When you or someone you love is facing a drug or alcohol addiction, it’s important to locate a quality substance abuse rehab center to begin the process of recovery. In many cases, COBRA may cover at least some of the cost of detoxification and rehabilitation services. If you’re wondering if your COBRA plan will cover your treatment, read on to learn more.
Does COBRA Cover Addiction Treatment?
COBRA continuation coverage allows individuals and their families to temporarily continue their insurance coverage, but it is often more expensive what they paid when they were active employees because their employer is no longer paying for any of the employee’s coverage. Therefore, all the costs can be charged to the individual.2
However, if you choose to use COBRA to continue coverage, the coverage you are given must be identical to the coverage that is available under the plan to active employees and their families. Typically, this is the same coverage you had prior to a qualifying event.2 Therefore, if you had coverage that included substance abuse treatment, then you would still have that coverage.
Does COBRA Include Mental Health Treatment?
The Affordable Care Act (ACA) requires that insurance companies provide some degree of coverage for mental health treatment, which includes substance use disorder (SUD) treatment (including coverage for drug and alcohol addiction), so the insurance plan you have through COBRA will most likely cover addiction treatment.3 So yes, it is highly likely that your COBRA insurance will cover addiction treatment.
What Are the Coverage Levels and Plans for COBRA?
The amount of coverage you have can vary widely based on your state of residence, whether the facility is in- or out-of-network, the length of your stay, and your insurance plan level. The cost of drug and alcohol addiction treatment will vary from person to person and will also depend on the rehab center, the type of program attended, and specific services received.
COBRA is optional self-pay insurance coverage you have the option of continuing even after your employment has ended. Your COBRA coverage is typically the same as that during your employment. Your eligibility for covered drug and alcohol addiction treatment services will vary based upon your individual health plan. In some cases, treatment will be fully covered; in other cases, copays or deductibles may apply. You can expect that your eligibility for coverage will require a medical evaluation that determines the scope of your addiction and the amount of treatment you require.
Your COBRA plan will cover the same rehab services your employer-sponsored plan would have covered. All insurance plans are different, and determining the amount of coverage to which you are entitled can sometimes feel challenging.
When your doctor indicates that rehab is medically necessary for your health, your insurance may cover all or part of your treatment, whether you opt for inpatient rehab at a residential facility or outpatient treatment through a doctor or rehab center.
Check Your COBRA Insurance for Rehab Coverage
It’s always best to be sure about what your healthcare benefits entail. You don’t want to be caught by surprise with unexpected financial costs. You may wonder if COBRA covers addiction rehab treatment, and the only way to really have the answer is to check your COBRA health plan coverage.
Knowing exactly what your COBRA plan covers can give you peace of mind while you or your loved one is in drug and alcohol rehab. You can do the work of getting and staying sober without worrying about unexpected costs or financial struggles. You can check your COBRA coverage by calling , click here, or fill out the form below.
What Different Types of Addiction Treatment Does COBRA Cover?
Getting the proper addiction treatment is essential for your recovery effort. The type of treatment plan you need will depend on the severity of your addiction and where you are in the journey to well-being. You might start out at one level of treatment and work way to another level, then continue until you don’t need treatment.
Some of the treatment programs you may expect to be covered through COBRA include:4,5
- Detox services: In some cases, you may need assistance when detoxing from drugs and alcohol, which can potentially be uncomfortable, painful, or even life threatening. Medical detox helps you safely withdrawal from drugs and alcohol, as you’ll receive around-the-clock medical supervision. You might also be given medications to help minimize withdrawal symptoms.
- Inpatient or residential care: Inpatient/residential live-in treatment centers provide drug and alcohol rehab while you live onsite at the facility. Most inpatient programs last anywhere from 15–90 days, depending on the program you’re in and your individual needs.
- Partial hospitalization (PHP): Partial hospitalization programs give you the opportunity to live at home while attending treatment during the day.
- Intensive outpatient program: (IOP): Intensive outpatient programs involve attending treatment programs a few evenings a week. In an intensive outpatient program, you can live at home and even go to work during the day.
- Outpatient treatment: Individuals who have completed inpatient treatment often attend outpatient treatment for ongoing support on their journey to sobriety. You live at home and spend 10–12 hours a week at the treatment facility for therapy and support.
Do Rehab Centers Need to Be In-Network to Accept COBRA Insurance?
Your COBRA plan will cover the same rehab services your employer-sponsored plan covered. Therefore, your plan will cover in-network and out-of-network treatment in the same way that it was covered under your previous insurance.
In-network providers have a contract with the insurance carrier to offer services at a set price. This means that your out-of-pocket expenses will likely be lower than if you select an out-of-network facility. You could even be responsible for all treatment costs if you choose an out-of-network facility. Whenever possible, it is usually best to select a facility that is in-network with your COBRA plan.
How to Verify the Coverage of Your COBRA Plan?
The cost of drug and alcohol addiction treatment will vary from person to person. It will depend on the treatment center, the type of program attended, and specific services received.
Before deciding on a rehab center, check your COBRA policy benefits to determine which costs will be covered by your insurance plan and which will be out-of-pocket for you. Call the number on your insurance card or log in to your account on COBRA’s website to determine how much you may need to cover in terms of copays and any deductible that must be reached before coverage kicks in for the services you need.
American Addiction Centers can also verify your insurance coverage for you. Visit our insurance verification page, enter your information, and you will immediately be able to see if the center you are considering is in-network with COBRA. Or call to speak to one of our admissions navigators to have them check your benefits and help you understand what is covered.
What Should I Do if COBRA Won’t Cover the Total Cost of Rehab?
In the event your COBRA insurance won’t cover some or all your treatment, you may still be able to pay for the care you need. Before allowing lack of coverage to deter you from seeking detox or rehab for drug or alcohol addiction, explore all your options thoroughly. Many facilities may be willing to offer payment plans, installment options, or sliding-scale rates to help you receive the treatment you need even if COBRA will not pay for it in full. Government programs also offer aid to recovering addicts that can prove helpful. Many facilities will work with you to figure out how to have access to treatment and make it affordable.
There are other resources to help you cover the cost of rehab. You can check with the rehab facility for a sliding scale fee or payment arrangement. Additionally, some facilities offer financial aid or scholarships for treatment. If those options aren’t available, you could try to get a loan from family or friends.
Here are some resources that can help:
So, can you use your COBRA insurance coverage for addiction treatment? Yes, you can! The specific details and how much the insurance pays for will depend on your plan and the provider you choose. However, there are options to help you pay if your insurance doesn’t cover the full cost.
What’s most important is that you can get the help you need to treat your addiction. There is a lot of information regarding health insurance that can be confusing and perhaps overwhelming. If you would like some help in sorting through this information to the get the addiction treatment you need, make sure to call your insurance company or speak to one of our admissions navigators today. They can outline the details of your plan and help guide your search.
- U.S. Department of Labor. (n.d.). Continuation of Health Coverage (COBRA).
- U.S. Department of Labor. (n.d.). FAQs on COBRA Continuation Health Coverage for Workers.
- Healthcare.gov. (2021). Mental Health and Substance Abuse Coverage.
- National Institute on Drug Abuse. (2018). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition): Types of Treatment Programs.
- National Institute on Drug Abuse. (2014). Principles of Adolescent Substance Use Disorder Treatment: A Research-Based Guide: Treatment Settings.
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