Residential Drug Rehab


Although residential drug rehab has been shown to maximize sobriety success rates, less than 15 percent of those needing professional drug rehabilitation ever experience residential drug rehab treatment. Many patients avoid seeking residential drug rehab treatment because they perceive that therapeutic stays will be cost-prohibitive. However, insurance coverage can enable the majority of individuals to facilely afford treatment, by greatly reducing the cost of residential drug rehab, even in some cases, leaving the resident with virtually no financial burden at all.

Steps to Speaking with Your Insurance Company About Residential Drug Rehab


After you have made the life-changing decision to enter residential drug rehab treatment, you will want to contact your insurance company in order to organize and understand the details involved with your coverage and treatment. Below, you’ll find an accessible primer to help you navigate your initial phone call to your insurance company regarding residential drug rehab coverage.

Confirm That Your Insurance Policy Is in Effect

Because of issues with bill payment that may have arisen during drug addiction, your first question when you contact your insurance company to inquire about costs and coverage associated with residential drug rehab should be to confirm that your policy is still in good standing. Make sure that you are up to date on policy premiums, and then ask to speak to an insurance representative about your substance abuse policy coverage and benefits. Should you find that your insurance policy has entered lapsed status due to nonpayment or other issues, inquire about the steps you need to take in order to reinstate insurance coverage.

Ask About Coverage Flexibility

Secondly, you’ll need to ask about benefits covered under your drug rehab insurance policy that may apply to residential treatment stays. Some insurance policies will categorize core components of residential drug rehab programs under other coverage areas, such as prescription medication plans, mental health coverage or preventative care. As such, contact the residential drug rehab center of your choice and ask the intake specialist for a list of services involved in treatment. You can make inquiries at your health insurance company as to whether any services and costs uncovered by your substance abuse policy are covered under other areas of care.

Inquire About Insurance Limitations on Residential Drug Rehab Coverage

Some insurance policies provide restrictions on the extent or number of residential drug rehab stays covered. Ask about the allowed number of days you may spend in residential drug rehab, as well as any lifetime limits on the number of treatment stays you are entitled to (particularly if you have relapsed and are reentering drug addiction treatment).  Also, ask your insurance company about any financial burdens that may be out of pocket for you as you approach residential drug rehab, such as annual deductibles that first need to be met before coverage initiates, or copayments that you may need to make as you proceed through treatment.

Understand Additional Treatment Approval Policies

In some cases, your insurance company may approve exceptions to policy treatment caps so long as preset criteria has been met. In some cases, you may be able to receive approval for extensions of residential drug rehab duration, additional therapy sessions or other specialized services involved in long-term treatment. Make sure that you understand the procedure for requesting such exceptions – often involving justification in writing by treating doctors – in order to gain approval should the need arise.

Ask About Eligibility Requirements for Residential Drug Rehab

Some insurance companies will require that you meet certain, pre-specified eligibility requirements before treatment at a residential drug rehab center will be covered. These can include professional diagnosis by a clinical therapist, a prescription for rehab provided by your personal physician, or meeting of prerequisite criteria before treatment is allowed.