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Medical Mutual Insurance Coverage for Drug and Alcohol Rehab

Medical Mutual of Ohio insurance offers coverage for a range of healthcare services, including mental health and substance abuse treatment. If you or a loved one are struggling with drug or alcohol addiction and seeking treatment, Medical Mutual of Ohio may be able to help cover some or all of the cost of rehab.
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Medical Mutual Insurance Coverage for Drug and Alcohol Rehab

Medical Mutual of Ohio is a health insurance provider dedicated to serving members throughout the United States.1 For over 85 years, Medical Mutual has provided health insurance for individuals and families through various HMO, PPO, POS, Affordable Care Act (ACA), and Medicare insurance plans.1,2

Does Medical Mutual Cover Addiction Treatment?

If you’re ready to seek treatment for drug or alcohol addiction, your Medical Mutual insurance covers the costs to some extent. You could receive coverage for some or all of the costs for different addiction services, like medical detox, inpatient rehab, outpatient programs, and medications. Your level of coverage depends on several factors, including your specific Medical Mutual plan, the facility you choose, and the services you need.

Types of Addiction Treatment Covered by Medical Mutual

Medical Mutual health insurance covers several types of addiction treatment. Recovery is unique for everyone, and treatment is often most effective with an individualized plan.3 That’s why many levels of care are available to meet you where you are in your recovery journey.

Addiction specialists widely use the American Society of Addiction Medicine (ASAM) guidelines to determine the best level of care for patients seeking addiction or co-occurring disorder treatment.4 The ASAM ranks levels of care from 1 to 4, from prevention and early intervention to intensive inpatient care.4 Your provider can determine the appropriate type of treatment based on your situation.

Detox Covered by Medical Mutual

Some undergo detox to safely withdraw from drugs or alcohol under medical supervision before starting a treatment program.3 In detox, you have continuous access to medical professionals who can administer medications to ease withdrawal symptoms and reduce cravings.3

Although detox can be beneficial for some, it isn’t always necessary. Detox is often helpful for people with severe addictions or those addicted to substances with potentially life-threatening withdrawal symptoms.5 For example if you have a severe alcohol addiction, detox might be necessary to safely manage seizures.

Detox and withdrawal management is essential for some, but it’s most important to continue treatment after.3 Addiction specialists agree detox is only the first stage in treatment.3 Continuing to a formal treatment program, like an inpatient rehab or outpatient care, is most effective in promoting long-term recovery.3

Inpatient Drug and Alcohol Rehab Covered by Insurance

Inpatient and residential rehab provide a safe environment to live while in recovery.3 During inpatient rehab, you participate in therapeutic interventions, including behavioral therapies, psychoeducation, group counseling, and peer support. These approaches help you learn about the underlying factors contributing to your addiction and build coping skills to navigate life without substances.3

Inpatient rehab can benefit many but may serve certain people better than others. If you struggle with chronic relapse and have already tried other levels of care, treatment in an inpatient program could be beneficial.6 Inpatient rehab is also helpful if you require medical supervision while in recovery.6

People with mental health disorders and addiction might also find inpatient rehab beneficial.6 Co-occurring conditions are common, and mental health professionals recommend treating both in tandem to promote long-term recovery.3 An inpatient rehab can provide targeted treatment to help you address co-occurring disorders from all angles.6 You might also attend inpatient treatment to remove yourself from your everyday environment. Taking a break from the people and places that may be contributing to your addiction helps you focus on recovery in a stable space.

Some inpatient programs are short-term, lasting about 30 days, while other more long-term programs can last 12 months or longer.6 Remaining in treatment for at least 90 days is recommended to promote long-term recovery.3 Your provider can help you determine the appropriate inpatient program duration that works for your situation.

After completing inpatient care, you’ll likely transition to another level of care, like an outpatient program. Taking an efficient amount of time in addiction aftercare helps you stay focused on recovery while using the skills you learned in treatment to transition back to everyday life.

Drug and Alcohol Outpatient Rehab

Many options for outpatient rehab covered by insurance are available, from standard programs to more in-depth treatment. Outpatient programs typically include similar therapeutic approaches as inpatient rehab, but you can live at home while in treatment.6 An outpatient program can offer structure and flexibility in treatment. The type of outpatient program you attend can differ based on your unique situation.

Traditional outpatient programs are less rigid, requiring less attendance frequency and more independence. Intensive outpatient programs (IOPs) and partial hospitalization programs (PHPs) are more structured with a required amount of dedication. Most IOPs provide at least 6 hours of weekly contact.7 A PHP is the most in-depth outpatient program, usually requiring daily attendance for about 6 hours.8

Addiction specialists see outpatient programs as a significant part of aftercare. Quitting substances is only the first part of recovery. Learning to function without drugs or alcohol, recognize and fight triggers, and continue building relapse prevention skills is an essential part of the continuum of care.3 Remaining in outpatient treatment after completing a formal inpatient program helps you integrate what you’ve learned and continue recovering.

