According to the National Survey on Drug Use and Health (NDSUH), 18.2 million people aged 12 and older did not receive specialty treatment despite needing one. The 2017 survey revealed that 1.0 million people perceived they needed substance use treatment, but did not get treatment at a specialty facility. Of this number, about 2 in 5 were not ready to stop using, and 1 in 3 had no medical cover and could not afford the cost. Others did not seek treatment because they did not know where to go for help or had no means to travel to the specialty facility.
Specialty facilities include rehab centers providing outpatient and inpatient services as well as inpatient services at hospitals. But they exclude treatment received in a support group, emergency room, or private doctor’s office. Although specialty facilities can be effective in addressing drug addiction and related problems, their locations and associated costs may be a hurdle for certain individuals who need substance abuse treatment.
Financial limitation is a big barrier to getting effective treatment. Many drug-dependent individuals lack insurance, which covers a large percentage of treatment costs. Without insurance, the out-of-pocket costs can make care unaffordable for many people – even low-cost options like individual or outpatient therapy.
Here are some common reasons why many people remain uninsured:
In 2018, 27.9 million individuals, 65 years or younger, were uninsured in the United States. This number is higher (by 500,000) than what was recorded in 2017. About 5% of the uninsured were Native Hawaiian/Asian, 15% black, 33% Hispanic, and 44% white.
People without insurance coverage have far less access to care than those who are insured. Several studies show that uninsured individuals are less likely to get treatment for drug use and related conditions than the insured counterparts. Most of them would rather avoid seeking treatment because of the amount they would need to pay-out-of-pocket.
The National Comorbidity Survey Replication (NCS-R) of 9,000 participants asked why individuals with dual diagnosis (substance abuse and mental disorders) did not seek professional care. Almost 15% of participants quoted financial limitations such as concerns about cost or lack of insurance. About 17% said they had to stop treatment because of the cost and their insurance not financing further treatment.
The actual price that an individual pays for substance use rehabilitation depends on a range of factors, including:
Rehab facilities costs vary based on the aspects mentioned above. But on average, people bay about $1,500 to 2,500 per month.
Every policy or plan is different, but employer-subsidized insurance, private insurance, and the Affordable Care Act (ACA) cover abuse and mental health treatments. The ACA doesn’t consider substance abuse as a pre-existing condition. So it doesn’t deny treatments. Those who are covered under Medicare or Medicaid can also get funding and treatment options for substance use.
Insurance is a great way to fund addiction treatment. But as we’ve discussed earlier, people might not have it for several reasons. The good news is that there are free drug rehabilitation programs that patients can join. Most states offer to fund rehab services that can be accessed by those with little to no income or insurance. These treatment centers often require that the patients meet certain requirements to qualify. For example, one will have to demonstrate a lack of income, addiction status, and need for help. Substance Abuse Mental Health Services Administration (SAMHSA) maintains a Single State Agencies (SSA) for Substance Abuse Services directory that helps individuals determine who to contact for free rehabilitation programs.
The Salvation Army is yet another widely recognized and available addiction resource providing free drug rehabilitation services. It maintains a database of no-fee rehab programs, and those with low or no income or insurance cover can access treatment facilities. Salvation Army has been offering emotional, social, and faith-based help for people struggling with alcohol or drug addiction problems for more than 100 years. Their no-cost programs provide food, housing, community, counseling, and employment as they work to treat symptoms and eventually, the root causes of prolonged substance use.
Some programs offer financing options. Financing is a better option as free rehabs often have waiting lists and limited funding. Some individuals may be somewhat skeptical about taking on a debt, but it’s essential to look at addiction treatment as an investment. In the end, it pays off. When someone attains sobriety, they can go back to their healthy, productive lives. Their loved ones, too, can have peace of mind to focus on other essential aspects of life.
Those that choose to pay for care out of pocket can avoid different hassles and challenges. They have the freedom to pick the rehab facility of choice without third-party influence, and not have to worry about uncovered or unusual expenses as well as hidden fees. Besides, paying cash allows one to negotiate the cost of care, and sometimes, get great deals along the way. LA Times analysis revealed that a majority of treatment facilities offer deep discounts to individuals who pay for care out of pocket. The report pointed out that those who paid in cash could pay $250, while those who used private insurance paid $2,400.
A study published on CNBC indicates that 62% of Americans do not have enough money to pay for emergencies. These families are living paycheck to paycheck, and lack savings to pay for rehabilitation costs. Insurance plans that offer coverage for substance abuse come in handy because they cover about 60-80% of the overall cost. But again, not everyone has insurance coverage. That said, the pricing (or cost) shouldn’t hold patients back. As mentioned earlier, there are free rehab programs, low- and no-cost addiction rehabs, financing among other options to explore.