How to Get Drug and Alcohol Treatment Without Insurance
According to the National Survey on Drug Use and Health (NSDUH), an estimated 21.7 million people aged 12 and older needed substance abuse treatment in 2015. Of those, only 2.3 million actually received professional treatment.1
People in need of drug and alcohol rehab may not seek treatment for many reasons. Unfortunately, one of the biggest reasons is financial. Many people are uninsured or underinsured and simply cannot afford the high costs of addiction rehab centers without insurance coverage.
Addiction is a chronic illness that typically progresses and gets worse over time without professional intervention or treatment. Early intervention, rehabilitation, and aftercare programs can save lives by preventing drug overdose and decreasing the risk of medical complications associated with chronic drug and alcohol abuse.
Fortunately, there are ways that a person can receive addiction treatment services even if they don’t have insurance. These include crisis hotlines, public insurance, low-cost or free programs, 12-step groups, and financing or sliding scale payment arrangements.
How Much Does Treatment Cost?
The costs of addiction treatment can vary greatly depending on the type of treatment program, among other factors.
Detox programs can cost as much as $1000 a day, residential stays can set you back $200-900 per day, and some outpatient programs may be priced at $100-$500 per session. 8
When length of treatment is considered, inpatient rehab centers typically end up being the most costly treatment option, as care is provided 24/7 for 30 days or more. This type of care includes room and board and other amenities in addition to addiction treatment and medical care. Professional detox facilities and hospital detox programs can also be costly, as they typically provide many medical interventions and support. Outpatient programs are usually the cheapest because they do not include meals, dormitories, and other related services.
The cost of treatment ultimately depends on the treatment program itself. Treatment costs can vary greatly from program to program and person to person depending on a number of factors, such as:
- Location. The location of the facility can drastically affect the price. For example, some insurance companies may provide less coverage for treatment programs that are out of state or simply out of their insurance network. The location of the facility can also affect cost just based on the cost of living in that area. Treatment programs may be cheaper in smaller communities than in larger cities. Treatment also tends to be much more expensive in vacation-like or exotic locations such as islands, beaches, and mountain resorts.
- Services and amenities. The services and amenities provided by a treatment program can also affect the cost of admission. Some programs may provide all services and amenities for a flat fee, whereas others may charge extra for certain amenities that patients can opt out of if they choose. Some services and amenities that can increase the costs of addiction treatment include private rooms, gourmet meals, oceanfront or mountain views, recreational centers, swimming pools, acupuncture, and room service.
- Length of stay. The amount of time you choose to stay at a treatment center will affect your overall costs. Many treatment centers have per diem rates, meaning that they charge you for each day you remain in treatment.
How to Get Immediate Treatment Without Insurance
Do not let insurance stand in the way of seeking addiction treatment for yourself or a loved one, especially in acute or emergency situations. If a person is at risk of suicide, overdose, or other serious physical or emotional harm to themselves or others (i.e., an “acute situation”), seek professional treatment immediately. In these situations, seeking treatment is often a matter of life and death.
- Call your local crisis hotline. Most states have crisis intervention programs that can provide you with resources and support. Each state is different, but they may have assistance programs available to help you get into drug rehab with little to no insurance coverage. If you know your local crisis center hotline, start by calling them for support (if you don’t, google your state or city and “crisis hotline”). You may have to enter your zip code to be routed to the most appropriate person.
- Provide as much information as possible. When you speak with community support personnel, give them as much information as possible so that they can find the best resources for you. If you are pregnant, homeless, severely ill, elderly, or under the age of 18, there may be specialized programs that will allow you to get into treatment faster or provide you with additional financial assistance.
- Find your state’s mental health and substance abuse agency. You can also conduct a Google search to find your state or county’s mental health and substance abuse resources. If you choose to find resources using Google, be sure they are credible organizations and websites. Look for legitimate “.gov” websites. Have a pen and paper handy to write down any relevant information you may find online or be given by a hotline.
