Navigating Insurance for Addiction Treatment

Understanding your insurance options is a critical step in accessing addiction treatment. We're here to help clarify the process and connect you with the resources you need.

The cost of rehab and navigating insurance benefits can be complex. This guide provides clear, straightforward information to help you understand how to use your insurance for addiction treatment in Indiana.

Key Insurance Terms Explained

In-Network vs. Out-of-Network

Deductibles

Copayments (Copays)

Coinsurance

Pre-authorization

Commonly Accepted Insurance Types

Private Insurance

Plans typically obtained through an employer or purchased directly from an insurance company (e.g., Anthem, UnitedHealthcare, Aetna, Cigna).

Marketplace (ACA) Insurance

Plans purchased through the Health Insurance Marketplace, which must cover essential health benefits, including substance abuse services.

Indiana Medicaid

A state and federally funded program providing health coverage to eligible low-income individuals. Many facilities accept Medicaid.

Medicare

A federal health insurance program primarily for people aged 65 or older, and some younger people with disabilities. Coverage can vary.

Important Note: Always verify acceptance of your specific insurance plan directly with the treatment facility. IndianaRehabs.com lists facilities but does not guarantee insurance acceptance for any specific provider.

How to Verify Your Coverage: Two Key Steps

Contact Your Insurance Provider Directly

Call the member services number on the back of your insurance card. Be prepared with specific questions (see our list below). This is the most direct way to understand your benefits.

Let Rehab Facilities Assist You

Most treatment centers have admissions staff skilled at navigating insurance. They can often verify your benefits for you and explain your coverage in detail. Use our directory to find facilities.

Find Facilities Now

Questions for Your Insurance Provider

Does my plan cover substance abuse treatment services?

What types of treatment are covered (e.g., detox, inpatient residential, outpatient, therapy)?

What is my deductible, and have I met it?

What are my copay and coinsurance amounts for these services?

Do I need a referral from my primary care physician?

Is pre-authorization required for any specific services or facilities?

Which local addiction treatment facilities are in-network with my plan?

What is my out-of-pocket maximum for the year?

Questions for Rehab Facilities

Do you accept my specific insurance plan? (Provide plan name and member ID)

Can you help me verify my benefits and estimate my out-of-pocket costs?

What is the typical length of stay for the recommended program, and how does my insurance cover that?

Which specific services within your program will my insurance likely cover?

Are there any services considered out-of-network or not covered?

Do you offer payment plans or financial assistance for costs not covered by insurance?

No Insurance or Limited Coverage?

Don't lose hope. If you lack adequate insurance, several alternatives can help you access treatment:

State-Funded Rehab Programs

Indiana offers state-funded programs that may provide treatment at a reduced cost or free of charge for eligible individuals.

Sliding Scale Fees

Some facilities offer payment plans based on your income, making treatment more affordable.

Financing Options

Healthcare loans or credit options might be available to help manage treatment costs over time.

Non-Profit Organizations

Certain non-profits and charitable organizations offer scholarships or financial assistance for addiction treatment.

SAMHSA National Helpline

A free, confidential, 24/7 treatment referral and information service (1-800-662-4357). They can guide you to resources.

Call 1-800-662-HELP