What does treatment for alcoholism cost, and does medical insurance cover this?
I used to work at a drug and alcohol detox center, and when I did they had me doing a couple of different jobs. One of those jobs involved getting people set up to come into rehab and making sure that they had proper funding in place for it. In other words, how was the treatment going to be paid for? If someone did not have the resources to pay for treatment then I had to refer them somewhere else that might be able to accommodate them.
It is not easy by any means to help an alcoholic recover, even if they want to change their lives. But it is also very expensive to try to do so as the cost of health care in this world has continued to spiral out of control.
What you really need to do if you are serious about getting help is to start asking questions.
Treatment is not free, but that should not stop you from exploring the possibility
After you convince yourself to go to rehab and overcome all of those excuses why you should not go, it is time to start asking questions.
My suggestion to you is to get on the phone and call up a treatment center.
Which treatment center, you ask? Any treatment center. Get on the phone and call them up. It doesn’t much matter at this point. You are at the information gathering stage. Your goal is to simply ask questions and find out what is possible.
What you should do when you call up a rehab is to tell them that:
1) You have a problem with drugs or alcohol.
2) You want help.
3) You need to find out who can help you or where you need to go to get that help.
That’s it. Really there is not much to it after you call them, they will do what they can to try to get you placement at their facility. If you do not qualify to go there then they will hopefully refer you to another treatment center that might be able to take you. Or failing that they will refer you to an agency that can help to get you funding.
Unfortunately it usually comes down to the issue of money and how the treatment will be paid for. Treatment is not free, and therefore everyone who attends treatment has to have some sort of funding for it.
There are basically 3 types of potential funding for rehab:
1) Cash money.
2) Medical insurance.
The first option is fairly straightforward: Anyone can generally walk into a treatment center and hand over a bunch of cash in order to receive services there. The cost will vary quite a bit depending on the treatment center, but you can expect to see a bottom of around a few hundred dollars per day for any sort of inpatient care, and up to a few thousand per day depending on how nice the rehab center is. The rehab center that I used to be employed at was under $500 per day for both medical detox and residential inpatient, but not by a whole lot. Treatment is expensive no matter where you go. Think of a hospital and how much overhead they have to have in order to house someone on an inpatient basis. That is very similar to the way that inpatient treatment is set up as well–lots of overhead. Building, staff, etc. It all adds up.
The problem of course is that most addicts and alcoholics do not have tons of cash laying around with which to pay for treatment. Therefore this option is pretty rare in my opinion, though it does still happen. People do pay cash for rehab services in some cases. Luckily there are other options as well.
Many people have some form of health insurance. This of course is going through a great deal of change right now as the United States attempts to fix its health care problems. I don’t think that the current changes that we are going through are really going to make any sort of huge impact on how treatment funding works for a lot of people. The bottom line is that you have a large population of struggling alcoholics and drug addicts, and most of these people have either no insurance, poor insurance, and very little money for copayments. In the meantime, treatment is just plain expensive. So no matter what happens with Obamacare I do not foresee a great solution when it comes to all of the people who are broke and who struggle with substance abuse. There are still going to be many funding challenges. Perhaps the recent health care reforms will at least be a step in the right direction, but that remains to be seen.
There are two problems with health insurance when it comes to substance abuse. The first problem is that many people who need help in this way do not have any insurance at all (more on this below). The second problem–which might be even worse–is that the health insurance coverage that people have is generally not very helpful. In other words, what good is having health coverage if you still have to pay $200 to $400 per day for inpatient rehab services? A typical 10 day stay in treatment will still cost in the thousands of dollars. I stopped working at the rehab center 3 years ago and I was already seeing this trend in substance treatment where people with “good” health insurance could not really afford the copayment on an inpatient stay. Or at the very least they had to struggle to come up with that copay. I suspect that this trend is only getting worse as insurance companies are shifting the burden onto the consumer.