- Use SAMHSA’s tool. The Substance Abuse and Mental Health Services Administration (SAMHSA) has an online behavioral health treatment services locator where people can search for mental health and addiction treatment programs and services in their local area. You may be able to find low-cost or free rehab centers that take people in a crisis.
Signing Up for Public Insurance
If you are uninsured and in need of addiction treatment, research public insurance options to see if you qualify. Three of the most common options are listed below.
The Affordable Care Act
The Affordable Care Act is a health reform law that was enacted in 2010 in order to make health insurance more accessible and affordable. This law increased the income limits for Medicaid eligibility and lowered the out-of-pocket insurance costs for those living at or below 400% of the federal poverty level.3
You can find government and private health insurance plans based on your eligibility by visiting the health insurance marketplace. All health insurance marketplace plans created under the Affordable Care Act are required to provide insurance coverage for mental health and substance abuse treatment.2
Medicaid and Medicare
Medicaid is a federal and state-funded insurance program available to low-income families, qualifying pregnant women and children, and individuals with disabilities. Eligibility requirements vary by state.7
Medicare is a federal insurance plan for elderly individuals over the age of 65, as well as people with certain qualifying disabilities.5
Public Insurance Program Coverage
Even though Medicaid, Medicare, and marketplace plans are all public insurance programs, their coverage for substance use treatment will vary.
- Marketplace plans will have some form of coverage for addiction treatment, although out-of-pocket costs can vary considerably depending on your individual plan.
- Medicaid typically provides some mental health and substance abuse coverage, but not every substance abuse treatment center will accept Medicaid coverage.2
- Medicare will provide coverage for substance abuse treatment if a doctor proclaims it as medically necessary and treatment is provided by a qualifying provider under the Medicare plan. Medicare coverage comes in 4 different parts: A–D. Inpatient treatment will be covered under Part A, outpatient treatment is covered under Part B, and prescriptions may be covered under Part D, if eligible.2
Other Ways to Pay for Treatment
If for whatever reason you are not eligible for insurance or not interested in it, there are other means of financing addiction treatment, such as:
- Sliding scale rehab centers. Many treatment centers providing sliding scale rates based on income for individuals who are struggling to pay for addiction treatment.
- Payment plans. Some rehab centers will provide payment plan options to those without insurance to make treatment more affordable and accessible.
- Borrowing from friends or family. It may be tough to ask for help, but friends and family members can often be a good source of support. Many of your loved ones may be willing to lend you money to make this important investment in your future.
- Crowdfunding. Crowdfunding allows you to fundraise money to cover the costs of your treatment. There are many crowdfunding websites you can use for this purpose, such as GoFundMe.
- Credit cards or personal loans. If you have no other means of financing treatment, you may want to consider paying for it using credit cards or taking out a personal loan. Just make sure that the repayment plans and insurance rates are affordable, so you don’t find yourself in a financial bind when you complete treatment.
- Free rehab centers. There may be free rehab centers and detox facilities available that can provide you with addiction treatment free of charge. Contact your local community resources or use SAMSHA’s behavioral health treatment services locator linked above to find out what programs may be available near you. Be aware, though, that these programs can have long waiting lists.
Getting a Professional Assessment
If you are unsure whether or not you or a loved one is in need of addiction treatment or what level of care is most appropriate, you may want to consider getting a Structured Assessment and Brief Intervention (SBIRT) from a qualified medical professional.
An SBIRT is an assessment technique that helps identify substance abuse disorders and provide early, effective interventions before the need for more intensive treatment arises. After the assessment is completed, a medical professional will refer you to the appropriate level of treatment.6
Many online tools and hotlines can assist people in finding low-cost or free rehab centers without insurance. These resources can provide addiction treatment information and direct you to resources to help assist you with the costs. Some can provide support services as well.
