Insurance and the Cost of Addiction Treatment

We write a lot on this site about why treatment for alcohol and drug addiction is a necessity. Whether discussing addiction as a family disease or simply talking about the tendency of many addicts and alcoholics to find themselves in legal trouble, the common theme is that recovery changes lives for the better. There is only one major snag in this argument: treatment is expensive. Not everyone has insurance, and those who do have insurance do not always fully understand the options that are open to them.

Due to the confusion that some families and individuals may face when attempting to pay for addiction treatment, we feel that it is worth taking a closer look at this issue. Just how much does treatment cost, and what types of insurance options are available to those who are in need? Does this cost hurt those who are badly in need of treatment? And more importantly, how can Amethyst Recovery help those who may struggle to afford treatment, regardless of whether or not they have insurance? Find the answers to all of these questions below.

The High Cost of Addiction Treatment

Recovery can be expensive. And given that some insurance programs will only cover a couple of weeks a year, it can feel like getting caught in a trawl net made of treatment fees. (Natalia Lukiyanova/123RF)

In some ways, it isn’t that surprising that treatment for drug and alcohol addiction can be highly expensive. After all, many of those who have never been exposed to treatment on a personal level are only familiar with the rehab stories of celebrities. We know about celebrities such as Amy Winehouse, who certainly could have afforded decent care but unfortunately did not recover. We also know about celebrities such as Lindsay Lohan, who might have spent up to $100,000 per month during her stay in the private facilities at Promises.

For those who do not have the money and status of your average celebrity, treatment can still have a heavy impact on one’s pocketbooks. For instance, Hazelden is one of the oldest treatment centers around, and certainly one of the most prestigious. But those who elect to participate in one of their inpatient treatment programs will have to spend anywhere from $20,000 to $32,000 without insurance coverage. The amount that they have to spend will vary in accordance with the particular level of service they need. In other words, those who need help the most will have the most financial trouble as a result of getting it if their insurance does not meet their particular needs.

We do not want it to seem as if we are picking a fight with a well-known and respected treatment center. This is not the case at all. Hazelden has done a lot to influence the field of addiction treatment, and for that we are ever thankful. We also do not mean to pick on Promises for offering high-quality care to those with the means to afford it. We are merely establishing a trend in the high costs of addiction treatment. In fact, informational website The Clean Slate ran some numbers back in 2011 and found that the average cost of a one-month treatment center (insurance not included) was about $25,166.

Again, a determinant factor is often the services included. For instance, the aforementioned average was slightly higher when only accounting for treatment centers that offered on-site detoxification services, while the average price was much lower when only accounting for treatment centers that did not offer any form of detox whatsoever. Our own research on the national cost of treatment returned an average of about $18,200. While this is lower than the 2011 average returned by The Clean Slate, it is still rather high.

In fact, while our average may seem lower, it actually draws attention to just how troubling the cost of addiction treatment can be for some families. Let’s say that a family without decent insurance coverage found the need to enroll one of its members in treatment at a cost of $18,200. Based on data collected in January of this year, one out of four American families would have to sacrifice more than 50% of their annual income in order to afford rehabilitation. Some families would find a way to make ends meet, while others would simply forgo treatment and hope that the problem would resolve itself.

How This Hurts Addicts and Alcoholics

The outlook for those who cannot complete treatment is not a particularly great one. (Photo via Doves & Serpents)

The sheer fact that some addicts and alcoholics will not receive the treatment they need is already a problem. But it is also a problem regarding the way they are perceived. The family will often feel a need to rationalize their decision not to pay for treatment, and this rationalization could go one of two ways. First, they might engage in negative personality stereotypes of addiction, which could lead them to feel as if their loved one is beyond help. Not only will the family then decide not to pay for treatment, but they will leave the addict feeling hopeless and alone.

Conversely, the family might decide to rationalize their decision not to pay for treatment by deciding that their loved one is simply a functioning addict or alcoholic, and that it’s okay for them to continue using with a little discipline. This may work for a while, but it doesn’t have much longevity. The addict is then in for a long cycle of high-functioning addiction with periods of heavy, low-functioning use in between. And, more likely than not, their continued use will still hurt the family financially. It may not happen all at once, but they will likely spend more on their addiction over time than they would have spent on treatment.

To be fair, these are only two possible circumstances. But there are also ways in which the high cost of treatment can be hurtful to addicts on a much greater scale. While many private rehab facilities are setting prices that make it nearly impossible for those without insurance to receive treatment, the government is spending nearly $21 billion per annum to provide more affordable options. Unfortunately, such a budget can only stretch so far. The more patients who must turn to public treatment facilities for the care they need, the harder it will become for the government to provide adequate care for all of them.

