Does Insurance Pay for Therapy & Drug Counseling

Will Insurance Cover Drug Counseling?

For the many Americans who need substance use treatment, just a small fraction get the help they need.¹ One of the most common obstacles to treatment is the inability to pay for it.

However, health insurance can make treatment much more affordable. The Affordable Care Act mandates that insurance companies offer some type of coverage for substance abuse treatment, which typically includes drug counseling and other forms of behavioral therapy.

The extent of insurance coverage for drug or alcohol addiction may vary. You can verify your insurance coverage online using the confidential tool.

What is Drug Counseling?

Drug counseling is a process of helping people with substance abuse issues to overcome their addictions and understand the root causes of them. Counselors are professionals who are trained to deal with the multitude of complex problems that addiction can bring up.

Drug counseling is something many who struggle with addiction need to revisit throughout recovery. It doesn’t necessarily need to be rendered at a treatment facility though. Drug and alcohol abuse counselors are employed as therapists and mental health professionals at local health departments, and they frequently have their own private offices.

Some individuals who need drug counseling need help for poly-drug abuse. Secondary drug use is most common alongside alcohol addiction.² Drug and alcohol counselors do not normally screen for and diagnose mental health disorders, but they can report their findings to therapists and psychiatrists who are capable of rendering such diagnoses.

For those with mental health symptoms, drug counseling helps them to comprehend how symptoms like depression and anxiety may have led them to self-medicate with drugs or alcohol. Once individuals understand why they engaged in substance abuse in the first place, they have a better chance at resisting triggers to use or drink again and sustaining sobriety.

Drug Counseling Insurance Coverage

Individuals in need of treatment can verify their insurance coverage options prior to seeking treatment. While rehab centers usually have a human resources or administrative representative available to assist potential clients in navigating their insurance plans, the insurance company is still the primary resource for gaining this kind of information. A simple phone call can clear up any confusion. Questions to ask insurance companies about an individual’s policy coverage include:

• Is substance abuse treatment covered?
• Is the policy deductible met yet?
• Is drug counseling a covered service, and at what percentage is it covered?
• Is there a copay?
• Is there any limitation on how long drug counseling services will be paid?
• Is a referral necessary to start treatment?

The Affordable Care Act & Addiction Coverage

Fortunately, legal mandates concerning insurance policies in recent years have aided in making treatment options readily available to individuals who need help. Insurance coverage is far more widespread today than it was just a few short years ago, thanks to the Affordable Care Act.

With the ACA’s passing came strict enforcement of new legislation. This legislation requires that health insurance plans offered under the government marketplace’s umbrella supply some extent of coverage for substance abuse and mental health treatment services.

These coverages range from outpatient Suboxone programs through a primary care physician to residential detox to long-term therapy.

In addition, the ACA made a strong push for Medicaid to expand treatment coverage options, too, which the Kaiser Family Foundation reports it has in 32 states.³ As a result, 80 million Americans were covered by Medicaid in 2014, according to the Center on Budget and Policy Priorities.⁴ Nationwide, there are 11,988 facilities that treat substance abuse and addiction, per SAMHSA.⁵ Among them, 7,146 accept Medicaid and 7,976 accept private insurance plans.

Employers most often provide private insurance plans.

Insurance coverage varies widely depending on an individual’s policy. Some people may benefit from full coverage for drug counseling while others have to pay a significant portion of their treatment costs. A middle-of-the-road plan will typically cover around 80 percent of an individual’s healthcare costs, but it’s important to verify drug counseling coverage prior to committing to a specific treatment regime.

Call an admissions navigator at to verify your insurance coverage at American Addiction Centers (AAC) and begin the admissions process. You can also fill out the confidential form below.