Cocaine Rehab Treatment Insurance Coverage
When you get treatment as soon as you realize you need it, your outcome is better, but you need to have a plan for dealing with cocaine rehab insurance. Your first step is to learn the details of your health insurance plan and the drug rehab coverage it provides.
The main types of health insurance plans that cover cocaine rehab treatment include:
- PPO plans
- HMO plans
- POS plans
- Employer Group plans
- Medicare plans
- Medicaid plans
These plans all work in similar ways to cover cocaine rehab costs. You usually pay a monthly premium and must meet a deductible before you get coverage. Depending on your plan, your cocaine addiction treatment may be 100% covered or there may be a copay or a coinsurance fee that you must pay.
From there, the details are different depending on the insurance provider, policy type, and whether you have private or state-funded insurance.
Here’s what you should know about cocaine rehab insurance and what it covers:
What is Precertification and Prior Authorization for Cocaine Treatment?
Nearly all health insurance providers require precertification or prior authorization before they’ll cover cocaine addiction treatment. (They’re both terms for the same process.)
Precertification is an insurance process that verifies that cocaine rehab treatment is medically necessary. Your family doctor might handle this process, or you may need a referral to a behavioral health doctor, who will handle it.
Once your insurance company verifies the precertification with your medical provider, they’ll let you know your cocaine rehab insurance coverage.
What Are Deductibles for Cocaine Treatment?
A deductible is the amount you must spend out-of-pocket before your insurer covers cocaine treatment. Your deductible starts over every year, either at the start of the calendar year or the start of your annual policy.
The amount of the deductible can be as low as $200 if you have government-funded insurance like Medicare or Medicaid. The average deductible for a private insurance plan ranges from $1,200 to $2,500 depending on the policy, plan, insurer, and your location.
What are Copays for Cocaine Treatment?
A copay is the amount that you must pay out-of-pocket when your insurer covers cocaine rehab treatment. If your insurer offers partial coverage for cocaine addiction treatment, then you’ll be responsible for a copay.
Not all insurance policies include copays for cocaine treatment. If your policy offers 100% coverage, you won’t need to pay a copay.
What Are Lifetime Limitations for Cocaine Treatment?
Some insurance policies include a lifetime limitation for cocaine treatment. A lifetime limit means that you receive coverage up to a certain dollar amount or days spent in treatment.
Once you pass the lifetime limit for your plan, your insurer won’t cover cocaine treatment anymore. That doesn’t mean you can’t get treated for cocaine addiction—it simply means that you should look for another insurance plan that will keep covering it.
What Are Premiums for Cocaine Treatment?
A premium is the monthly fee you pay your insurer to keep your health insurance plan active.
When you have state-funded insurance like Medicare or Medicaid, most people don’t pay a premium. If your coverage requires a premium, the standard for Medicare is up to $471.
For private insurance plans, the average premium is $1,000. If your plan is employer-funded, then your premium is likely to be much less.
What Factors Into the Cost of Cocaine Addiction Treatment?
There are many factors that go into the cost of cocaine treatment. They include:
Types of Rehab Addiction Center
The rehab center itself (and its programs) can determine the cost of treatment. The factors include location, size, length, and programs offered.
Location of the Addiction Center
The cost of a treatment center can vary depending on the state and city where you attend cocaine rehab. Urban treatment centers are often costlier due to demand, while rural treatment centers may be more affordable.
Size of the Addiction Program
Small, cozy addiction programs may cost more, since there’s a bigger ratio of staff to patients. Larger addiction programs that are less personal may be more affordable.
Length of the Addiction Program
Addiction programs for cocaine treatment can range in length from a few weeks to a few months. Longer programs cost more than shorter programs.
Cocaine Rehab Treatments Offered
Some types of treatment for cocaine use disorder are more intensive than others. That means they may cost more, but you should still expect coverage to some extent.
Cocaine Detox
Cocaine detox programs are necessary for the early stages of recovery, so insurers always cover them. These programs reduce the risk of relapse by monitoring and treating the symptoms of cocaine withdrawal.
What is Cocaine Detox?
A cocaine detox program uses supportive care to help you through withdrawal from cocaine. You may receive:
- 24/7 monitoring
- IV hydration
- Nutritional support
- Symptom management
How Long Does Cocaine Detox Take to Complete?
Cocaine detox programs often last 5 to 7 days. The average withdrawal process takes 3 to 5 days.
Why Cocaine Detox Plays a Critical Role in Addiction Recovery
Cocaine detox is a critical part of recovery because it reduces the risk of relapse. You’re the most vulnerable to relapse when you first stop using cocaine. Detox programs help you commit to recovery and stay safe and comfortable.