This is already affecting many states. Pennsylvania increased its $43 million budget by $5 million back in May, but they had to accept applications to decide which treatment centers could actually be helped. New Jersey was given $950,000 to advance medication assisted therapy, but it’s still easier to get drugs like heroin in their state than it is to get medications like Suboxone or Vivitrol. In Illinois, state funding for treatment is going down despite a rise in demand. The only state that seems to be winning overall is Maryland, which increased funding for the treatment of prisoners by about half a million dollars back in June.

Increases in funding are great, but they clearly aren’t enough for many of the states that have received them (let alone the states that haven’t). The government can’t fight addiction on its own, and private facilities that charge an arm and a leg for treatment are not doing much to help the issue. According to the National Institute on Drug Abuse, every dollar given to treatment programs has the ability to save us between $4 and $7 out of the $600 billion spent on substance abuse every year. But given the fewer incarcerations, increased workplace productivity, and reduced death rate that are accompanied by widespread drug treatment, isn’t it worth improving further on these savings?

Insurance Options for Those in Need

This is kind of what it feels like to receive only two weeks of insurance coverage for necessary treatment. (Photo via Murphy Writes)

It should be clear from the above information that state-funded treatment centers are largely struggling, but many private treatment centers are not affordable to those who need them. It would seem as if the only viable solution is insurance coverage. And this truly does seem like a viable solution, since close to 90% of Americans currently have access to insurance coverage. Granted, this figure drops to about 78% when looking at those who make less than $36,000 per year.

Marketplace insurance programs made available through Obama’s healthcare reforms generally cover substance abuse, so those with access to these programs have some helpful benefits when it comes to addiction recovery treatment. Of course, there are some stipulations. Not everyone is granted the same benefits. The scope and quality of their insurance coverage will largely depend upon the state in which they reside as well as the particular program for which they have applied.

Some of these insurance programs do not offer the level of coverage needed to ensure a true attempt at recovery. In Pennsylvania, some patients are admitted to three-month treatment centers with insurance programs that will only cover them for thirty days. Some programs only cover them for as little as two weeks. It can sometimes take an addict at least this long just to start getting over their denial so that treatment can begin to truly take effect. Addicts covered by such insurance programs are essentially lifted up just so they can be dropped back down.

The Affordable Care Act has made some great changes in terms of substance abuse coverage, but they aren’t enough. The National Alliance on Mental Health has discovered that over 40% of patients are struggling to receive decent insurance benefits for the coverage of mental health issues such as substance addiction. The biggest issues in such insurance coverage pertain to those in college. Adolescent insurance providers often cater only to those below the age of 18. Adult insurance providers prefer those who are about legal drinking age. There is a three-year period during which many youths are beginning to experiment with drugs and alcohol, and they are often out of luck if addiction should happen to take the reins.

Those who receive health insurance through employee benefits may also find that their coverage is lacking. A page under HBO’s Addiction Project reminds those who receive their health insurance through an employer should consult their benefits handbook to see what type of health insurance they are offered. If mental health coverage is a major weak point in the employee’s insurance program, then they should consult with their employer to see if they can reach a solution together. Otherwise, it might be worth consulting HealthCare.gov to see what types of Marketplace options are available.

Why Amethyst Recovery Can Help

Amethyst can help to free you from the bonds of low income and limited insurance coverage. Contact us today, and we’ll work out a plan together. (mihtiander/123RF)

While highly laudable recovery website The Fix can perform a check to see whether or not your insurance program covers addiction treatment, you do not need to wait for one of their representatives to get back to you. If you simply contact us today, when can process your insurance information and let you know whether or not your insurance will provide you with the care you need. We can also get in contact with your provider to find out the length of the stay that would be covered, since many have entered other treatment centers only to discover that they were in for a very short treatment period.

At Amethyst Recovery, we accept all major insurance plans while also offering a number of private pay options. We offer free verification, and those whose insurance does not work at Amethyst will still be offered placement in one of our programs. Every treatment center is a business, but we realize at Amethyst that patients must be treated with parity, and as such we place more value on parity than on profit. That’s why our treatment programs can be accessed for as little as around $9000, far below the averages we discussed earlier.

We also maintain our own sober living facilities, so those who cannot remain in treatment for very long do not have to be turned out and forced to live on their own with limited sobriety, or with a family that might still be in pain. Being forced to either return to old routines or live alone for the first time is a major issue for patients whose insurance cuts out early during treatment. Sober living helps them to establish a new lifestyle without having to subsist completely on their own.

At Amethyst Recovery, we feel it is our duty to help addicts recover through a full continuum of treatment. Much of our staff has struggled with this disease ourselves, and we understand that those who need to recover cannot always afford the high cost of treatment when insurance options remain limited. Addiction is not a cost-effective disease. This is why we do our best to ensure that everyone who needs treatment can receive it, regardless of status or income. If you or someone you love is in need of our services, then please contact us today. We will help you in any way that we can.