Does Health Insurance Cover Detox?


If you’re ready to get help for your addiction, knowing where to start can be daunting. Cost is definitely an understandable concern, as well as what steps to actually take. 

The great news is, that it doesn’t have to be daunting at all. There are many ways of paying for drug detox programs. Between using health insurance for detox, and affordable cash pay rates, there are options available. Figuring out which one works best for you is the next step.

What is Drug and Alcohol Detox?

Drug and alcohol detox is the intervention used for physical or clinical dependence on drugs or alcohol. It also helps alleviate withdrawal symptoms and provides care for overdose patients.

Will Insurance Pay for Alcohol and Drug Detox?

While it depends on which insurance company, and plan you are currently a part of, the answer to this question is usually yes. Many health insurance companies, group policies, and even Medicaid/medicare cover at least a portion of a detox program.

The insurance carrier may ask that you go to an “in-network” facility, or approved provider. Doing so could cost less out of pocket in terms of expenses like deductibles and co-payments. If a treatment center is out-of-network, they may still be able to accept your insurance policy and provide treatment.

How Long Does Insurance Cover Detox?

Just like the level of coverage, the length of stay in a detox facility is variable, as well. If the health insurance covers detox, the insurance provider will most likely work with the facility and its doctors to determine what types of treatment are needed. They will then come up with an individualized treatment plan. It is typical for an insurance company to cover the entire detox stay, and even cover some or all of the next steps like inpatient rehab

The Affordable Care Act & Drug Detox

The Affordable Care Act requires that all health insurance plans provide coverage for behavioral health services. This includes drug & alcohol detox and treatment. The ACA also requires insurance coverage for the treatment of mental illness, which can go hand in hand with substance abuse. The level of coverage does still depend on each individual plan.

Factors That May Determine If Insurance Will Cover Medical Detox

When choosing a medical detox facility it is crucial to choose one that is either in-network or on an approved list for your insurance provider. This way you can ensure you are maximizing your benefits. 

Even though the ACA has mandated that addiction treatment be covered, insurance companies will often request proof from a doctor that detox is “medically necessary”. This is usually done during treatment or upon admission by the facility you are going to.  

Verify Your Insurance Benefits

There are a few ways to verify your insurance benefits to ensure you are maximizing your benefits package. Usually, there is a toll-free number on the back of your insurance card. Calling the insurance company directly is always a great start.

 If you are not confident you will know what to ask, you can always call us at Agape Detox Center. There are admissions coordinators ready to help you. If you would prefer to verify your insurance digitally, our website has a “Verify Insurance” button on the top left of our website. You can fill out the secure and confidential form, and we will contact you to discuss treatment options.

How to Pay for Detox Without Insurance

If you don’t have health insurance that covers detox or have a plan that doesn’t include addiction treatment, there are other options you can explore. Depending on circumstances, affordable cash pay rates might be an option for you if you are uninsured. Some facilities also offer scholarships or have government funding. The way to find out specifics is to contact our detox center to talk to an admissions coordinator. 

Taking the next step may feel difficult, but we are here to help! Call us today so we can get you the help you need, and deserve! 

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