Using Health Insurance for Medical Detox from Drugs & Alcohol
Addiction is a serious health problem that warrants professional treatment.1 Intense cravings and withdrawal symptoms can potentially trigger a relapse, making it difficult to stop using the abused substance. Withdrawal symptoms not only have the potential to trigger a relapse but also can be dangerous and even deadly, depending on the specific substance of abuse.
Professional addiction treatment can significantly reduce the chance of relapse by making the withdrawal process safer and more comfortable.1 Professional addiction treatment can be expensive, potentially creating a barrier for many people to seek the help they need. This often leads many individuals to ask the question, does insurance cover detox?
Does Health Insurance Cover Drug & Alcohol Detox?
In most cases, your health insurer will provide coverage for medical detoxification. In fact, due to the Affordable Care Act (ACA) and mental health and substance use parity laws, most insurers are obligated to cover addiction treatment.2,3 Detox is often the first step in the addiction treatment process, which means it may be covered by health insurance.1
Medical detox helps eliminate the addictive substance from the body in a safe and supervised setting to help manage withdrawal symptoms. Medical detox can typically last a few days to a week.
While detox is a crucial part of treatment, detox is just the first step to someone achieving long-term recovery. Many patients need to build the skills necessary to resist substance misuse through various psychotherapies and sometimes medication.1 Patients can usually use health insurance for inpatient or outpatient rehabilitation treatment as well.2,3
While addiction treatment is typically covered by health insurers, the level of coverage will depend on your specific insurance policy. Many plans only cover treatment centers within their care network (i.e., facilities that they have contracted with to provide services), or only provide reduced coverage for facilities outside their network.4
Check whether your policy covers treatment at Oxford Treatment Center by using our confidential or by speaking to one of our admissions navigators at .
Which Insurance Carriers Cover Medical Detox?
Coverage for medical detox and other addiction treatments is highly variable depending on your specific treatment policy. However, it may be helpful to go over some general information regarding the most common health insurance companies and how coverage is applied to detox treatment:
Factors That May Determine If Insurance Will Cover Medical Detox
When you choose a medical detox facility, it’s crucial to use one within your health insurer’s care network. Failure to do so will often result in limited coverage or no coverage at all. Your insurer may provide a directory of available facilities on its website, or you may contact a representative to find out which facilities are covered.
Despite extended coverage mandated by the ACA, insurance companies still have the right to require proof that treatment is “medically necessary”—that is, professional treatment is needed to diagnose or treat a condition, and that the treatment route chosen is the best possible option.14
This typically means that a doctor’s referral or prior authorization will be required to obtain coverage for addiction treatment. Staff at Oxford Treatment Center can assist you with this process before you start treatment.15,16
How to Pay for Medical Detox Without Insurance
If your insurance policy does not cover detox treatments, don’t despair. There are options for free services, other ways to pay for addiction treatment, and treatment centers that charge on a sliding scale based on your income.17 This is also helpful for the millions of Americans still without any health insurance.
There are many options for state-funded rehab services for low-income individuals with addiction disorders. The services offered and requirements to be accepted into such programs vary with each state, so you’ll need to contact the program itself to see if you qualify.17
The Substance Abuse and Mental Health Services Administration has a directory containing contact information for each agency in every state.
Each agency may have different policies on whom it will accept. Those who are accepted can get free treatment or treatment at a significant discount. The downside to these programs is that they can require a significant wait, as many apply and only so many can be treated by the state at a time.18 Certain at-risk individuals, such as pregnant women, may be given priority.19
In addition to state-funded treatment centers, there are also faith-based options across the country. The Salvation Army Adult Rehabilitation Centers and other organizations offer free or discounted detox services in many locations.20
However, not all of these facilities offer full services and may only provide 12-step meetings and counseling. Again, space might be limited, though the application process is usually less intense.
Additionally, some private treatment facilities also offer “scholarships” for low-income individuals who need addiction treatment. These may also be offered through organizations dedicated to combating addiction and helping those affected by it. If money is an issue, be sure to ask any private treatment center about grants for those in need.17
Verify Your Insurance Benefits
Our quick and easy benefits verification form below is private. Within minutes, you’ll know whether your health insurance covers treatment at Oxford.