In this guide
- Does insurance cover rehab?
- How much does rehab cost with insurance?
- What is pre-authorization?
- What if my insurance denies treatment?
- Will my employer know I went to rehab?
- Do you accept Medicaid or Medicare?
- What is an out-of-network single-case agreement?
Does insurance cover rehab?
Yes. The Mental Health Parity and Addiction Equity Act and the Affordable Care Act require most plans to cover substance use and mental health treatment as essential health benefits. Coverage details vary by plan, which is why verification matters.
How much does rehab cost with insurance?
With a PPO plan, most clients pay their deductible and coinsurance up to their out-of-pocket maximum. Many clients pay little to nothing beyond the deductible. We give you the estimate before admission.
What is pre-authorization?
Insurer approval that a level of care is medically necessary before it begins. Required for detox, inpatient, and PHP on most plans. Our utilization team submits it and usually has approval the same day.
What if my insurance denies treatment?
We appeal through peer-to-peer review with the insurer's medical director. Many denials are overturned. If coverage is still limited, we discuss step-down options or payment plans.
Will my employer know I went to rehab?
No. Claims are protected by HIPAA and 42 CFR Part 2. Insurers do not report claims to employers.
Do you accept Medicaid or Medicare?
Coverage varies by state and location. Call us and we will tell you directly.
What is an out-of-network single-case agreement?
A negotiated contract between an out-of-network provider and an insurer for one client. We pursue these when a plan has no in-network option that meets the client's needs.