What kind of questions do you need to ask to find the right drug rehab for you?
There are more than 14,500 specialized drug rehab centers in the United States alone. Families searching for care for someone in need have plenty of options, but they will need to ask in-depth questions about the facility’s focus, treatment options, accreditation, and cost in order to make an informed choice. Understanding treatment options and interviewing providers can be time-consuming, but the work could help the family settle on the right provider, at the right price, for a person in need.
In a study of addiction habits all around the world, published in the online journal PLOS Medicine, the United States took the top spot in terms of the use of illicit drugs like cocaine. In this country, both the use and abuse of substances are widespread. As a result, there are hundreds of drug and alcohol rehab centers people can utilize when their use spins out of control and develops into an addiction.The National Institute on Drug Abuse (NIDA) reports that there are more than 14,500 specialized drug rehab centers in the United States. There are many other providers in private practice that offer help to people with addictions. Nonprofit support groups are available, too, that can assist people who do not want to get formal professional help.
If you are searching for a drug rehab center for yourself or for someone you love, this is all wonderful news. It is clear that you have options available, and there is bound to be a provider out there that can assist you or your family with the addiction problems you face. But which option should you choose? And more importantly, how can you be sure that the option you do choose is the right one?
This guide can help. Here, we will detail the options open to you, along with important questions you can ask before you settle on a specific provider.
When people think about the word rehab, they often think about drug abuse services provided within a specialty rehab facility. That might account for the popularity of this particular type of care. In 2012 in the United States, for example, about 2.5 million people got care for addiction in a specialty facility, according to the Substance Abuse and Mental Health Services Administration (SAMHSA). When people need rehab help, they often look for a specific type of facility. However, rehab facilities can do a number of different things. Some facilities tackle just one part of the recovery spectrum, without touching on any other part of the care a person with an addiction might need.
So if you’re looking for help with an addiction from a specialized drug rehab center, you will need to do a little more digging. Specifically, you will need to find out what kind of care the facility offers, and what format is available. These are just a few of the drug rehab formats open to your family.
Medical detox is often considered to be the first step in the recovery process. It is here that people transition from intoxication to sobriety, with the help of a dedicated team that can soothe physical distress and alleviate psychological concerns. Someone addicted to illicit opiates like heroin, painkillers like Vicodin, benzodiazepines, or alcohol will need medical detox.
There are several levels of medical detox available, according to SAMHSA, including:
Ambulatory medical detox, without onsite monitoring: Someone receiving this care might head to a doctor’s office for medication management, but might not get any kind of daily physical monitoring in a facility.
Ambulatory medical detox, with onsite monitoring: In this model, someone visits nurses or other health professionals on a set schedule, and gets regular medical monitoring throughout the day.
Clinically managed residential medical detox: Here, someone has peer and social support during detox, 24/7, but medical staff may or may not be involved.
Medically monitored inpatient medical detox: In this model, the person has 24/7 access to a medical team.
Medically managed intensive inpatient detox: This model provides acute care for medical and mental health conditions during detox.
Simply asking whether or not a facility can assist with detox is probably not an effective strategy. You will also need to know more about what type of medical detox the facility specializes in, so you can make the most informed choice.
Partial Hospitalization Program (PHP)
PHPs provide intense care for several hours each day, but the person might go home at night or head to a sober living home during off hours. This option is designed for people who are medically stable, but who need intense supervision in order to handle the dangers drug use can cause.
People like this might need regular medication for long-term drug withdrawal, or they might need medical monitoring for issues that are serious but not life-threatening. They do need intense help for their drug addiction, so they can avoid a relapse, and they may need supervision so they are able to resist the temptation to use.
PHPs, according to research published in the Journal of Psychosocial Nursing and Mental Health Services, provide recovery-oriented services. They do not simply attend to physical ailments caused by drugs. These are programs that assist people with skills they will need in order to stop using drugs. But their rigorous nature ensures that participants stay healthy, and supervised, while that healing takes hold.
An inpatient rehab program delivers around-the-clock mental health assistance for a drug use issue. People enrolling in these programs are typically healthy, at least physically, but they may be incapable of handling the temptation to relapse when they are not in a controlled, supervised environment.
Your family might choose an inpatient rehab for a loved one who has a long and complex history with drugs, and who has tried other recovery options in the past. Something about the place the person lives, or the people that person sees, impedes the recovery process, and that can make maintaining health very difficult. An inpatient program is a good solution, as people get the help they need in this safe and secure environment.