Cocaine Inpatient Rehab
Inpatient rehab for cocaine addiction is usually covered if it’s medically necessary. These intensive treatment programs are a first-line treatment for most people who need cocaine rehab.
What is Cocaine Inpatient Rehab?
Cocaine inpatient rehab is a residential program that helps you start recovering from cocaine addiction. Residential programs for cocaine treatment usually include behavioral treatment like counseling or cognitive-behavioral therapy.
How Long Does Cocaine Inpatient Rehab Take to Complete?
Cocaine addiction programs should last at least 90 days, if not longer. The longer you attend cocaine treatment, the better your outcome can be.
Why Cocaine Inpatient Rehab Plays a Critical Role in Addiction Recovery
Cocaine inpatient rehab gives you a treatment-focused place to recover, which is critical for dealing with your addiction. While you’re in treatment for cocaine use disorder, you’ll be in an environment free of temptation with no possibility of relapse.
Cocaine Medication-Assisted Treatment Rehab
Cocaine rehab insurance does not cover medication-assisted treatment rehab. That’s because MAT doesn’t work for cocaine use disorder, and insurance companies only cover evidence-based treatment.
Cocaine Outpatient Rehab
Cocaine outpatient rehab is covered by most insurance policies as a medically necessary treatment. These part-time programs may cost less overall than detox or residential inpatient programs.
What is Cocaine Outpatient Rehab?
Outpatient rehab for cocaine is a complete treatment program that includes behavioral treatment, addiction education, and social support. You may attend daily (partial hospitalization programs) or a few times a week (intensive outpatient).
How Long Does Cocaine Outpatient Rehab Take to Complete?
Cocaine outpatient rehab should last at least 90 days. Since outpatient rehab is flexible, you should attend as long as possible beyond 90 days.
Why Cocaine Outpatient Rehab Plays a Critical Role in Addiction Recovery
Outpatient rehab for cocaine addiction makes it possible for you to recover without sacrificing responsibilities.
If childcare or work keep you from seeking help, cocaine outpatient rehab can make treatment accessible.
Addiction Rehab Amenities at Bedrock Recovery Center
The amenities at your treatment center may affect the cost. At Bedrock Recovery Center, the amenities include:
- Beautifully Remodeled Facility
- Movie Theatre
- Fitness Center
- Outdoor Recreation
- Yoga Studio
- Salon
- Laundry Services
- 5-Star Food Service with Gluten-Free and Vegetarian Options
What Types of Health Insurance Cover Rehab Treatment?
All long-term health insurance plans cover rehab treatment as long as it’s evidence-based and medically necessary.
Do Private Health Insurance Plans Cover Rehab?
Private health insurance plans cover rehab for cocaine addiction, including:
- PPO health insurance
- HMO health insurance
- POS health insurance
- Employer group health insurance
Do PPO Insurance Plans Cover Rehab?
PPO health insurance plans cover rehab for cocaine treatment in most cases. You may need a referral or prior authorization for full or partial coverage.
What is a PPO?
A PPO is a Preferred Provider Organization. This type of insurance plan allows you to use treatment providers that are out-of-network, but your out-of-pocket cost might be higher.
Do HMO Insurance Plans Cover Rehab?
Like all long-term plans, HMO insurance plans generally do cover rehab for cocaine treatment. You must follow the prior authorization process to get coverage for cocaine rehab.
What is a HMO?
An HMO is a Health Maintenance Organization. These health insurance plans require that you use a provider that’s in-network. If you choose an out-of-network provider, you’ll be responsible for 100% of the costs.
Do POS Insurance Plans Cover Rehab?
POS plans cover cocaine rehab that’s medically necessary. You can choose in- or out-of-network providers, but your cost is higher with out-of-network rehab.
What is a POS?
A POS is a Point-of-Service health insurance plan that’s a combination of HMO and PPO. These plans have more flexibility than PPO plans and are more affordable than HMO.
Do Employer Group Insurance Plans Cover Rehab?
All long-term employer group insurance plans cover rehab for cocaine addiction if it’s medically necessary. You might get partial or full coverage for cocaine treatment with an employer group plan.
What is an Employer Group Insurance Plan?
An employer group plan is a healthcare policy that’s partially paid by your employer. It can be an HMO, PPO, or POS plan.
Do Federal and State Health Insurance Plans Cover Rehab?
Government-funded healthcare plans cover medically necessary rehab for cocaine addiction. That includes state-funded Medicaid plans and federal Medicare programs.
Do Medicare Insurance Plans Cover Rehab?
All Medicare plans cover cocaine rehab that’s considered reasonable and necessary. Like other types of insurance, your coverage for cocaine treatment might require prior authorization.
