Paying for treatment: insurance, and what to do without it

Check two things before you call anyone

First, whether the facility is in network with your plan. Out-of-network care is often still covered, but at a far higher share of the cost. Second, whether the level of care you need requires prior authorization — for residential and detox it usually does.

The insurance names listed on a facility page here come from the facility. Treat them as a strong hint, not a guarantee, and confirm with your plan before you commit.

Questions that prevent surprise bills

Ask these of the facility and, where you can, of your insurer. Getting a name and a reference number for the call is worth the extra minute.

• "Are you in network with my specific plan?" — plans differ within one insurer.
• "What will I owe out of pocket, including any deductible?"
• "Is prior authorization needed, and who requests it?"
• "Are physician and lab charges billed separately from the program?"
• "What happens if my insurer stops authorizing further days?"

If you have Medicaid or Medicare

Both cover substance use and mental health treatment, though which facilities participate varies by state, and state Medicaid programs go by different names locally. A facility that accepts one plan does not necessarily accept all of them, so confirm your specific program by name.

If you have no coverage at all

Options exist and they are worth pursuing before assuming treatment is out of reach.

• Ask directly about a sliding scale — many programs have one and few advertise it.
• State-funded programs exist in every state; your state substance use agency can point you to them.
• SAMHSA's national helpline is free and confidential, 24/7: 1-800-662-4357.
• Some nonprofit facilities hold scholarship or charity-care beds set aside for exactly this.