How to Pay For Rehab Without Insurance

Last Updated: Jan 31st 2020

Reviewed by Brittany Polansky

There are ways for someone to pay for rehab without insurance. It is possible to pay out of pocket with the right amount of research or planning. Besides, there are ways to make the payment process less painful. Paying out of pocket doesn’t have to leave you in debt.

First, there are payment plans that enable the full amount to be broken into smaller parts to be paid off in a more extended period of time. This would be similar to paying gradually by using your credit card, which is also a good option. Both of these choices allow you to receive treatment even before it’s been paid for. But the former isn’t always available and would depend on the clinic or center chosen. The latter, however, can be done by anyone with a credit card.

Another great option many don’t know about is rehab grants or scholarships. These can either be funded by state or federal government, or even the rehab itself. They are used as an encouragement for those who can’t afford treatment to still get the help they need. Some of these can help payment either partially or in full.

Other Options for Paying for Rehab

Many states have programs that fund rehabilitation services. Hopefuls must meet the criteria to be eligible for help. Applicants must qualify according to their income status, or by proving their addiction status and/or need for intervention. In order to apply, you can contact a local or state mental health agency and substance abuse agency. A directory provided by the Substance Abuse & Mental Health Services Administration (SAMHSA) can help you find out who to call.

Another way to afford rehab that some might resist is getting a loan. You can take a private loan, a personal loan, and use home equity in order to pay for rehab treatment. To get it, it is required that a person has good credit. Loans need to be paid in time to avoid extra charges, so if you choose it, make sure to have all your finances planned out.

Additionally, an option that has become popular, thanks to social media is crowdfunding. A lot of people use online donation platforms to ask others for help paying for treatment. It would require effective online reach and a lot of people helping, but it has worked for many, even if partially.

Medicare and Medicaid – Rehab Coverage

Medicare and Medicaid are state- and federal-funded programs, created in 1965. Both of them can be used to help pay for rehab treatment in Florida and any other state.

However, both Medicare and Medicaid suffer some yearly changes, as they are government-funded. This is especially important for eligibility, since depending on the changes, more or less, people might be eligible for aid. Nonetheless, it also means that you need to check on your coverage benefits every year. These changes are required to avoid economic issues and debt. 

It is not usual for people to confuse Medicaid and Medicare. While being created at the same time, its differences include coverage of services for rehabilitation, like mental and behavioral treatment. Some people do qualify for both Medicaid and Medicare, but they are entirely different.

Medicaid Drug Rehab Insurance

Medicaid benefits people that can prove low income and can’t afford a majority of the plans available. The income maximum varies depending on the state. You will need to check what the eligible amount is on your state to see if you’d apply. The standard might also change from one year to the other.

Residents of Florida can get coverage for rehabilitation treatment through Medicaid. Even non-citizens with medical emergencies might be able to do so.

Medicare Drug Rehab Insurance

Medicare was created to help those over 65 years of age and people with severe disabilities. Unlike Medicaid, the eligibility for Medicare has nothing to do with income. It will not require proof that you have a low income to get help. 

Some requirements for Medicare coverage, even for rehab, are: being over 65 years old and having paid Medicare taxes for 10+ years; being married to a person who paid Medicare taxes for 10+ years; having a severe disability (at any age); suffering from End-Stage Renal Disease. 

The drug rehab insurance that is provided by Medicare includes outpatient and inpatient treatment programs. Medicare is divided into parts A, B, C, and D, and each of them covers different stages and services of rehab treatment. But there are limitations to each setting you need to be aware of before starting treatment. 

For example, part A of Medicare only covers upwards to 190 days in any psychiatric hospital. And this is not per year; this is the lifetime coverage a patient will get. When it comes to prescription medications, part D does not cover buprenorphine or methadone. These and other details should be checked so you can avoid any surprises when it is time to pay. 

The Problem With Not Having Insurance

If you choose not to get insurance, you should know a bit about the consequences of not having it. First, not having insurance will put you at risk of having to pay high medical costs. If you need an emergency visit or any type of unexpected procedure, they might not be so cheap.

