Posts Tagged Drug Rehabs

The Difference Between Insurance and Private Pay Drug Rehabs

Information on what differentiates drug rehab centers that accept PPO or HMO insurance plans versus those that only accept out-of-pocket private payments

Most licensed residential & outpatient drug rehabs and treatment centers work with at least a few of the major health insurance providers nationwide.  Examples of such companies would be; Blue Cross/Blue Shield, Aetna, Pacificare, Humana, Kaiser Permanente, Cigna, United Healthcare and several others.  In most cases clients with PPO plans will have many more options than those with HMO plans.

Most health insurance providers have very stringent standards and are extremely tight with their payouts when a client requires treatment services.  As a result, it is quite rare that one’s health insurance coverage will cover the cost of rehabilitation in its entirety.  In most cases there is a standard deductible or copayment required upon intake that can range anywhere from several undred to as much as several thousand dollars.  Beyond that, it may also be the case that your health insurance provider caps out at a certain monthly or annual payout and thus, any residential or outpatient treatment center charges above that mark are the client’s responsibility.

The real question remains, in a scenario of a treatment center only accepting private payments versus one that contracts with health insurance providers, which tends to offer a higher and/or more effective level of care?  The truth is, that when it comes to things like drug addiction, alcoholism, substance abuse and dual-diagnosis issues, so many variables exist that it’s difficult to truly assess which treatment center is in fact more or less effective.  What we can say, however, is that facilities charging higher rates or solely funded through private pay clients have more flexibility and thus, typically offer a broader array of both, clinical as well as non clinical services.  Private pay rehabs often have expanded holistic and ancillary components like yoga, pilates, personal training, private coaching, naturous activities and so on.  All this is of course in addition to primary elements like group & private therapy, counseling, relapse prevention, etc.

Health insurance companies always have what are termed “contracted rates” which means that they pay far less for the same program that the client would otherwise spend on an out-of-pocket basis.  A drug rehab charging 22 thousand dollars per month for non insurance clients might only receive half that amount from the provider of an insurance pay client.  Whether or not the client has the ability or is required to make up the difference is entirely on a case by case basis.

In the final analysis, there is no set equation as to determining the effectiveness and success rates of drug rehabs accepting health insurance versus those that don’t.  One word of caution though, if a facility does not accept any type of health insurance provider it is extremely important that you verify their state licensing during your initial inquiry.  While some addiction & alcoholism treatment centers are fully licensed yet opt to not accept insurance in lieu of their elite, high-end environment, others will commonly avert licensing restrictions and operate as a “recovery environment” as opposed to a bona fide “treatment center” which means they essentially have no governing body being held accountable to.

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America’s Major Recovery Regions and States – CA, FL, AZ, TX

Why are states like California, Florida, Texas and Arizona almost always on the forefront of addiction and alcoholism treatment services


Throughout the United States it has become quite well known among those working within the addiction & alcoholism treatment industry that states like California, Florida, Arizona & Texas tend to be among the most frequented by people needing rehabilitation.  Why is this?  Is it because some of the most well known facilities are located in these regions?  Is it because luxury and higher-end treatment centers tend to offer a broader array of recovery and ancillary components?

People fly to these states from all corners of the world in order to check into some type of rehab, be it for drugs alcohol, eating disorders, co-occurring disorders and so on.  Moreover, many choose to stay longer, post-treatment, in order to transition into some of their highly recognized sober living homes as well.  Whatever the case may be, and while it’s true that California, Florida, Arizona & Texas tend to draw the most attention in this regard, it is important to realize that many other regions offer wonderful mental health & addiction/alcoholism treatment centers as well.

One of the key differences with these 4 states is that they seem to offer a higher percentage of what appears to be more luxurious, higher-end rehab facilities for men and women.  Is this truly the case when compared percentage wise with all the other local recovery services in the region?  We don’t know but one thing is for sure, these specific facilities tend to have created a very strong reputation for themselves in a umber of ways.  Most of these locations accept health insurance but are costly to the point that a substantial out-of-pocket investment will need to be added to the insurance portion.  In turn, there are usually more enhanced clinical services, expanded ancillary services and of course, better cuisine and more privacy.

A.T.R.I. does not present this material as any type of endorsement for any specific treatment center or recovery approach.  We are simply speaking from experience.

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The information above is intended as a general guide based on the experience of many. The creators of this web page are not licensed physicians; we are caring individuals whom have experienced the horrors of addictive-type illnesses on many levels. We speak from many years of personal and professional experience. Please feel free to contact us for any reason at:

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