This is perhaps complicated by the idea that substance abuse is not something where it seems “fair” to take lots of taxpayer money and funnel it towards the problem. After all, the alcoholic and drug addict has problems that are of their own making according to public perception in many cases. Not only that but many people who leave treatment will relapse immediately which seems like a complete waste of money. If governments are trying to decide where to funnel their tax dollars to then it makes a hard case when you look at the lousy relapse rates of most rehab centers. Why keep putting money into something that doesn’t really work all that well, when there is an endless list of other medical areas where people need funding and/or help? This is an attitude that exists and is not helping the substance abuse industry.
So “health insurance” is not necessarily the answer when it comes to the need for treatment. Just having health coverage is not necessarily a solution for someone who is struggling with substance abuse.
What if you do not have health insurance, or your insurance does not cover inpatient rehab?
So what happens if you have no health insurance at all?
There are basically 3 options that I can see:
1) Try to round up enough cash to pay for treatment out of pocket. Not a very helpful suggestion for most people though.
2) Try to apply for insurance through the government or at least see if you qualify for assistance. This can be helpful but you have to do the footwork.
3) Inquire about assistance to get funding for treatment. This was very common at the treatment center that I worked at.
The last option might be called a grant. People who did not have any insurance or any way to pay for rehab could apply to get a special grant to go to rehab with. This was tax dollars through the State. So obviously this option will vary a great deal depending on where you live. The bottom line is that you are going to have to ask questions.
If you get on the phone and call up a rehab and say that you need help, they will try to organize for you to come get checked in. In order to do that you have to have funding, so they will immediately ask you about that and see if you qualify. If you don’t have insurance or cash they will likely refer you to an agency that can potentially help you with some sort of grant. At that point you will have to apply for this assistance and see if you qualify.
It can be a lot of hoops to jump through but all of it can generally happen over the phone. This is what I used to do for a full time job–I set people up to come into treatment in terms of their funding source. People who did not have insurance needed to apply for a grant. So I referred those people to a separate agency that could then see if the person qualified to get help. I would say almost half of the people who came to treatment did so based on these sort of grants. But again, this will vary depending on where you live and what sort of help is set up for people in your country or state.
How to be persistent in getting the help that you really need
As you can see there are many ways to get funding for treatment, and not everyone will qualify for assistance.
My suggestion to you is that if you are serious about wanting to get help for your addiction then you need to be persistent. If you are both persistent and really nice to people then it is all but insured that you can get the help that you need. People will bend over backwards to try to help you so long as you are not rude.
Think about it: The people who are setting others up for treatment are just doing their jobs. They deal with various people all day long. If you are desperate and nice at the same time then they will try harder to help you. This is just common sense really. Don’t be rude and you can expect to get better results. At the same time that you are being nice to these people, you also want to be persistent. If someone says “well, I guess you cannot come to our rehab center” then you need to follow that up with a few questions. Never just hang up the phone without another lead for how you might get some help. These questions might serve you well:
“Do you know of any other treatment centers that I might be able to call?”
“Do you know of any funding agencies that I might be able to apply for?”
“Do you know of any other phone numbers I could call in order to get the help that I need?”
“Is there any insurance or programs that I could apply for that might be able to get me funding for treatment?”
“What is my next step?”
“What would you recommend that I do next in order to get the help that I need?”
Don’t just let someone hang up the phone on you and tell you that you are at a dead end with no hope in sight. Ask them questions. Use the list above and try to get people to nudge you in the right direction. Like I said, being nice has everything to do with this. If you are civil with people and show them respect then they are more than happy to do their jobs and get you the help that you need. On the other hand if you are rude and angry then it becomes much more likely that they will not get you pointed in the right direction. It makes a difference. You want to be very persistent but you also want to be very nice. This is just a suggestion based on the fact that I have been on both sides of the phone call–I have worked at the rehab for many years but I also was the one calling the rehab at one point and was desperate to get help. And during that call I had no health insurance and needed to be pointed in the right direction.
