Will My Health Insurance Pay for Rehab in California? - ARISE Treatment

Using Health Insurance to Pay for Drug and Alcohol Rehab

Addiction takes a toll on your mental and physical health. It can strain even your strongest relationships, put you at risk of serious harm, and lead to legal and financial trouble that can follow you for life.

Many people with addiction require treatment to overcome the condition. There may be barriers to getting the treatment you need. The stigma surrounding addiction, taking time away from work or family, and concern about the cost of addiction treatment may prevent some people from seeking help. Fortunately, many of the expenses related to addiction treatment and recovery are covered by health insurance plans.
If you or someone you love lives with substance abuse or addiction, you must get the support and treatment you need to avoid addiction’s devastating, lifelong consequences. Understanding how to use insurance to go to rehab and your other payment options can help you make the best decisions about your care.

Contact the caring specialists at Arise Treatment Center today for information about starting addiction treatment.

Does Insurance Cover Rehab?

Many people wonder if their health insurance will cover the cost of substance abuse treatment or rehab. The Affordable Care Act (ACA) is a law passed in 2010. It requires health insurance providers to pay for addiction treatment and mental health costs. Even though insurance providers are required to cover these types of treatments, plans can vary significantly in what programs and therapies they cover.

When considering a treatment program, it is essential to determine what costs will be covered by your plan and which will be your responsibility. You must verify the benefits of your specific plan before beginning treatment.

In many cases, you must first get an evaluation and diagnosis from a medical professional or addiction specialist before using insurance to pay for rehab. This evaluation will consist of a medical and mental health summary, questions about your substance abuse and treatment history, and other personal information. The practitioner will use this information to determine which level of care or type of treatment program is suitable to meet your needs.

There are several levels of care in addiction treatment, including:

  • Medically-supervised detox
  • Inpatient or residential
  • Outpatient
  • Partial hospitalization programs (PHP)
  • Intensive outpatient programs (IOP)

Once your addiction specialist has recommended a level of care, you can begin to look for an appropriate rehab or treatment program.

What Levels of Care Are Covered By Insurance in California?

Addiction treatment is offered at several levels, and many insurance providers cover all levels of treatment. Addiction specialists adjust the program length and therapies used because addiction is not a single-size-fits-all condition. The severity and length of your addiction, your history of treatment attempts, mental health or medical conditions, and the kinds of substances you used will affect your treatment plan. There are four primary levels of care you may find at an addiction treatment facility.


Many people begin substance abuse treatment by completing a supervised drug and alcohol detox program. Detoxification is the body’s natural process of eliminating toxins. As this happens, you may experience symptoms that can be highly uncomfortable. Some withdrawal symptoms, such as changes in blood pressure or seizures, can be dangerous.

When you go through a medically supervised detox program, you receive supervision and treatment for your withdrawal symptoms to keep you as safe and comfortable as possible during the detox process. You also receive support to keep you from relapsing when your cravings for drugs or alcohol are likely to be intense. These forms of support may allow you to experience a complete detox. Research suggests that participating in a supervised detox program increases the likelihood of long-term success.

Inpatient treatment

Inpatient residential treatment is a good option for people who need intensive addiction treatment with 24-hour care. You will receive medical care, individual and group therapy, and education during an inpatient treatment program. The goal of an inpatient treatment program is to give people the skills they need to live healthy, fulfilling lives without using substances. Inpatient treatment also provides constant support and therapies that can keep people medically and emotionally comfortable during the treatment process.

The length of time you spend in an inpatient program will depend on the length and severity of your addiction and other personal and environmental factors. Residential treatment is ideal for people who do not have safe housing and those who require medical or mental health care.

Intensive Outpatient Treatment

Intensive outpatient treatment (IOP) may benefit people who need intensive care. It is essential to ensure that people in an IOP have stable housing where no one will be using drugs or alcohol to reduce the likelihood of relapse.

In this level of care, people have a structured treatment schedule that includes group therapy, education, individual counseling, and family therapy. Instead of living at the facility, people return home to sleep after their daily treatment activities. This makes IOP treatment a good option for people with family responsibilities and those who want to stay connected to their community support.

Intensive outpatient treatment can be a choice for people who want intensive treatment but are unwilling or unable to participate in residential treatment. It can also let people practice sobriety in their environment, which may provide valuable insight into their commitment to maintaining sobriety in real life. It may not be the right choice for those with significant medical or mental health needs. While people with special considerations receive medical or mental health care referrals, those services are generally unavailable to those in IOP programs.

