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What Changes the Price of Alcohol Rehab
Alcohol rehab prices in Ohio shift with: the type of services offered; whether they're offered on an outpatient or inpatient basis; and whether you have health insurance, Medicaid, or are eligible for government funding. Out-of-pocket costs also vary depending on the kind of treatment needed.
Here's a look at how these factors can affect the price:
- Counseling. The price for counseling varies with the kind of therapy, how often it's administered, the length of treatment, and who provides it (an MD or a licensed therapist). The cost also depends on whether you're paying privately or have insurance.
The severity of addiction is another factor that can affect the cost of alcohol rehab. People who suffer from moderate or mild alcohol use disorders (AUDs) may be able to manage their symptoms with outpatient treatment plans.
The amount of time you spend at an addiction recovery facility will affect how much it costs. A shorter stay is generally less expensive than a longer one.
Another significant cost driver is the services offered by the program. For instance, residential programs typically provide meals and housing as well as therapy and support services.
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Price Patterns by Level of Care
The level of care that you receive will determine the cost of treatment. Generally, lower intensity programs like outpatient treatment are less expensive than higher levels of care such as inpatient or residential programs.
Outpatient providers may charge an hourly rate or for each individual office visit or therapy session. Prices vary widely between different parts of the state.
The longer you stay in treatment, generally the more it will cost—but there are some exceptions. The higher the level of care needed, generally the more it will cost.
The exact cost of alcohol rehab can vary dramatically based on your situation. The biggest factors include:
- Level of care needed
- Length of time in treatment
- Type of medical insurance you have
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Private Coverage and Ohio Parity Rules
The Ohio Department of Insurance handles parity questions for privately insured Ohioans.
MHPAEA requires that group health plans and insurers provide mental health and substance use disorder benefits in a way that is no more restrictive than the plan's medical/surgical benefit.
Some types of limitations commonly used by plans to manage costs are:
Financial requirements (i.e., co-pays, deductibles, and out-of-pocket maximums).
Treatment limits (i.e., days in treatment or visits per year).
Medical management techniques (i.e., prior authorization, step therapy protocols, precertification, etc.).
A "financial requirement" refers to any co-payments, coinsurance, deductibles, out-of-pocket limits and other similar cost sharing mechanisms.
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Ohio Medicaid and Managed Care
Medicaid managed care plans in Ohio work with an extensive network of certified providers to provide members access to a wide range of behavioral health services.
The Ohio Department of Medicaid (ODM) is the single state agency that administers Medicaid in Ohio. It oversees the operations of managed care plans as well as fee-for-service Medicaid.
The Ohio Department of Medicaid (ODM) provides Medicaid benefits to eligible Ohioans. The program offers a variety of health care services to low-income families, children, pregnant women, seniors, and people with disabilities.
Medicaid is a government-funded health insurance program for low-income people who meet certain eligibility criteria. The federal government sets minimum standards for all states to follow when administering Medicaid programs, but each state has its own rules for how it administers the program.
OhioRISE is a new model that will address the needs of children with complex behavioral healthcare challenges.
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Board-Funded Care When Coverage Is Thin
The ADAMHS Board provides funding through a contract network of licensed, certified, and approved alcohol, drug addiction, and mental health services providers.
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Sliding Fees and Payment Help
Some Ohio programs set their charges on the basis of your ability to pay. A sliding fee scale is one way they do this.
Payment plans can be set up so that payments are made over time, either weekly or monthly, for a fixed amount of care. This can also be set up with sliding fee arrangements.
Treatment programs can vary widely in how they handle fees. Some charge by the day, some by the hour, some charge by the month or for a full program.
In some cases, the program may be able to help find other ways for you to pay for your care. If the person has medical insurance, there are often cost-sharing rules that limit how much they have to pay (for example, a copayment or coinsurance payment) and what is covered by their insurance plan.
A deductible is a fixed amount of money that must be paid before the health plan begins to make payments. Some insurance plans have deductibles for medical care as well as prescriptions.
A social worker or case manager at the program may know about programs to help people pay for treatment.
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Cost Questions to Ask Before Admission
Programs at the same level of care differ in cost; residential programs are generally more expensive than outpatient services. You can also expect that costs will go up with the intensity of treatment (the number of hours per week you receive it and the number of days per month). For example, a partial hospitalization program would be more costly than intensive outpatient treatment.
Treatment costs typically include:
- Evaluation: This determines what type of treatment is needed. It may consist of a phone call, an in-person interview or meeting, a physical examination, laboratory tests (blood and urine), and/or psychological tests.
- Medications: These are usually prescribed by physicians but may be given by nurses or nurse practitioners. The cost of medications will depend on your specific diagnosis and your insurance coverage.
Treatment costs vary widely, depending on the facility and services offered. Costs also may depend on the person's ability to pay, whether they are admitted under their private insurance or through a state-funded program.
Some programs offer specialized therapies (e.g., cognitive behavioral therapy), educational classes, and recreational activities.