Back when the Affordable Care Act (ACA) was created, people who chose not to have insurance were charged penalties for not having insurance. While this was officially repealed in 2019, those who didn’t have coverage until 2018 will still be penalized come tax time. Even though it was repealed, some states will still charge a fee in their taxes for those who don’t have insurance.

If you’re wondering how to pay for drug rehab without insurance, maybe you’re asking the wrong question. Perhaps you should wonder how to make rehab more affordable, or how to get help paying for it. Insurance plans are important, and not just for coverage for rehab. There are many cheaper options out there that can make quite a difference when the time comes. 

Affording Insurance And Other Insurance-Required Benefits

There are many affordable insurance options and ways to make treatment more affordable. You don’t need to pay for expensive plans in order to get insurance and coverage. By getting an insurance plan, there are other benefits you’ll have access to that can make treatment more affordable. Many of these benefits require that a person has insurance to be eligible.

To get insurance, you will need to apply in a specific marketplace. Marketplaces, also called “the exchange,” have different health care providers available. They can be state, federal, or private insurance, and each has its advantages. The benefits a person will get depends on the provider and the plan chosen.

The plans available usually fall under two categories, HMOs and PPOs. There are some key differences between the two, which are:

Health Maintenance Organization (HMO) – HMOs charge lower monthly premiums. A patient will have a primary care physician of their choice. Therefore, they’d have only one doctor coordinating their healthcare services. HMOs require individuals to get a referral when they need to visit a specialist. Except in the case of proven emergencies, going to a professional without a referral will not allow for insurance coverage for the services provided.

Preferred Provider Organization (PPO) – PPOs charge high payments for premiums. However, a PPO plan gives the individual a lot more independence over their health choices. In this case, the person can choose which professional they will get treated with, and they won’t need a referral. Still, they will only get coverage if they want an in-network option.

Apart from picking cheaper health insurance options (which are usually HMOs), there are other forms of help for rehab treatment. There are even laws that help protect workers and people with disabilities. Some of them are FMLA (Family Medical Leave Act) and ADA (Americans With Disabilities Act). But one of the most popular programs is Obamacare.

Affordable Care Act/Obamacare for Drug Rehab

The Affordable Care Act, also called Obamacare, covers drug rehab insurance in the entire U.S., including Florida. Obamacare health insurance plans cover substance abuse disorders. The ACA actually stipulated that mental health should be covered as part of the 10 essential health care benefits. This includes substance abuse disorders as well. 

But when it comes to how much is covered, that changes from person to person. Through ACA alone, no one will have 100% coverage for treatment. Therefore, some costs for rehab will need to be paid by the patient. This goes for inpatient programs as well as outpatient ones. The percentage of coverage a person gets depends on their cost-sharing.

To find out how much would be covered, the person will have to check with their insurer and their plan. But even though ACA provides only partial help, it can cut costs drastically. Any other expenses will be dictated by insurers and will depend on someone’s plan, but they have to provide parity protections.

Get Help At First Step Behavioral Health

If you or a loved one need rehabilitation services but don’t know if you can afford it, we can help. First Step Behavioral Health has partnerships with many insurers, and we can discuss what your options are. We understand that programs might not be cheap and that they need to be as accessible as possible.

You can make an insurance verification right on our website, or by calling us today. We will help you find out how you can check for benefits and coverage, and see how we can best serve you. Rehab does not have to be expensive, and those that need help deserve it. Contact us for more information, and don’t let finances get in the way of your healthier, addiction-free self.

Reviewed for Medical & Clinical Accuracy by Brittany Polansky

Brittany PolanskyBrittany has been working in behavioral health since 2012 and is a Primary Clinician at our facility. She is an LCSW and holds a master’s degree in social work. She has great experience with chemical dependency and co-occurring mental health diagnoses as well as various therapeutic techniques. Brittany is passionate about treating all clients with dignity and respect, and providing a safe environment where clients can begin their healing journey in recovery.