Does Insurance Cover the Cost of Alcohol Detox?

Does Insurance Cover the Cost of Alcohol Detox?

As many as 32 million Americans may be in need of alcohol detox. Only about one in five, however, actually seek that detox. Possible reasons: denial, pride, fear of being labeled “alcoholic,” fear of having to give up drinking permanently—and fear of not being able to pay for treatment. That’s not an unjustified concern: initial detox plus a month of rehab can run from around $7,500 to over $20,000, depending on the center and treatment program. (Although ignoring the problem isn’t cheap either. Alcohol-related accidents, illnesses and lost productivity cost the country nearly $225 million a year.)

If you’re serious about entering an alcohol detox program, your first question after “How much will it cost?” may be “Will my health insurance cover the cost?” In nearly every case, the short answer is yes. Alcohol use disorder is a recognized medical illness, and health insurance laws require policies to cover mental–behavioral sicknesses and injuries. Still, not every insurance plan will cover the full cost of alcohol detox. In this article, we’ll look at ways to find out exactly what you can expect, as well as other ideas for financing and minimizing treatment costs.

One caveat first, though. If you’re thinking of taking the “no-cost” path of detoxing cold turkey on your own—DON’T. Alcohol withdrawal can produce extremely dangerous physical symptoms such as elevated heart rate, rising blood pressure, severe dehydration, seizures or stoppage of breathing. It can also bring on hallucinations or mood swings that could lead to dangerous, even suicidal, behavior. To “just stop drinking” without qualified medical supervision is like driving with your headlights off and trusting to luck that you’ll see any trouble before you hit it. Detoxing from alcohol is only safe under the care of someone who knows what to do in case of emergency.

To ensure maximum help paying for that qualified care:

1. Don’t make assumptions.

“The insurance will pay” belongs in the category of Famous Last Words. Yes, your policy will likely cover at least some expenses—but you’re inviting trouble if you make all the detox arrangements first and ask questions later. Your insurance company may have its own ideas on the ideal length of the residential-treatment period, what aspects of care are worth paying for, and whether a specific detox center offers such superior treatment as to justify high residential expenses combined with long-distance travel costs.

With a thousand possible rules and exceptions involved in the business of insurance, alcohol detox or any other major health expense requires some advance planning.

2. Review the details of your insurance coverage—with an agent’s assistance if necessary.

No question, health insurance policies can be complicated. The bare bones of what you need to understand is the amount of your deductible, your copayment policies, any situations that will void coverage, what services are covered under “mental health treatment” specifically, and what doctors/treatment centers your plan recognizes as “preferred” or “network” providers. Depending on your situation, you may also need to know how much and under what circumstances your insurance will pay for a treatment center that’s not in its primary network.

If you can’t decipher all this (or find answers to your other questions) by studying the policy yourself, talk to a human insurance representative who can explain confusing points. You may already have an individual insurance agent; if not, consider visiting your company’s local brick-and-mortar office and asking to speak with an onsite agent (usually more comprehensible and less frustrating than trying to get information from whoever answers the official “customer service” line). Or try a social-services or nonprofit organization; many of them provide free or low-cost counseling on financial and health matters.

3. Find out whether detox treatment will affect your future premiums.

This may be written into your policy as well, but it’s a common enough concern to rate some extra attention. If your premiums are going to go up significantly, better to prepare in advance than to add a budget shock to the stresses of newly achieved sobriety.

Fair or not, insurance premiums do tend to rise after a large payout. The exact “yes or no and how much” will be affected by specific treatment plan, whether more treatment is needed than originally anticipated, and how likely the health problem is to recur. It’s no secret in the business of insurance: alcohol detox, like most forms of addiction detox, is no guarantee against the problem recurring. In fact, addiction has an unnervingly high relapse rate. You may be able to head off some premium increases by sharing your long-term sobriety plan with your agent as evidence that you’re serious about avoiding another stay in detox.

But if you do all the above and conclude that detox will be a financial burden even with insurance, please don’t abandon the whole idea! There are ways to further reduce expenses.

4. Consider other financing and budgeting options.

Religious and other nonprofit groups often have financial-aid programs: check with your congregation or ask your public library for a directory. You may also be eligible for federal or state government assistance, perhaps as a “person with a disability.”

Your preferred detox center may be able to help you work out a payment plan, or to suggest ways to reduce expenses (e.g., foregoing nonessential patient services or substituting outpatient care for inpatient). Or your too-expensive first choice may be able to refer you to a different, lower-charging center.

Even your place of employment may be willing to help, especially if you present a convincing case of how alcohol detox will make you a more effective worker to their financial advantage. Or if you aren’t too proud to go public with your problem, “crowdfunding” via requests posted to social media is often an effective way of raising money.

Asking friends or extended family to pitch in is more problematic—the people who care most about your needs are also the people who feel most uncomfortable about putting the relationship on an “IOU” basis. When you have alcohol use disorder, they probably also consider you and money a risky combination, period. If you must take this approach, ask your one closest and most responsible intimate to assume official responsibility for collecting the money and making sure it gets to the treatment center. And do all you can to personally repay every contributor after detoxing.

(Side note: Use credit cards or other high-interest financing only as an absolute last resort!)

Paying for alcohol detox, by insurance or any other means, can be hard. But when all is said and done, the consequences of allowing alcohol addiction to continue are far harder. Don’t let finances or anything else become excuses for not seeking help!

If you or a loved one need advice on alcohol detox, call Inland Detox at (888) 739-8296. We’re the leading provider in southern California.