Outpatient Treatment

The goals of outpatient treatment are the same as other levels of care: to teach people the skills they need to avoid relapse in the future by helping people understand the roots of their addiction.

Outpatient treatment is the most flexible of all the levels of care provided in addiction treatment. People receive high-quality, focused care from mental health and addiction practitioners while being able to work, care for family members, or attend school.

Participating in outpatient addiction treatment is a good option for people who are not ready or willing to complete a higher level of care. It allows people to practice being sober and managing cravings while facing real-life triggers. Outpatient care is ideal for people who have already completed a higher level of care, such as IOP or inpatient treatment but want more support.

What Factors Affect the Cost of Addiction Treatment?

Many things can affect the cost of addiction treatment. These include:

  • Services: The type of services offered can affect the cost of addiction treatment. Facilities that provide mental health care, medical services, or other specialized services may cost more than more basic programs that do not.
  • Location: The cost of treatment can vary based on the program’s location. The number of centers, availability of treatment programs, and cost of providing treatment may impact the overall cost of treatment in different areas.
  • Level of care: Inpatient and residential treatment programs are more expensive than outpatient programs.
  • Length of stay: Longer treatment programs tend to cost more than shorter ones.
  • Special requirements: Medical care, mental illness, pregnancy, and other factors can increase the cost of addiction treatment because they require specialized care.
  • Amenities: Luxury rehab facilities may charge more for their programs than standard rehab centers. Amenities like massage, acupuncture, yoga, or gourmet meals can be wonderful during treatment but tend to raise the cost of treatment considerably.

Choosing the best program for your needs is essential, regardless of cost. Before beginning treatment, verify the coverage offered under your specific health insurance plan to determine what costs you will be responsible for.

How to Verify Your Coverage Before Using Insurance to Pay for Rehab in California

Before beginning treatment, it is crucial to verify the details of your specific plan. Without doing so, you may be surprised by unexpected out-of-pocket expenses later. There are several ways to check the details of your particular insurance plan. You may:

  • Call the number on your health insurance card and speak to a representative about the treatment you need.
  • Visit your insurance company’s website to learn more about covered services and find providers.
  • Ask the staff at your treatment facility to navigate your insurance plan.

Often, treatment programs have dedicated staff to help clients verify their insurance and make payment plans, if necessary. The specialists at Arise Treatment Center work with insurance companies so people living with addiction can focus on the most important thing: their recovery.

How to Find an In-Network Rehab Facility in California

After determining the level of care you need, you can look for a facility that offers those services. Choosing a facility that accepts your insurance will ensure your plan will cover the services you require at the highest level. You can locate addiction treatment facilities that accept your insurance in several ways, including:

  • Call your healthcare company and speak to a representative about your options
  • Search the insurance company’s website for in-network providers and programs
  • Ask the staff at the treatment facility

Many insurance companies provide coverage for addiction treatment, and most facilities accept a broad range of insurance plans. However, it is crucial to ensure you understand what services, treatments, and providers your specific plan covers. Before starting treatment, make sure you know what expenses will be covered and what you will need to pay out of pocket.

Paying for Rehab Without Insurance

Concerns about paying for treatment can sometimes keep people from getting the help they need. This may be especially true for people who do not have individual health insurance. Research suggests that only about 11% of people with substance abuse or addiction ever get treatment. Those who do eventually seek help may live with their addiction for months or even years.

Going through rehab or addiction treatment can be the only thing that helps people overcome addiction and learn how to live a healthy, sober lifestyle. There are several ways to pay for the treatment you need if you don’t have insurance or your insurer won’t cover certain services. They include:

  • Borrowing from savings or your 401k
  • Asking friends or family to support your recovery financially
  • Applying for a financial grant or scholarship for rehab
  • Working with your treatment facility to form an affordable payment plan

Worrying about the cost of treatment shouldn’t prevent you from getting help. Without treatment, addiction is unlikely to improve. You may face devastating mental and physical health consequences, relationships, and overall quality of life.

There are always ways to afford addiction treatment. Staying addicted is too costly.  The staff at Arise Treatment Center can help you find the right treatment program and payment plan you need to succeed in recovery.

Get Help Now

If you or someone you love requires addiction treatment, reach out to the specialists at Arise Treatment Center today. We are in-network with many major health insurance providers in California and can help you begin your recovery journey.


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