Does Insurance Pay for Couples Drug Rehab?

If you and your partner are struggling with substance abuse, rehab is an important step in recovery. Rehabilitation or substance abuse treatment services use therapy, counseling, and complementary skills like emotional management, building coping skills, stress management, and building healthy routines to help people overcome not just their substance abuse but also the underlying problems that resulted in it in the first place. If you’re with a partner who also has problems, getting couples drug rehab means you go together and often receive relationship and family therapy alongside drug addiction treatment to ensure you can rebuild your relationship on a healthy basis.

At the same time, drug addiction treatment is expensive. You want your insurance to pay for as much of it as-is possible. The question is, does your insurance pay for couple’s drug rehab? The answer is; that depends. We’ll go over the factors involved and how you can work to ensure you’re getting coverage for your program of choice – and what you need to do to ensure you get that coverage to begin with.

Your Insurance Covers Rehab

Your insurance plan is required to cover drug and alcohol abuse treatment. That’s the law under the Affordable Care Act (better known as Obamacare). You are legally entitled to rehabilitation or substance abuse treatment care under Federal law. This means that your insurance plan covers rehab. However, coverage offered can vary significantly per plan.

The good news is that, no matter what, you’ll get some coverage for your drug rehab. If you take a quick look at your plan, you’ll also see roughly what is covered. Usually you can expect 40-90% coverage depending on plan, although many providers have caps and custom options for inpatient treatment. Increasingly, insurance plans are rolling rehab under general clinic visits or specialty care, which means it might not always be straightforward to find rehab or substance abuse treatment on your plan. If you’re not sure, you can always call your provider for straightforward answers. That will also help you figure out if you have to go through a provider-sponsored treatment plan or assessment before you can get help – as some plans do require this.

What Your Insurance Plan(s) Cover

Insurance plans cover different things depending on the plan. Often, that’s equitable to the physical health coverage you have. For example, with a bronze plan you can normally expect to cover about 60% of total costs yourself and with a platinum plan that drops down to about 10% of total costs. That should remain roughly equivalent no matter what kind of treatment you’re looking for. Therefore, many insurance plans won’t care too much what kind of treatment you start, providing you pay the associated costs.

You’ll want to look at:

• What type of treatment is covered. E.g., inpatient or outpatient? Some plans require you complete an outpatient program before it will pay for an inpatient program
• Some plans have deductibles per day some plans have deductibles per treatment type
• Maximum coverage
• Maximum covered
• If deductibles change for inpatient vs outpatient care

For example, if you have a bronze plan, chances are very high that your insurance plan will attempt to cover the bare minimum. This means you might not get coverage for extras like couples’ rehab, unless that’s explicitly incorporated into mental health treatment and coverage.

You’ll also want to check whether:

• You both have the same insurance plan. If you’re both on the same plan, it will be easier to align treatment and get joint coverage. If you’re not, it may be much harder to do so.
• If you have different plans, your providers may work with a different network, which means it will be basically impossible to both get coverage from the same organization
• Couples rehab may be treated as “joint” therapy or as individual therapy for two people and the difference will matter a lot depending on your rehab program

Essentially, if you have to align two separate insurance plans, you may have more trouble getting insurance coverage. However, if you’re on a family plan together, it may be much easier.