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Paying for Drug Detox With PPO Insurance

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Facing your addiction is hard enough without the added burden of worrying about how you’ll pay for treatment. If financial concerns are holding you back, your PPO insurance may pay for your drug rehab.

Preferred Provider Organization Insurance (PPO) consists of a network of doctors and medical professionals. This type of insurance is often more accepted than EPO or HMO policies.

Typical PPO plans require you to pay a deductible each time you see a doctor. You may have to pay a certain amount before coverage begins.

If drug detox is covered by your PPO plan, you may need to pay a deductible first. If you’re seeking help for drug addiction, there are options for how to pay for it.

Here’s a look at paying for drug detox with PPO insurance.

PPO Drug Rehab Insurance

Like many insurance providers, PPO insurance typically offers some coverage for addiction treatment services. The Mental Health Parity and Addiction Equality Act was passed in 2008 and made addiction treatment coverage a federal law.

Although your PPO coverage may not cover a rehab stay, it must offer coverage for drug and alcohol treatment. A PPO cannot impose limits to exclude treatment unless it has similar limits on other medical coverage.

Paying for Drug Detox With PPO Coverage

One of the first steps to take is to check your PPO coverage. Knowing exactly what is covered and what is not can offer some peace of mind as you begin the hard work of getting and staying sober.

One thing you can do is call the number on the back of your insurance card. Ask about drug detox coverage and get a clear idea of what they will pay.

Drug Detox

Detox services are covered by most insurance companies that cover rehab. The key is to get your referring physician to demonstrate the medical necessity of treatment.

Most insurance carriers cover both inpatient and outpatient withdrawal management services to some degree. If the carrier deems certain services for the treatment of withdrawal symptoms unnecessary, they may not cover them.

Some services such as rapid detox, ultra-rapid, acupuncture, and others may not be covered.

Inpatient Rehab

Inpatient services often depend on a doctor’s referral. This revolves around the idea of what is a medical necessity.

Treatments that are not deemed medically necessary or appropriate may not be covered. Many insurance carriers cover inpatient drug treatment under emergency services.

Residential Treatment

Private insurance often covers some form of residential addiction treatment. The referring physician must recommend this form of treatment as a medical necessity.

If you’re worried about how to get insurance to pay for drug rehab, remember your doctor is key in getting your treatment underway.

Outpatient Treatment

Most insurance policies cover some form of outpatient drug treatment. Outpatient services may include therapy, medication, and supportive services.

These ongoing services are critical in the treatment of drug and alcohol addiction.


During the detox process and throughout treatment, you or your loved one may need prescription medication. Some people battling addiction also need medication for anxiety or other psychiatric conditions.

These medications are typically covered under most insurance policies. Medication coverage may vary from policy to policy.


Psychotherapy plays a critical role in addiction recovery. Individual therapy, group therapy, and family therapy are all helpful for addiction recovery. Therapy services that relate to an individual’s addiction treatment are typically covered to some extent by most health insurance companies.

If you’re ready to tackle your addiction, it helps to know what to expect from your insurance company.

Deductibles, Copays, and Out-of-Pocket Costs

If you’re hoping to pay for drug rehab with PPO insurance or another private insurer, it’s good to know what you will pay out-of-pocket.

Some sort of deductible or copay is standard for most people beginning treatment for addiction. Most policies will not cover every aspect of treatment.

Knowing what is expected of you is important to consider before committing to any drug treatment center.

Medical Necessity

Insurance companies usually require a demonstration of medical necessity before they will cover certain forms of addiction treatment. If you’re looking for rehabs that take insurance, keep this in mind.

Insurance companies expect proof that a treatment is backed by research and that a cheaper treatment will not meet an individual’s needs.

Proof of medical necessity is often a requirement for inpatient vs outpatient services. It is usually not required for substance abuse therapy, certain medications, and other standard, proven interventions.

Verify Your Rehab Insurance Coverage

The best way to know what your insurance policy covers is to read the policy. You can also contact the customer service department and ask what addiction services are covered under your policy.

There are rehabs that take Cigna insurance, rehabs that take Aetna insurance, rehabs that take Anthem insurance, and rehabs that take United Healthcare insurance, among other popular insurance carriers.

Insurance coverage for addiction services varies from company to company and from policy to policy. For this reason, it’s good to ask about rehab insurance coverage and what you can expect to pay yourself.

Another approach is to contact the treatment center you’re considering and discuss their services and what your PPO or insurance carrier may cover.

Most addiction treatment specialists are experts on what services may or may not be covered under various insurance policies.

PPO Insurance and Addiction Treatment

If you’re worried does insurance pay for alcohol rehab or drug treatment, that’s good news. It means you’re taking the initial steps to get sober and fight for a happier, healthier life.

Knowing what your PPO insurance or other health insurance covers helps you begin treatment without any financial surprises. At Altitude Recovery Community, we are on a mission to help people.

We offer modern, luxury drug rehab treatment in Camarillo, California. Our goal is to help you find a path forward toward sustainable, individual, and long-term recovery.

Contact Altitude Recovery Community today to get started.

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