Intensive Outpatient Program (IOP)
The person you love might be physically healthy, and the person might live in a supportive and safe home. Those are all great benefits, in terms of recovery. But this person might also find it hard to fill up the hours that were once consumed with drug use. This person might be at risk of relapse without some kind of intensive drug care. An IOP can fill that need.
SAMHSA reports that IOPs provide at least nine hours of therapy per week, typically delivered in three-hour blocks. That means IOPs require a great deal of work from a person in recovery. These are not simple rehab programs your loved one could complete with an already packed schedule. These are programs that combine the intensity of inpatient care with the comforts of home.
If your loved one has completed inpatient care, or if the person you love is already on the road to recovery, outpatient care might be best. Here, addiction therapy is provided in a series of appointments that could, in some cases, be spaced far enough apart to accommodate other tasks. The person you love could keep working, going to school, and volunteering in the community, all while in therapy for addiction.
A main benefit of outpatient care, per NIDA, involves cost. These programs can be much less expensive than inpatient programs. But, outpatient programs do not provide an intense level of supervision, so they could spark a relapse in some people.
Other Rehab Providers
While facilities might seem like a go-to choice for addiction care, there are other providers that can assist with an addiction issue. For example, mental health providers may provide a form of outpatient care for people with addictions.The Bureau of Labor Statistics reports that there were close to 90,000 jobs for counselors working on substance abuse and behavioral disorders in 2012, and the number of open positions was expected to rise by 31 percent between 2012 and 2022. These numbers suggest that there are many people who could assist with an addiction issue. Many of them could be working in private practice, not in a facility that specializes in addiction.
The prevalence of these providers makes this kind of care an enticing option. But there are drawbacks, as addiction providers working independently may not be able to provide the full suite of services that a facility can provide. According to the website Counselor-License, the therapies providers offer can vary dramatically from state to state and educational background to educational background.
For example, someone with a doctoral degree in psychiatry may be able to diagnose a mental illness and prescribe medications for that illness. But someone working as a clinical social worker may not have those same prescriber rights. In some states, some counselors may be able to perform certain tests only when they are under the supervision of someone with a doctoral degree.
It can be a little confusing to determine how these people might assist with an addiction concern, and unless someone in your family also has a medical degree, it can be hard to figure out what all of the letters and symbols that follow a provider’s name can mean.
Working with a provider in private practice can also mean dealing with different billing schedules, costs, joining fees, and more. That could make some providers that seem inexpensive a little more expensive when all of the bills come due.
Support groups that follow the 12-Step method can also factor into recovery. There are many available, including:
Crystal Meth Anonymous
Some people use support groups as a form of maintenance therapy. When they have completed their routine care for addictions, they keep going to meetings in order to keep their skills sharp and their resistance to relapse as high as possible. They might be going regularly as a form of ongoing aftercare, but they are not really using these meetings in order to get sober. This could be an effective strategy for sobriety maintenance, and according to the National Institute on Alcohol Abuse and Alcoholism, people who use meetings after therapy tend to stay sober longer than those who do not go to meetings.
It is unclear how many people use only 12-Step meetings without therapy in order to beat back an addiction, but in general, it might not be the wisest choice. Addictions can come bundled with other mental health issues, and they can be sealed in place with deep scars and long-held behavior patterns. While peers can deliver support and understanding, it is often best to work with a mental health professional to gain insight as sobriety develops. Support groups just cannot deliver those benefits, as there are no experts involved in the care delivered there.
Making an Informed Decision
Cost and expertise – these are the two factors you will need to balance as you look for the right addiction care provider. You do not want to choose a group that provides rock-bottom pricing if they cannot deliver the care needed in order to start the recovery process. And you will not want to choose the most experienced, top-of-the-line provider, if the person who needs care can handle a less intense form of treatment. So how can you find balance? Your treatment provider may help.
For example, when people contact American Addiction Centers about addiction care, the admissions staff starts a conversation about addiction and insurance. The staff tries to determine:
How long the addiction has been in place
What therapy options people have used in the past
How the addiction is impacting the person’s life
What therapies the insurance company might be willing to cover
With that information, and a few followup phone calls, the staff can make a recommendation on a treatment program. Should insurance cover part of that care, the staff can work on preauthorization issues, too.
“A majority of clients who come through our doors are in some way covered by a private insurance policy….Our insurance department is able to assist with the verification of benefits to uncover what a particular policy offers; also, insurance is going to take into account the medical necessity of treatment for a client. Clients will take part in a clinical assessment to ascertain medical necessity, which influences greatly how much their insurance provider will assist financially, based on benefit coverage max.”
— Eric Cox, Call Center Training Specialist at American Addiction Centers.
At American Addiction Centers, this process takes about 24-48 hours. Other providers might need more or less time to do that work, and the results can vary.
