Will My Insurance Pay for Rehab in Another State?
Yes, your health insurance may pay for drug and alcohol rehab in another state. If it will depend on your specific insurance plan, the treatment facility, and whether the insurance plan is in-network or out-of-network. This can also depend on if the level of care you need is covered by your specific insurance plan.
You don’t need to limit yourself to treatment in your state only. This only limits your options for treatment.
Some families will look out of state to find the best treatment program for their loved one, or because the treatment centers close to them are full. Others choose to go out of state for privacy, a different treatment environment, or to find a rehab center that specializes in treatment that their loved one needs and is not available locally. Sometimes it is just because the out-of-state treatment facility looks like a better fit for their loved one.
The important thing is to find out what your insurance plan will cover before making arrangements for treatment.
If you’re looking at rehab in another state and aren’t sure where to start, call Addiction No More at 1-800-513-5423. We can help you explore treatment options and identify the insurance questions that need to be answered.
Will my insurance cover rehab if I live in one state and go to treatment in another state?
It might.
Having insurance in one state doesn’t mean that you have to receive treatment for addiction in that state alone. But the coverage for out-of-state treatment varies by plan.
For example, you might be living in Arkansas but want to receive treatment in Florida. Or you might live in Texas and are looking at getting into a drug rehab center program in California. Your insurance company will need to confirm that the particular program you are considering and the type of treatment are covered under your specific plan.
DO not assume that the answer is a no just because the treatment program you are looking at is across state lines. Do not assume that ist is covered just because the treatment center says it accepts your insurance, either.
The question isn’t just whether your insurance covers rehab; it all depends on whether your plan covers the specific treatment program at the location and level of care you need.
What is the difference between out-of-state rehab and out-of-network rehab?
This is where some people get confused.
Out-of-state just means that the facility is located in another state outside of where you live.
Out-of-network means that the treatment center does not have an agreement with your insurance provider and usually costs more in deductibles and co-insurance.
These are two entirely different things.
The rehab center that is out of state may be in-network with your insurance and the treatment center in your state may be out of network with your insurance plan. This will mean that you may pay more for treatment in your own state, while it is cheaper for you to leave your state for treatment.
This distinction can make a significant difference in what you pay for treatment.
Before ruling out an out-of-state treatment program, ask whether the rehab center participates in your specific insurance network
To learn more about insurance and coverage, check out our pages on insurance and coverage HERE <<<<<<<<<
Depending on our plan, you may have fewer options for non-emergency treatment outside of your network or outside of your service area.
That doesn’t mean that you should give up on finding a treatment program outside of your state. Ask your insurance provider whether an out-of-state residential treatment center is covered by your plan, whether an exemption is possible, and what requirements must be met for insurance to cover the costs of treatment at your program of choice.
Can I use my insurance for luxury rehab out of state?
Possibly.
There are luxury programs that offer benefits such as private rooms, more amenities, and specialized services. Whether your insurance pays for specific treatment programs is based solely on your insurance plan and provider.
Insurance generally evaluates treatment programs and benefits based on the services and level of care necessary to help you handle the addiction. Not just simply whether the facility is a luxury treatment program. You may have coverage for the medically appropriate treatment while having to pay extra for certain services and amenities or upgraded accommodation.
What if my insurance says I must stay in-network?
Ask if there are appropriate in-network treatment programs that can meet your treatment needs. You can also ask your insurance provider to identify appropriate treatment options that are covered by your insurance plan.
Do not assume that you do not have any alternatives until you have confirmed what your plan allows.
What should I have ready before calling about an out-of-state rehab program?
If possible have:
- Name of the insurance company
- Your member ID number
- Your home state
- The state you would like to receive treatment in.
- The name of the facility, if you have one chosen already.
- Whether you need a detox, residential treatment or any other level of care.
- Prior treatment attempts and name or names of the facilities.
- And medical conditions or mental health concerns.
- How quickly you need to receive addiction treatment.
You do not need to know everything before asking for help. Start with the information you have on hand and find out what needs to be verified.
Can Addiction No More help me find rehab in another state?
If you’re struggling to find an appropriate program near home, or you’ve found an out-of-state rehab but don’t know whether your insurance will cover it, Addiction No More can help you explore your options.
Call 1-800-513-5423.
Tell us where you live, what insurance you have, what kind of treatment you’re looking for, and whether you have a particular state or facility in mind.
We can help you look at potential treatment options and identify the insurance questions to ask before you make a decision.
You may have more choices than you realize.
You don’t have to limit your search to your hometown, and you shouldn’t have to guess what your insurance will pay.
Before you commit to an out-of-state rehab, find out whether the program is appropriate, whether your insurance benefits apply and what you may have to pay.
