Does Insurance Cover Rehab?

The Short Answer

Yes — in most cases, insurance covers at least part of addiction treatment. Under the Affordable Care Act, substance use disorder treatment is classified as an essential health benefit, meaning most PPO and marketplace plans are legally required to provide some level of coverage. The exact amount depends entirely on your specific plan.

What's Typically Covered

Most PPO plans provide coverage across the full continuum of addiction care, though the specific percentage and any deductibles vary by plan.

• Medical detox — physician-supervised withdrawal management
• Residential / inpatient treatment — full-time structured care
• Partial hospitalization (PHP) and intensive outpatient (IOP)
• Standard outpatient therapy and aftercare
• Psychiatric evaluation and medication management
• Medication-assisted treatment (MAT) for opioid or alcohol use disorder

In-Network vs. Out-of-Network

If a treatment facility is in-network with your insurance provider, your out-of-pocket costs are typically lower and more predictable. Out-of-network facilities can still be covered, often at a different reimbursement rate — many PPO plans include out-of-network benefits specifically for this reason. This is exactly what a benefits verification clarifies before you commit to anything.

How Verification Works

1. 1You provide basic insurance information to the admissions team — no commitment required
2. 2The team contacts your insurance provider directly on your behalf
3. 3Your specific benefits, deductible, and coverage percentage are confirmed
4. 4You receive a clear, plain-language explanation of what's covered
5. 5You decide whether and how to move forward — with full information

What Information Is Needed

• Insurance provider name and member ID
• Group number, if available (usually found on your insurance card)
• Policyholder's name and date of birth, if different from yours
• A general description of the level of care being considered