Although outpatient programs provide similar therapeutic approaches to inpatient rehab, like one-on-one counseling and psychoeducation, they differ in some ways. You have the flexibility of living at home and tending to your everyday responsibilities while attending outpatient treatment. Outpatient programs are also more cost-effective than inpatient rehab.

Does Medical Mutual Cover Mental Health Treatment Services?

Yes, Medical Mutual covers mental health treatment services. The Affordable Care Act (ACA) of 2010 requires that all health insurance companies cover essential health benefits to some extent, including mental health treatment.9 So, you’ll have at least some coverage for co-occurring disorders or dual diagnosis, regardless of your Medical Mutual health insurance plan.

In 2021, more than 9 million adults reported struggling with addiction and mental health conditions, like anxiety, bipolar disorder, depression, or post-traumatic stress disorder (PTSD).10 It’s unclear whether one causes the other. Some people may form addictions through self-medicating with drugs or alcohol to relieve the symptoms of their mental health illness.11 Others may develop mental health conditions from chronic substance use disorder (SUD).11

Despite the onset, mental health professionals recommend treatment for both illnesses at once to promote long-term recovery.11 Insurance typically covers dual diagnosis treatment. Many programs that treat co-occurring disorders use various types of therapy.11 Some, like motivational interviewing (MI), help you recognize and change your behaviors.11 Others, like eye movement desensitization and reprocessing (EMDR), help you process trauma.12 Here are some behavioral therapies your Medical Mutual insurance may cover:

How to Find Medical Mutual In-Network Rehab Facilities for Addiction

Finding in-network rehab facilities is simple with the right resources. Medical Mutual plans should cover at least some of the costs for in-network addiction treatment and rehab.

Your plan includes a list of Medical Mutual in-network providers and hospitals. Medical Mutual health insurance contracts these providers to offer healthcare services covered under your plan. Treatment from an in-network provider should be covered to some extent. If you choose an out-of-network provider, the services likely won’t be covered, and you’ll pay higher out-of-pocket costs.

Every health plan is different. It’s best to verify your coverage to confirm your benefits. American Addiction Centers (AAC) can help you verify your insurance online or by phone. Use our “verify your insurance” online tool to check your benefits or call our helpline to speak with an admissions navigator who can verify your benefits while you’re on the phone.

Once you know your coverage levels, you can find treatment near you using our locator tool and directories. You can explore treatment options nationwide and filter by type of care, payment accepted, and location.

Paying Out-of-Pocket Costs for Addiction Rehab

There may be instances where insurance doesn’t cover the cost of rehab. Whether you’re paying for out-of-pocket costs or paying for addiction rehab without insurance, you can still afford rehab in many other ways.

Some rehabs offer flexible payment options, like sliding scale fees and payment plans, which set the payment amount based on your income. You can also self-pay with cash, credit, or a loan. State-funded programs and free rehabs are also available to help those with limited finances get the care they need.

Starting the journey to recovery may seem overwhelming, but it opens the doors for support and encouragement. Seeking treatment can connect you with the resources you need to get better. If you’re ready to embark on your journey to recovery, contact AAC and we can help you along the way. Call .


  1. Medical Mutual. (n.d.). Corporate profile.
  2. Medical Mutual. (n.d.). Medical insurance plans.
  3. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (third edition).
  4. American Society of Addiction Medicine. (n.d.). About the ASAM criteria.
  5. Substance Abuse and Mental Health Services Administration. (2006, last revised 2015). TIP 45 Detoxification and Substance Abuse Treatment.
  6. National Institute on Drug Abuse. (2019). Treatment Approaches for Drug Addiction.
  7. Substance Abuse and Mental Health Services Administration. (2021). Clinical issues in intensive outpatient treatment for substance use disorders.
  8. Substance Abuse and Mental Health Services Administration. (2006). TIP 47: Substance abuse: Clinical issues in intensive outpatient treatment.
  9. (n.d.). Affordable Care Act (ACA).
  10. Substance Abuse and Mental Health Services Administrations. (2023). Co-occurring disorders and other health conditions.
  11. National Alliance on Mental Illness. (2017). Understanding dual diagnosis.
  12. Gainer, D., Alam, S., Alam, H., & Redding, H. (2020). A FLASH OF HOPE: Eye Movement Desensitization and Reprocessing (EMDR) Therapy. Innovations in clinical neuroscience, 17(7-9), 12–20.
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