Substance Use

How to Get Insurance to Pay For Inpatient Rehab

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Using Your Health Insurance for Inpatient Rehab

Insurance companies are required to cover addiction services, including some or all of the cost of your inpatient treatment. To get insurance coverage, you may need to meet certain requirements, like being up-to-date on your premiums. There are other options to help cover any out-of-pocket costs that your insurance policy leaves you with. 

Getting help for drug or alcohol addiction takes courage. The last thing you want standing in your way is the cost of treatment. To help you understand what your insurance provider will cover, here’s a straightforward guide.

Do you have questions about the cost of treatment? Zinnia Health can help you get answers. Make a no-obligation call to our helpline 24/7 at (855) 430-9439 for a breakdown of insurance coverage and alternative payment options.

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Will Insurance Cover Inpatient Rehab?

If you or your loved one is entering drug rehab for the first time, you might have many questions about what health insurance will cover. There is a way to have insurance pay for 100% of your costs, but there are some requirements and limitations associated with this. 

Major insurance companies like Blue Cross Blue Shield, Aetna, and Cigna will generally pay for most or all of your treatment assuming that you:

Below is a more thorough explanation of these requirements.

1. You Must Be Up-To-Date on Your Premiums

Your premium is the amount you pay either monthly or bi-annually just to keep your insurance plan. If you haven’t been paying your premiums, you may not be covered.

Give your insurance company a call to see if you are behind on payments and, if you are, ask them what coverage you have.

2. You’ll Need To Reach Your Annual Deductible First 

Your annual deductible is based on your insurance plan. Generally, the higher your premium, the lower your annual deductible will be, and vice versa.

If you have a $2,000 annual deductible, that means you must pay $2,000 out-of-pocket for covered health services before your insurance policy will cover anything.

3. You May Still Have To Cover Copays

Your coinsurance — also known as your copay — is the amount you pay per visit or per service. The copay tends to vary depending on the type of service being provided.

For instance, a general office visit may have a $20 copay, while a specialty visit may have a $42 copay. Check your insurance policy to find this information.

Policies will limit how much you spend in copays for a given year. So, if you have been to the doctor many times this year, stayed in a hospital, or even been to rehab, you may have already met this limit, which means your insurance company will pay more.

How To Determine Your Insurance Benefits

If you are not sure what your coverage limits, annual deductible, or copays are, you need to dig up your insurance policy.

You may have been sent a paper version of this policy when you signed up for your insurance plan. If you were not, or you can’t find it, you can always access this information online by going to your provider’s portal.

If you’re unable to access that information online for any reason, give your health insurance company a call.

1. Get Information on Your Policy and Coverage

You’ll want to ask your insurance company representative a few questions:

  • Are all of my premiums paid? When is my next premium due?
  • What is my annual deductible? How much is remaining of that deductible?
  • What is my copay maximum? How much is left before I reach it?

You can also ask the representative to mail or email your insurance policy to you, which will have all of your plan limits and coverage details written out so that you can reference it.

2. Find In-Network Providers 

You may also need to find an inpatient treatment center that is “in-network,” which means they have a relationship with your insurer. Your insurance company can provide a list of in-network rehab providers.

Once you have this information, the next step is to reach out to the inpatient treatment center of your choice. 

Finding the right treatment program is important. Zinnia Health can help. With personalized addiction treatment services provided by our caring staff, we can get you back to what matters. Call our helpline 24/7 at (855) 430-9439 to get started.

Options To Cover Your Out-of-Pocket Expenses

While private insurance should be your first avenue if you have coverage, don’t be discouraged if your plan still leaves you with out-of-pocket costs.

In the event that your insurance company will not cover the total cost of your inpatient substance abuse treatment, there are alternative options.

1. Medicare and/or Medicaid

If you are eligible for Medicare and/or Medicaid, you should pursue it.

  • Medicare is a federal health insurance program that provides low-cost healthcare coverage.
  • Medicaid is a state and federal program that can help close the gaps and cover any costs that Medicare doesn’t.

If you are disabled or low-income, you might qualify for these programs.

You can find out if you qualify for Medicare on the official website and you can look into Medicaid on your state government’s website.

2. SAMHSA Grants

The Substance Abuse and Mental Health Services Administration has a block grants program where they provide money directly to rehab centers to help cover the cost of treatment for those who can’t afford it.

While these block grants tend to be designated for certain populations, like pregnant women, it’s always worth checking.

If you have a residential treatment facility in mind that you’re thinking about attending, give their helpline a call and see if they have any grants from SAMHSA (or any other organizations) available.

If you qualify for a grant, it may cover some or all of your cost of treatment, and you will not have to pay any of that money back.

3. Varying Levels of Care

Some insurance companies will limit the number of days of inpatient treatment that they will cover in a given period.

If you are running into this problem, you might consider a short-term inpatient program where you then transition to outpatient care.

While you should discuss your options with your treatment provider, know that there are many ways to address substance use disorder and financial constraints should never stand in your way of receiving care.

Zinnia Health Can Help with Inpatient Rehab Insurance Questions

There are many types of treatment available for someone trying to overcome alcohol or drug abuse. The last thing that should stand in their way is complications with insurance.

If you’re ready to explore your treatment options, why not reach out to a facility that puts people first?

At Zinnia Health, we have a team of caring recovery specialists standing by to help you choose the best treatment plan for your needs and figure out how to cover the costs. We offer:

  • Flexible, personalized rehab programs
  • Guidance in finding payment plans and grants
  • Extensive aftercare to keep you on track

If you’re ready to take the next step toward addiction recovery, Zinnia Health’s drug addiction hotline can help. Our recovery specialists are standing by to answer your insurance questions and help you get on the path to a life free from addiction. Call our helpline any time, day or night, at (855) 430-9439 to get the information you need. 

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(855) 430-9439
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