“There is no set price that a family can expect to pay, when utilizing insurance as their payer source,” Cox says. “This depends greatly on the insurance policy and the degree of medical necessity (determined primarily by the clinical assessment completed prior to granted admission at our facilities).”
Questions to Ask
Once you know the specifics involving program type and price, you can work on your final selections. There are a few great questions to ask each provider before you settle on a final choice.
The therapy choices your loved one needs can be based on all sorts of factors, including addiction history and personal preference. But the facility may have standardized plans to show you that can give you a feel for how similar issues are treated by that provider.
This is an especially important issue to clarify if you are choosing an inpatient program. You will need to know what sorts of resources the staff can provide in order to ensure that the person does not have the opportunity to relapse.
Some rehab facilities offer therapy in a group format, and sometimes, that group therapy edges out individual therapy options that are necessary. For example, an analysis in TIME found that some programs offer up to eight hours of group therapy every day, with little time left for individual therapy.
It can be helpful for the person you love to have access to a counselor in one-on-one therapy sessions. Asking this question ensures that the facility you choose will provide that kind of care.
This can be a sticky and complicated subject, as the Department of Health and Human Services suggests that license and certification requirements can vary depending on the state and facility type. Some individual providers do not need the same oversight that a facility might. So you will not get the same answer from different provider types. They need different things in order to get the job done. But the people you ask should be able to demonstrate compliance with at least some oversight committees and groups. Those that cannot might best be avoided.
Understanding your treatment options and seeking out that perfect treatment provider can be a time-consuming task, but all your work is worthwhile. After all, everything you learn about addiction and every step you make toward a treatment decision could help the person you love to heal. Sometimes, that work could even help you to heal. We hope this guide helps you to get started.
A typical rehab program consists of several components, all of which may or may not be included within one treatment price. These include:
Continuing therapy sessions
Room and board
Continued outpatient care
Sober living homes
Families can use insurance, private pay, and/or private loans to cover costs.
Dollar amounts are estimates. They are provided for the purpose of researching treatment options and are not to be considered absolute or binding. This guide may also contain information or solutions that American Addiction Centers does not offer. This information is still included to provide you with a comprehensive resource.
An addiction left untreated can punch a huge hole in a family’s budget. An analysis in Forbes suggests, for example, that a person living at the poverty level could expect to spend up to half of every dollar of income on the addiction. That leaves little funds available for other vital expenses, including food or housing.Families can break that cycle by investing in drug rehab. “Some families have gone through similar processes of getting their loved ones in treatment on numerous occasions, so they expect the price point,” says Eric Cox, Call Center Training Specialist at American Addiction Centers.
But sometimes, families are unaware of the costs they will be expected to cover when they ask for this vital help. They are unaware or surprised when the admission process moves forward, and the numbers start to become clear.
That’s why this guide was created. Here, you will find information about all the options you might use in order to cover your loved one’s recovery journey.
The Actual Cost of Drug Rehab
A family that wanted to buy a car could simply hop online, type in a few pertinent notes, and come across detailed lists about pricing gathered from all across the country. With that information, they could determine which car dealership had the best price and which car was the right one to meet their needs. Unfortunately, the rehab industry is a little different.
According to Cox, rehab can cost anywhere between $15,000 to near $27,000, and that huge variability is due, in part, to the nature of a well-structured rehab program.
Unlike cars, which might come with a specific set of details and functions, rehab is almost endlessly variable. Some people need more recovery components than others, and some need in-depth services that others can skip. Some have plans that change midstream, which can cause a rise or dip in fees. And some have complications that necessitate screenings the family did not plan for. All these things make pulling together ballpark figures very difficult.
That said, a typical drug rehab center might include standard components within one treatment price, such as:
Medications and medication management
Support group services
Continued therapy sessions
Room and board (with inpatient/hospitalization programs)
Other components that might be needed, which might not be included in the rehab price, include:
Continued outpatient care
Sober living homes
“When prospective clients and their families first contact American Addiction Centers about beginning the process of treatment for addiction, they can also jumpstart the process of managing the financial aspect of recovery…In most cases, families and their loved ones in need of addiction treatment will begin by determining what treatment services and programs will be covered by their health insurance policy and what costs will be associated with treatment. This begins with a quick pre-admission assessment done with a treatment consultant over the phone that is then sent to AAC’s Verification/Placement department.”
— Johana Desir, Director of Assessment and Placement at American Addiction Centers
As Desir’s comments make clear, families looking for treatment help are not required to determine what kind of care the person needs and/or what ancillary services might be beneficial. Those are steps the admissions staff might handle.
