health insurance may have at least partial coverage for treatment; however, not every insurance program will cover specific types of treatments for these disorders, and many individualized insurance plans will not cover the entire cost of treatment for a substance use disorder.
Many health insurance plans will cover a good percentage of withdrawal management treatment programs. Most of these will cover a good number of the expenses for inpatient withdrawal management but may not cover costs that are not directly related to the treatment itself, such as the cost of food. Therefore, if an individual is going into an inpatient withdrawal management program, it is important to find out what costs will be covered and what costs will not be covered. In addition, anyone undergoing a withdrawal management program should make sure that the referral to the program is completed by a licensed physician, as insurance companies will more readily accept these referrals than referrals made by therapists, social workers, counselors, etc.
Rapid detox treatments are typically not covered by most insurance programs because these treatments have very little research to support them. They are still considered to be experimental, and they are often deemed to be dangerous.
Outpatient treatment for substance use disorders is covered by a good number of insurance plans. Typically, these programs have some type of out-of-pocket expenses associated with them, such as a deductible or co-pays.
Individuals who are unsure as to the coverage of their particular insurance plan should simply call their customer service representative and discuss the issue with them. A customer service representative can typically answer all questions regarding coverage. Individuals can also contact treatment providers directly and discuss coverage with intake counselors.
Options for Individuals with No Insurance
Even if someone has no insurance, they may be able to either get coverage or find a way to cover the cost of substance use disorder treatment. There are several options that one can investigate. These include:
- Governmental insurance programs: Even if one has already been diagnosed with a substance use disorder before acquiring insurance, insurance providers can no longer exclude individuals with pre-existing conditions. There are a number of public insurance programs, such as Medicare (can be used for low-income individuals or individuals with disabilities), Medicaid, and the Children’s Health Insurance Program, that will cover medical expenses for individuals from low-income groups. The actual amount of coverage will depend on the individual and their situation. One can shop for affordable insurance at the Marketplace online. Individuals interested in finding out if they qualify for Medicaid can apply directly at the Medicaid application website.
- Treatment may begin before full enrollment. Many community treatment centers will begin treating individuals who have signed up for Medicaid or some other form of public assistance. Your enrollment in the program does not need to be complete.
- Use SAMHSA: If getting any form of insurance is totally out of the question, individuals still have a number of alternatives. One viable alternative is finding reliable but low-cost treatment for substance use disorders. The federal government gives money to various state agencies to offset the cost of substance abuse treatment in the state, and these funds are controlled by the Substance Abuse and Mental Health Services Administration (SAMHSA). An individual may be able to access relatively inexpensive treatment for substance use disorders through the SAMHSA website.
- Look to the state. Many states have state-run treatment programs for individuals with substance use disorders. One can check their state website to see if these programs exist in their area. Simply go to the state website (the name of your state followed by .gov) and look under behavioral health services, mental health services, and related titles. Some states have addiction treatment hotline phone numbers that can be found online as well.
- Look for programs that offer a sliding scale treatment plan. A number of state-run community treatment centers will offer treatment services on a sliding scale. These programs adjust the payment for the treatment based on the individual’s ability to pay (typically on their income level). A number of universities have formal clinical psychology graduate programs, and many of these may offer therapy on a sliding scale in order to provide experience to advanced graduate students. All of the graduate students in these programs are supervised by licensed psychologists. For individuals who need therapy for substance use disorders, this may be a viable option.
- Finance your treatment. One can borrow money from family or friends and arrange a payment plan with them to pay them back. Some treatment programs also offer a payment plan option to finance treatment. Prospective clients can ask intake counselors if this option is available. Some individuals may be able to secure a loan from a finance company or bank.
- Look into free options. There are a number of free supportive programs that are offered by support groups or even nonprofit organizations. Some of the most well known of these are Alcoholics Anonymous, Narcotics Anonymous, and other 12-Step groups that can be attended without cost. These groups finance themselves through donations by their members; however, individuals are not required to pay a penny for attending. These programs offer excellent social support, they are extremely accessible as meetings are held nearly every day at different times and ongoing. One does not have to make an appointment, sign a contract, or do anything other than show up. Individuals who have issues with transportation can often ask other members for help, and transportation is often provided for these individuals. There may be a number of other community treatment groups that are inexpensive or relatively free. In some states, the Salvation Army has free care options available for individuals with substance abuse issues.
The bottom line is that most individuals can afford some form of treatment. There are a number of options to paying for treatment for a substance use disorder, and there are a large number of relatively inexpensive or even free treatment options available for anyone who wants to access them. The best policy is to keep asking questions and looking for the treatment option that best fits your individual needs.