People with drug and alcohol addiction can face many challenges. Substance abuse can harm a person’s health, relationships, emotional well-being, and ability to function. Overcoming addiction can be very challenging, but treatment can help.

Many people living with substance use disorder (SUD) require comprehensive rehabilitation services to put addiction in the past. Even with comprehensive treatment, addiction recovery can be difficult. Most people with SUD experience at least one relapse during their recovery journey.

Insurance companies have a legal obligation to cover substance abuse treatment. But will insurance cover rehab multiple times?

This article will explore how many times health insurance plans will cover addiction treatment programs. You will learn:

  • An overview of how to use insurance to go to rehab
  • How many times insurance will cover rehab center stays
  • What to expect during inpatient rehab and outpatient treatment plans
  • Where to find an addiction treatment facility

If you or a loved one struggles with substance abuse or addiction, you are not alone. Find comprehensive support and treatment at First Step Behavioral Health. Learn about our programs or schedule an intake appointment by contacting our specialists today.

Insurance Coverage for Rehab: An Overview

The Affordable Care Act (ACA) requires insurance companies to cover mental health and substance abuse treatment. Under the ACA, SUD and mental health treatment are essential health benefits, and insurance companies cannot deny payments for these services.

However, each insurance plan provides different levels of coverage. It is essential to explore the details of your specific plan and find treatment centers that work with your insurance.

There are several ways to learn about your coverage, including:

Contacting an insurance representative by phone using the number on your insurance card

Reading about the details of your plan on your insurance company’s website

Contacting the insurance specialists at First Step Behavioral Health for guidance

Understanding your plan’s details will help you make informed decisions about your care.

Will Insurance Pay for Rehab Multiple Times?

Relapses are common among those in addiction recovery. Studies show that most people in recovery have at least one relapse after attending a rehab facility.

So, will insurance pay for people to return to rehab after a relapse?

The answer to this question isn’t straightforward. In most cases, an insurance company will cover rehab after a relapse. However, there may be situations where the company will not pay for rehab again.

An insurance company may consider:

  • How many times you have attended rehab in the past
  • How recently you have attended rehab
  • The specific coverage details of your insurance plan
  • The likelihood that additional rehab will be effective

Your treatment specialists will typically work with your insurance company to get coverage for your care. Your treatment team will advocate for your needs and attempt to secure insurance coverage for additional treatment as needed. However, there may be cases where your insurance company can deny coverage for multiple rehab stays.

It is critical to explore the details of your plan. Contact your insurance company to learn more about rehab coverage, including what programs are covered.

What To Do if Your Insurance Provider Won’t Pay for Rehab Again

If your insurance provider denies coverage for another round of rehab, it can feel discouraging—but you still have options. Here’s what you an do.

First, try to appeal the decision by requesting a formal review of your case with the insurance company. Be sure to ask your treatment provider for support—they may submit additional documentation proving the medical necessity of rehab.

Additionally, check your state’s insurance laws, as some states have protections that require insurance companies to cover multiple treatment attempts.

If your current insurance won’t cover another stay, consider your other options:

  • Employer Assistance Programs (EAPs) that offer addiction treatment support.
  • Sliding scale payment plans that some rehab centers offer to make treatment more affordable.
  • If inpatient rehab isn’t covered again, your insurance may still cover outpatient treatment, counseling, or medication-assisted treatment (MAT).
  • Ask the rehab center about financing or payment plan options

Even if your insurance provider denies coverage, help is still available. Reach out to treatment professionals to explore your options and find a solution that allows you to continue your recovery journey.

What to Expect in Rehab

Insurance generally covers many treatment options, including inpatient, outpatient, and aftercare programs. Here is a quick overview of the levels of addiction treatment.

Inpatient programs

Inpatient rehab programs provide intensive, round-the-clock support for people who need continuous care. Inpatient programs may include:

  • Medical detox programs
  • A secure environment
  • 24/7 access to medical treatment and mental health care
  • Behavioral therapies
  • Support groups
  • Individual therapy
  • Relapse prevention education
  • Holistic therapies like exercise, nutrition counseling, mindfulness, and creative expression
  • Aftercare support

People may attend an inpatient treatment at the beginning of their recovery journey or after a relapse. This intensive support can help people get on track and work toward lifelong sobriety.

Outpatient programs

There are many types of outpatient rehab programs, including:

People may attend outpatient rehab programs after completing inpatient care. People may also benefit from outpatient treatment after a relapse.

Aftercare support

Insurance plans may cover many aspects of addiction aftercare, including:

  • Individual therapy
  • Medications
  • Medical treatment
  • Addiction counseling

Creating and following an aftercare plan can help people remain committed to sobriety after rehab or after a relapse.

Contact the First Step Behavioral Health specialists to learn about what level of care is right for you. Our insurance specialists can help to determine which levels of care your insurance covers. They can also help you find the type of treatment that best meets your needs.

Find Treatment and Support

If you or a loved one struggles with addiction or relapse, you are not alone. Find compassionate, knowledgeable treatment at First Step Behavioral Health. Contact our intake specialists to learn about our programs, insurance coverage, and payment plans, or to make an appointment. Take the first step of your recovery journey by contacting us today.

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