- Alcohol & Drug Help Line. This is a 24/7 addiction treatment referral hotline for those suffering from substance abuse disorders. Please note that their phone number is not toll-free, and long distance charges may apply depending on your telephone provider.
- SAMHSA’s Behavioral Health Treatment Services Locator. The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a free and confidential source of information online for those seeking substance abuse treatment services. Many of the programs you’ll find in this database accept public insurance or offer sliding scale rates for those looking to attend rehab centers without insurance. You can use this tool to search for free inpatient rehab centers and free detox centers near you. You can also call SAMHSA’s 24-hour helpline for assistance and information at 1-800-662-HELP (4357).
- National Runaway Safeline (1-800-RUNAWAY). This is a national helpline that offers confidential support for those who are contemplating running away from home or who have already done so. This hotline can be a source of support for individuals facing addiction who may feel helpless in their current situation.
- Boys Town National Hotline. This is a 24-hour crisis hotline staffed by counselors who provide support as well as community resources. Callers can ask questions, obtain resources, and even get parenting advice for difficult situations.
- National Suicide Prevention Lifeline. This is a free, confidential helpline available 24/7 to provide support and resources to those in crisis or distress who may be contemplating suicide or otherwise affected by it.
You may also want to check with your local or state mental health agency, community health center, church, or other local nonprofit organizations to see if they have any low-cost or free detox centers or addiction treatment programs available.
That said, free inpatient rehab centers and outpatient treatment programs often have long waiting lists, so this may not be the best option for those in need of emergency assistance. If you are not in an acute situation or immediate crisis, you can always join the waiting list and call back regularly to check your status.
Support groups are available across the country for individuals struggling with substance abuse disorders. Even though these programs can offer an invaluable source of support for people, they do not provide detox services or medical treatments. Some programs that follow the traditional 12 steps include:
- Alcoholics Anonymous (AA). This is the original 12-step program that was created in 1935. AA is a free, international peer support group for those struggling with alcoholism. The only requirement to join is a desire to stop drinking.
- Narcotics Anonymous (NA). This is the most popular 12-step program for individuals struggling with drug abuse. The program is open to anyone abusing substances that desires a drug-free lifestyle. The program is available globally with no membership costs or requirements other than the desire to be free of mind-altering substances.
- Cocaine Anonymous (CA). This is a free, international 12-step support program specifically for people struggling with cocaine addiction. The only requirement to join is the desire to quit using cocaine and any other mind-altering substances.
- Crystal Meth Anonymous (CMA). This is a free, international 12-step support program for individuals struggling with crystal meth addiction. The only requirement to become a member is the desire to stop using crystal meth and other mind-altering substances.
In addition to traditional 12-step programs, other alternative support groups are available for those who prefer a different approach. These include:
- Secular Organizations for Sobriety. This is a network of secular, nonprofit support groups that help encourage sobriety. These support groups do not have any emphasis on religion or spirituality. Meetings are confidential and free of charge.
- SMART Recovery. This is a global support group that is based on the latest scientific evidence related to substance abuse, recovery, and treatment. Meetings are available in-person as well as online, at no cost to members.
- LifeRing Secular Recovery. This is a secular peer support group that focuses on abstinence, empowerment, and group sharing through in-person and online meetings.
- Bose, J., Hedden, S., et al. (2016). Substance Abuse and Mental Health Services Administration. Key Substance Use and Mental Health Indicators in the United States: Results from the 2015 National Survey on Drug Use and Health.
- U.S. Department of Health and Human Services. (n.d.) Health Insurance and Mental Health Services.
- Healthcare.gov. (n.d.) Affordable Care Act (ACA).
- Medicaid.gov. (n.d.) Eligibility.
- Medicare.gov. (n.d.) What’s Medicare?
- Department of Health and Human Services (2015). Screening Brief Intervention and Referral to Treatment (SBIRT) Services.
- Medicaid.gov. (2016). Who can tell me if I am eligible for Medicaid?
- American Addiction Centers. (2017).