What Are Medicare Insurance Plans?
Medicare is a federal healthcare program for people who are over 65 years old or people with certain disabilities. These plans are low-cost or even no-cost depending on your situation.
Do Medicaid Insurance Plans Cover Rehab?
Medicaid insurance plans cover medically necessary rehab for cocaine use disorder. Depending on your state, the coverage may be full or partial.
What Are Medicaid Insurance Plans?
Medicaid is a state healthcare program for people who need assistance paying for medical care, including cocaine rehab. Other people who are eligible for Medicaid include emancipated young adults, pregnant people, children, and people with high medical needs or disabilities.
What is the Average Cost of Cocaine Addiction Treatment with Insurance?
The average cost of cocaine addiction treatment with insurance varies depending on the length of the stay and your policy.
It’s not possible to estimate the average cost of cocaine addiction treatment for most insurance plans. There are dozens of insurance providers and hundreds of policy types, and the cost of rehab is different with each combination.
Private insurance plans that cover addiction treatment include:
- HMO
- PPO
- POS
- Employer Group
If your insurance policy falls under any of the above types, call the phone number on your insurance card to verify your coverage.
What is the Average Cost of Cocaine Rehab with Medicare Insurance?
While you can’t estimate coverage for most kinds of cocaine rehab insurance, Medicare is an exception. The federal program publishes costs for each type of medical treatment, including addiction.
How Long Does Medicare Insurance Cover Cocaine Rehab?
Medicare covers cocaine rehab for 60 days. After that, you can use lifetime limitations to get 60 more days of treatment at a higher cost.
What Rehab Treatments Are Covered by Medicare Insurance?
Medicare covers all medically necessary treatment for cocaine addiction. That includes Medicare-approved programs that are evidence-based.
Is Cocaine Detox Rehab Covered by Medicare Insurance?
Medicare covers detox programs for cocaine addiction in part, often without any premium costs. To get coverage, you must attend a Medicare-approved facility that’s in network.
Is Cocaine Inpatient Rehab Covered by Medicare Insurance?
Cocaine inpatient rehab is covered by Medicare insurance as long as it’s medically necessary. Your cocaine rehab insurance may cover residential services, counseling, and therapy.
Is Cocaine MAT Rehab Covered by Medicare Insurance?
Medicare does not cover medication-assisted treatment for cocaine addiction. That’s because there’s no evidence that MAT works for stimulant use disorders, including cocaine. Medicare only covers evidence-based cocaine addiction treatment.
Is Cocaine Outpatient Rehab Covered by Medicare Insurance?
Medicare covers approved outpatient programs for cocaine treatment. Those include partial hospitalization, intensive outpatient, and standard outpatient, but not medication-assisted treatment for cocaine.
What if You Don’t Have Insurance That Covers Cocaine Rehab?
If you can’t afford the costs of rehab after insurance, or you don’t have insurance that covers cocaine treatment, you don’t have to give up on treatment. Instead, explore other resources that may help you find coverage.
Your options include:
Talk to Your Employer
If you have employer group coverage and your plan doesn’t cover rehab, you may have a temporary plan. Talk to your employer about switching to an insurance plan that covers cocaine rehab.
Talk to the Addiction Rehab Center
Addiction treatment centers want to help you pay for treatment. Many of them have resources on hand like financial aid and payment plans, so give them a call about your situation.
Talk to Your Family and Friends About Your Struggle With Cocaine Addiction
Your loved ones can be a powerful resource if you open up to them about your need for treatment. Even if they can’t fund your treatment directly, they can help crowdsource rehab scholarships, affordable insurance, and other solutions.
The True Cost of Cocaine Rehab vs. the Cost of Cocaine Addiction
It’s common to put off rehab for cost reasons, but the reality is that cocaine addiction costs much more than recovery.
What is the True Cost of Cocaine Abuse?
The cost of cocaine abuse mounts over time if you don’t get treatment or stay in recovery. Not only does the substance itself cost money, but having an untreated substance use disorder costs you in these ways:
- Lost income
- Health problems
- Mental health problems
- Legal costs
Bedrock Recovery Center Can Help With Cocaine Rehab Insurance
Bedrock Recovery Center wants to help verify your cocaine insurance coverage. If you need treatment for cocaine addiction now, give us a call so we can help you get help!
Sources
- Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health
- State Trends in Employer Premiums and Deductibles, 2010–2019
- 2021 Medicare Costs.
- What Is the Average Health Insurance Premium?
- How long does drug addiction treatment usually last?
- Preferred Provider Organization (PPO)
- Inpatient Rehabilitation Care Coverage
