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6 Ways to Cover the Cost of Opioid Treatment

By  Marta Manning
Here’s how you can get the help you need, whether you have health insurance or not.

Facing the prospect of paying for opioid addiction treatment can seem daunting, especially if you’re underinsured or you don’t have insurance. But there are many federal, state-level, and local programs that can help you pay for the treatment you need.

Treatment options for opioid addiction include medication-assisted treatment with drugs like methadone and naltrexone, inpatient rehab, and outpatient programs. According to the National Institute on Drug Abuse (NIDA), medication-assisted opioid dependence treatment through an outpatient program costs between $460 and $1,176 per month. The average cost of inpatient treatment is $4,383, says a 2018 study in the Journal of Pain Research.

When you look for ways to pay for opioid addiction treatment, it’s important to realize there isn’t a one-size-fits-all solution. Available programs will vary depending on where you live.

“Every state is set up so differently that it is hard to say what someone can do in, say, Tennessee, compared to Michigan,” Julie Bayardo, MSW, deputy director at Community Mental Health for Central Michigan, tells WebMD Connect to Care.

“The best place to start is always with your primary care physician. He or she can not only do a complete physical examination, but also refer [you] to substance abuse providers. They can also call treatment facilities directly because they typically know how to guide them through getting funding for treatment.”

Ways to Pay

Use existing health insurance. Under the Mental Health Parity and Addiction Equity Act (MHPAEA) of 2008, insurance companies must pay for substance use treatment as they would for any other medical treatment. This includes Medicare Part B.

Apply for insurance through the Affordable Care Act (ACA, or “Obamacare”).  Because of the ACA, drug addiction is no longer seen as a preexisting condition and cause for denial of insurance. People with opioid addiction can apply through Healthcare.gov or a state-sponsored insurance marketplace.

Apply for short-term disability. Because opioid addiction is an illness, you can apply for short-term disability while you’re getting treatment. Talk to your therapist or social worker about how to apply.

Scholarships and grants at clinics. “Most of the methadone clinics have been given grants for people that do not have insurance or access to funds,” addiction psychologist Cali Estes, PhD, MCAP, says. “A lot of people do not know all they need to do is walk [your loved one] to the methadone clinic and ask if they have received the grant money. If that clinic has and it’s in the millions of dollars, usually they will have free care and [you] won’t even need to file for insurance.”

Addiction treatment clinics often offer scholarship programs to support those who can’t pay for treatment. “If a loved one calls around, they can ask do they have any scholarships available, and you can call any treatment center and ask that and usually get a free bed,” Estes says.

Medicaid. If you meet income criteria, you may be eligible to apply for Medicaid through your state office to help paying for your treatment.

Get assistance from federal and state agencies. Through the Department of Health and Human Services (HHS), government agencies can provide help if you’re denied insurance coverage, exceeded coverage limits, or can’t pay your deductible.

Get Help Now

If you or a loved one is struggling with opioid addiction, WebMD Connect to Care Advisors are standing by to help.