But families are required to determine if the proposed care is worth the cost, and that can be a difficult thing to do. How much is real recovery worth? And how much does it cost to get there? Defining the goal of treatment could help families to answer those questions.
Health: Physical and mental health concerns that cause discomfort, distress, or both should be eliminated or managed.
Home: The person should have access to a safe and comfortable place to live.
Purpose: Meaningful activities, such as work, volunteerism, or creative endeavors, should be part of daily life.
Community: Social networks that foster feelings of friendship and love should surround the person.
A program that can help a person with addiction to move in this healthy, confident direction might be worth the cost. Those that cannot, or that will only assist with some points and not others, might not deliver the value the family is looking for.
But this is a subjective consideration, to be sure. One cannot put a price on a feeling of home and community, for example, and it can be difficult to determine if a facility can really provide all that it claims to provide. But, before families leap away in fear at the first mention of price, it can be helpful to remember what rehab is designed to deliver: real healing.
How to Pay for Rehab in Your Current Financial Situation
It’s clear that drug rehabilitation is worth the price of admission, but how can families pay for this care? There are numerous different options that could be useful, and two of those options have nothing to do with insurance coverage.
Some families choose to pay for rehab services out of the family’s checking or savings account. According to Cox, there are benefits to this option. “The greatest benefit is control of care and location,” he says. “With insurance, a client is at the mercy of that insurance policy as to the quality of care that can be sought.” When people pay with cash, they answer to no such authority. They can choose a provider and pay without that hassle.
According to the National Survey of Substance Abuse Treatment Services conducted in 2012, nine out of 10 facilities accept self-payment for drug abuse rehab services. That means families that wish to pay in cash might have many different providers to choose from, since so many accept this form of payment.
There’s certainly no stigma attached with borrowing money. The Federal Reserve Bank of Kansas City suggests that consumer debt (excluding student loans) rose to over $10 trillion in 2012, which seems to suggest that almost every household in America has some type of outstanding loan. When there are needs the budget cannot cover, using loans seems reasonable to most people.
When families borrow money for rehab, they are typically asking for a type of loan called a personal loan. There are a number of documents families typically need to produce in order to get this type of loan.
For example, the bank One Main Financial requires a great deal of documentation, which might include:
Proof of identity, such as a driver’s license or passport
Pay stubs or proof of wages
Bank deposit statements
Credit card statements
All of these documents allow loan officers to dig into a person’s history of paying back debts, and they can provide officers with a glimpse into a family’s ability to pay back the loans they need.
A personal loan like this is typically not secured by something like a boat, a car, or a house, but even so, an analysis by Fox Business suggests that these loan products can deliver big savings to families, especially when compared with credit cards. A credit card might have an interest rate of about 12.36 percent, Fox reporters say, while a personal loan might have an interest rate of only 10.52 percent. That percentage gap could mean great savings for families.
American Addiction Centers uses an outside broker to assist with this process, Cox says. “There are some stipulations to an applicant being approved for the requested loan,” he says. So families will need to keep that in mind. Some providers cannot loan money to families, as those families do not have great credit scores or financial histories.
Affordable Care Act and Health Insurance Coverage
While families might choose to use loans or cash to pay for rehab, they might also choose to use their insurance providers. That is a step Desir recommends. She encourages callers interested in treatment to have their insurance card available for the pre-admission assessment and to be prepared to answer any questions about the nature of their addiction and how it has impacted their lives.
After the Verification/Placement department receives the potential client’s phone pre-admission assessment information, Desir says: “We call the client’s insurance to obtain [information regarding the client’s] eligibility and benefits, and we find out what type of policy they have and where in AAC will be the best placement financially and clinically. We also estimate what the upfront cost will be, and we send it back to the treatment consultant, who will then reach out to the client, relay the information, and [assist them with] booking their travel and getting them moving.”Since the passage of the Affordable Care Act (AC), more families have health insurance, so there is more authorization work for the team to do.
“The act gave greater access to care for all, including potential clients who may not have (prior to the ACA) been able to financially consider a facility like ours, without the Act…The Act helped with nullifying restrictions like pre-existing conditions, length of coverage for dependents on their parents’ insurance, and improvements to the Mental Health Parity act. Overall, the ACA expanded the pool of clients we are able to serve.”
— Eric Cox, Call Center Training Specialist at American Addiction Centers.
ACA legislation requires all individuals to hold a specific amount of health insurance each month, according to the Centers for Medicare & Medicaid Services, and people who are employed may get that insurance from their employers. But people who are not employed or who do not have insurance through their employers are required to get insurance, or else pay a penalty for noncompliance.