The opportunity cost of staying drunk and stuck in addiction
Treatment is expensive and I know that I keep harping on that fact but in reality treatment is actually fairly cheap compared to continued addiction.
What does this mean?
It means that if you continue to drink or abuse drugs then the cost of NOT going to rehab is actually much higher than the cost of treatment.
They have an exercise that they do in some treatment centers where they talk about “cost of addiction.” During this exercise the counselor or therapist will have everyone get out pencil and paper and try to calculate exactly what their addiction cost them in total. They will go through different categories and have each person estimate how much they spent on the drugs or the booze, how much work they missed, how much they might have spent in legal fees, and so on. Then they have them add it all up in order to put a number on how much their addiction actually cost them.
This is always an eye opening exercise and people are generally amazed at how much money they actually spent on their addictions. Normally we just think of the money that we spend on the substances themselves but there are all sorts of secondary and hidden costs that have to be factored in as well. So the number that they come up with is usually pretty shocking. In fact, people will then wonder where they even got the money to be able to afford their addiction in the first place. Anyone who has been addicted for 5+ years usually has a total number that runs into the six figures. People who have been addicted for 20 years or more generally have spent over one million dollars on their addiction. Remember that these figures also include opportunity costs, for example the fact that you are not working a job or that you may have lost a good job and had to take a job with lower pay, etc.
So let’s say that you find a rehab center and the cost is a thousand dollars per day. This sounds pretty expensive, right? For a 28 day stay you are looking at around thirty thousand dollars.
But let’s say that you go to this rehab center and you get results like I did. Let’s say that you then stay clean and sober for the next 12+ years. Would that thirty thousand dollars have been worth it?
I can tell you from experience that the answer is a definite “yes,” it is worth it. The amount of money that I would have wasted over these last 12 years would have been much greater than thirty thousand dollars. In fact, I probably would have spent more than that on just cigarettes alone, not to mention the cost of alcohol, other drugs, and all of the secondary costs involved.
When viewed from this perspective, treatment is an absolute bargain, even if it is rather expensive up front.
Health care costs are probably not going to suddenly come back down to earth. Rehab is not cheap and it is not about to suddenly get cheaper overnight. Therefore you have to be realistic about what the true cost of continued addiction really is. Can you really afford to keep drinking or abusing drugs for the next ten years? The next twenty years? How much money would you save over the course of a decade if you were clean and sober? For nearly every person that number is in the six figures. Treatment will cost significantly less than this, making it a good value.
Of course, you still have to motivate yourself to follow through when you leave rehab, and take the necessary action in order to change your life.
Why you should never give up on treatment
Even if you do not have a clear path to getting into rehab, you should not give up on the idea.
Or maybe you have gone to treatment in the past and it did not really work out for you.
Don’t despair. I went to rehab 3 times before it finally clicked for me.
Later on I worked in a rehab center for several years and I was able to see many patterns. I realized that most people who stay clean and sober have to try a few times before they finally “get it.” Three seems to be a common number from my subjective experience. Many people in recovery had to try at least 3 times in order to find success.
The cost of treatment is not trivial, and I realize that. But you have to realize too that the cost of NOT going to treatment is actually much, much higher than most alcoholics or addicts would care to admit to themselves. When you stay clean and sober on a permanent basis the savings really starts to add up quickly.
If I could turn back the clock and get sober even one year sooner I would pay any amount of money in order to do it. The rewards and blessings of sobriety have nearly infinite value, while the chaos and misery of addiction just stretches on forever. It is like night and day. There is no cost that is too high to justify for a ticket into a new life of sobriety (my opinion anyway, as someone who is now living that new life).
What has your experience been with alcohol treatment? Has it been too expensive for you to attend? Have you researched your options and asked plenty of questions? Let us know in the discussion forums. It only takes a second to register!