Cost Differences Between Inpatient & Outpatient Addiction Treatment
As addiction is a complex disease that affects each individual differently, no one program will be right for every person. Generally speaking, there are two main forms of addiction treatment: inpatient and outpatient programs.
How Much Does Inpatient vs Outpatient Rehab Cost?
Every rehab program will have its own cost structure, and each patient’s costs will be different depending on their exact treatment plan and the levels of care included in that plan, the duration of their program, and other factors such as your insurance coverage. Generally speaking, inpatient treatment is more expensive than outpatient programs.
The cost of outpatient programs can vary significantly, based on the type of outpatient program. A more intensive program, such as partial hospitalization that involves many treatment hours per day/week is likely to cost a great deal more than one or two hourly visits to outpatient therapy per week, for example.
Why Does Inpatient Rehab Cost More than Outpatient?
Inpatient rehabs are comprehensive treatment programs that typically include lodging, meals, medical care, and a host of therapeutic, supportive, and educational programs around the clock in a supervised and structured environment. Individuals stay on site and participate in a rigorous daily routine with multiple care providers. Inpatient treatment models vary in their accommodations and amenities, and a luxury treatment facility with more features and amenities is likely to cost more than a program with only basic offerings.
However, with insurance, these costs may be drastically reduced. With a robust health insurance plan, you may be able to cover most or all of the costs of an inpatient treatment problem.
Insurance Coverage for Inpatient vs Outpatient Treatment
If you have a health insurance plan, it can defray some or all of the costs of addiction treatment. You will usually pay a much lower portion of your costs if you stay in your plan’s network.
The way that your insurance covers inpatient treatment vs. outpatient may differ. For example, you may pay a coinsurance rate for medical detox or an inpatient program (e.g., you pay 20% of the costs, while your plan pays 80%) while for outpatient you may have a simple copayment for each visit. However, each plan is unique, and the coverage details will depend on your insurer and your plan.
Outpatient services may be more readily covered by your insurance, or you may be required to attempt outpatient rehab before an insurer will approve decide that an inpatient program is “medically necessary.” Healthcare services that are medically necessary are services that align with accepted standards of medicine and that your insurance company deems necessary to diagnose or treat your condition.1
You can call the number on your insurance card with questions about your plan or check your summary of benefits and coverage packet provided by your insurance company.
Which Insurance Carriers Cover Inpatient and Outpatient Treatment?
In recent years, health insurance laws have expanded access to mental health and substance use disorder (SUD) treatment.2
The Affordable Care Act made SUD treatment an “essential health benefit,” requiring all Marketplace and small group plans to provide coverage for these services. The Mental Health Parity and Addiction Equity Act also required that plans provide coverage for mental health and addiction treatment services that is no more restrictive than coverage for medical services. This means that if you have health insurance, you are likely to have at least some coverage for addiction treatment.2,3
However, not all facilities are guaranteed to accept your insurance or to be in your plan’s network. Doing some research and finding a provider in your network will help you keep your costs to a minimum. Oxford Treatment Center, a top-tier rehab in Mississippi, is in-network with many insurance providers, including:
If you choose to go out of network, or if you would like to attend a facility that doesn’t accept your insurance, you can explore other ways to cover the cost of treatment. Many facilities offer flexible payment plans, loans, and financing. Some may even adjust the treatment cost based on income and allow you to apply for a scholarship.
What’s the Difference Between Inpatient and Outpatient Addiction Treatment?
Inpatient treatment requires the patient to reside at the treatment facility, while outpatient programs allow the patient to return home after receiving services during the day. Inpatient and outpatient programs often utilize many of the same core treatment elements for patients struggling with addiction. These may include but are not limited to:
- Detox services: These help a person to process alcohol and/or drugs safely out of the body. Detox usually lasts 3-7 days. Detox can be inpatient or outpatient; however, withdrawal that is expected to be very severe may be best managed in an inpatient setting.4
- Pharmacological management: Medications can be helpful tools during detox and treatment, aiding in managing cravings, withdrawal symptoms, and any co-occurring mental health or medical issues. These may be given in both inpatient and outpatient programs and may be continued after treatment for as long as needed.5
- Therapy: Group, family, and individual therapy sessions help people to work through issues surrounding addiction and other maladaptive and self-destructive behaviors.
- Life skills training sessions: Sessions may focus on anger management, communication skills, and other beneficial tools for enhancing self-esteem and leading productive lives.
- Drug education: Sessions usually cover topics related to addiction and recovery, and they may be open to both families and clients alike.
- Support group meetings: Peer support or 12-Step groups offer a safe and healthy network of people who strive for the common goal of recovery.
- Holistic, complementary, and adjunctive therapy and offerings: A multitude of options are available for treating addiction in tandem with traditional methods, including acupuncture, massage therapy, yoga, mindfulness meditation, art therapy, and more.
- Nutritional planning: Trained nutritionists can help individuals to regain physical health through a balanced diet. Inpatient treatment programs often provide this as part of their care.
- Fitness programs: Exercise can be highly beneficial during addiction treatment and recovery, and gyms/classes may be included as part of an inpatient treatment program.
These services can vary widely in their cost. Outpatient programs may allow individuals to choose which services they will use and base payment on how many hours a person spends in a particular type of treatment, while an inpatient program may have a set cost for the duration of the patient’s stay. Services are typically included as part of a structured daily schedule.
Support group meetings, relapse prevention, aftercare services, and educational programs are usually free and often offered through community-based programs.
Check Your Insurance Coverage
We know that insurance can be confusing. You don’t have to figure it out alone. When you complete our free and secure form below, you can easily verify your benefits for substance abuse treatment. We will send you an email in just minutes with a verification of your coverage and help you take the first step toward beginning treatment.