This legislation ensures that all people have at least some semblance of health insurance (after all, people who pay a penalty get nothing in return, so getting insurance instead seems reasonable). But insurance does not cover all the expenses associated with rehab.Plans purchased in compliance with ACA come in several tiers: bronze, silver, and gold. Plans at the gold level are more expensive, but the coverage is broad. Plans in the bronze class are inexpensive, but many items are not covered.
As a result, the amount of money a family might be expected to pay when insurance is in play can vary widely. An analysis in USA Today suggests that the bill could rise to over $6,000 per person, per year, if just co-payments and cost-sharing are taken into account. That is an amount of money that could be hard for some families to pay back.
Regardless, it makes sense for families to at least explore their insurance options, so they can make sure they are getting the healthcare assistance their insurance plans should pay for.
In general, however, this is a process that tends to move quickly, as people with addictions need to get care as soon as they agree to do so.
AAC Billing and Insurance: What to Expect
When prospective clients and their families first contact American Addiction Centers about beginning the process of treatment for addiction, they can also jumpstart the process of managing the financial aspect of recovery. In most cases, families and their loved ones in need of treatment of addiction will begin by determining what treatment services and programs will be covered by their health insurance policy and what costs will be associated with treatment. This begins with a quick “pre-admission” assessment done with a treatment consultant over the phone that is then sent to AAC’s Verification/Placement department.
Johana Desir is the Director of Assessment and Placement at AAC and the resident insurance process expert. She encourages callers interested in treatment to have their insurance card available for the pre-admission assessment and to be prepared to answer any questions about the nature of their addiction and how it has impacted their lives.
“We call the client’s insurance to obtain [information regarding the client’s] eligibility and benefits, and we find out what type of policy they have and where in AAC will be the best placement financially and clinically. We also estimate what the upfront cost will be, and we send it back to the treatment consultant, who will then reach out to the client, relay the information, and [assist them with] booking their travel and getting them moving.”
— Johana Desir, Director of Assessment and Placement at American Addiction Centers.
From the initial call made by a prospective client or family member to American Addiction Centers, the process of determining insurance coverage and admitting the person to one of our facilities generally takes only 24-48 hours. Once admitted, all pertinent financial documents and admission paperwork will be explained and then signed at the facility. That is a process other facilities might use, too, although their timelines might differ a little.
Pros and Cons
Every family will need to consider these issues carefully, weighing all the options before choosing a plan that seems right for the person who needs care and the family that needs to pay for that care. There are many pros and cons to consider.
Pro Cons word on paper on table[/caption]For example, GroundWork Counseling suggests that private pay options can benefit clients, as they allow people to choose their own providers, regardless of what the insurance provider might think or say. Where an insurance company might specify one provider for care, a family might think that another option is best. Using private pay, either with cash or loans, allows the family to make that decision and stay in control.But cash options can deplete the family’s ability to pay for other necessities of life, and loans can reduce the family’s ability to take out future loans for things like cars and houses. As the Consumer Financial Protection Bureau points out, mortgage companies like to see a debt-to-income ratio of about 43 percent. Families that go over this price point have a hard time qualifying for a loan, and that could make their dreams of home ownership an impossibility.
Health insurance can help to keep the overall cost of care down, as families won’t be asked to shoulder the burden of all the bills alone. But again, insurance companies keep control over things like provider type and length of stay, so families will have limits. That is a con that is too big for some families to tolerate.
As you are deciding how you might choose to pay for care, it could be worthwhile to understand how much specific aspects of care cost. You could, in theory, use this information to help you plan. You might pay for some aspects of care yourself, for example, while leaving other aspects up to insurance.
According to Kristy Bryant at American Addiction Centers, these are a few cost ranges for services people might need in rehab:
Intervention: $2,500 plus expenses
Supervised medical detox: $500-650 per day (private pay rate)
Partial hospitalization: $350-450 per day (private pay rate)
Inpatient care in a facility: $500-650 per day (private pay rate)
That means families in dire financial straits might pay less than this amount for the help required, but not all facilities offer this service.
Help Is Available
If you are looking for assistance with a very real and very persistent addiction problem that is touching your family, you do not have to do the work alone. Most providers are adept at explaining rehab options, including costs, so you can understand just how much you will need to pay and how the program will work. If you do choose to use insurance, representatives can work with the rehab provider on preauthorization and other paperwork, so you will not have issues to handle when you are working to recover.Do not let cost stand in the way of a fight against addiction. The options outlined here could make your rehab journey affordable and attainable. As always, we are here to answer any questions you may have about how rehab works and why you might benefit.