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American Addiction Centers National Rehabs Directory

Using Health Insurance to Pay for Fentanyl

Fentanyl is a powerful synthetic opioid that is highly addictive.1 For those who develop an addiction to fentanyl, addiction treatment can help them stop using. If you are seeking help for fentanyl addiction, you may wonder how you will pay for rehab. Fortunately, most insurance providers will help cover at least some of the cost of treatment. Read on to learn about whether health insurance covers fentanyl rehab, how to use health insurance coverage for rehab costs, and options for paying for treatment if you don’t have insurance.

Does Health Insurance Cover Drug Rehab?

Yes, most health insurance plans will cover at least some of the costs of drug rehab. Health insurance is the second most common way that people pay for treatment, as using health insurance benefits can significantly reduce the financial burden of seeking treatment.2 Covered services and the cost for each benefit can vary widely from provider to provider and even person to person. To find out what your insurance covers, you can call the number on your insurance card.3 You can also call and speak to one of our admissions navigators at and they can help you find out what your insurance for drug rehab can cover.

The Affordable Care Act (ACA) expanded access to substance use disorder(SUD) treatment for millions of people and made it more difficult for insurance companies to deny coverage based on previous treatment episodes.4 Because of the ACA, facilities are now required to provide addiction screening and treatment that is no more restrictive than medical and surgical services.4 The ACA also allows parents to keep their children insured up to the age of 26, allowing more young adults to receive treatment for addiction.4

How to Use Health Insurance to Pay for Drug Rehab

Paying for drug rehab with insurance may seem confusing, but these are steps that you can take to find out what your insurance policy can do for you.

If you or a loved one are considering seeking treatment for drug or alcohol use, you can call the number on the back of your insurance card.3 The customer service representatives at your insurance carrier will help you understand what is covered under your policy, what you can expect as a copay, and what your deductible is.3 Your insurance provider can also give you the names of in-network providers that offer SUD treatment in your preferred mileage range.3 In-network facilities will cost you less than out-of-network facilities.

If you have a facility in mind that you would like to seek treatment at, you can also call them directly. Here are the steps to follow when you call:

  1. Ask if they accept your insurance. This information you’ll need to give them is located on your insurance card.
  2. If they accept your insurance, ask for a free substance misuse evaluation. An evaluation will determine whether you meet the criteria for admission.
  3. If they accept you as a patient, ask the facility to get a pre-authorization for rehab.
  4. Once the pre-authorization is complete, ask their billing or business office to provide you with the exact amount your insurance will pay and how much your out-of-pocket cost will be.

This is often the best and least confusing way to know the exact amount you will have to pay for treatment at a certain facility.

Notably, most insurance carriers may only approve 5-7 days at a time. On the last day of coverage, the utilization review department at the facility will contact your insurance provider and request additional days of coverage. The additional days are based on medical necessity, so you must share any symptoms you are experiencing with your doctor and therapist, as they will document this and provide it to your insurance company. It is not uncommon for facilities to inform you within a day or two that your provider is no longer covering your care. This is part of the insurance review process and should be part of your expectation for care.

Some of the more common insurance carriers include:5

  • Blue Cross Blue Shield (BCBS).
  • Aetna.
  • Kaiser Permanente.
  • Centene.
  • United Health Group.
  • Humana
  • Medicare—government insurance for the elderly or disabled.
  • Medicaid—state insurance for low-income individuals.

If you or a loved one are seeking treatment, the admissions navigators at American Addiction Centers can assist you. Our navigators can help you find a facility that is in-network with your insurance, and they can help you understand the costs associated with various facilities. You can also fill out the form below to find out what your insurance policy will cover.

Paying for Addiction Treatment Without Insurance

Using insurance to cover the cost of rehab treatment is usually the most cost-effective way to pay for treatment. Insurance, however, does not typically pay the full cost of treatment, so for most people there will still be an associated out-of-pocket cost. Some facilities will help you establish a payment plan for any out-of-pocket cost you may have. If this is something you or a loved one may need, make sure you ask the billing department about their payment plans.

If you or a loved one are seeking treatment for drug or alcohol use and you do not have insurance at all, there may be other ways to pay for rehab. The most commonly accepted forms of payment for substance misuse treatment are self-pay (90%), health insurance (74%), Medicaid (71%), Medicare (42%), and scholarships or charity support are offered by approximately 44% of rehab facilities in the United States.2

Some ways to pay for addiction treatment without insurance include:2,4

  • Self-pay.
  • Payment plans or financing with the rehab directly.
  • Sliding scale and financial assistance options.
  • Faith-based programs.
  • Crowdfunding (e.g., using gofundme.org).
  • State-funded rehab programs.
  • Charity at the rehab you are seeking services from.
  • Free drug rehab programs are offered in some states.

Medicare is a government-funded program for the elderly or for those who are younger and have a disability.6 Medicaid is a state-run insurance program for people who meet the standard for low-income and people with disabilities.7 Both of these programs may pay for certain levels of care and may be able to supplement the cost of rehab if you qualify.

If you are unsure how you are going to cover the cost of fentanyl addiction treatment, reach out to one of our admissions navigators so that they can provide you with the support, information, and guidance you need as you begin your journey toward sobriety.

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