Does Insurance Cover Outpatient Rehab?

Table of Contents

Many insurance providers cover some or all of the costs of outpatient rehab.

Thousands of U.S. addiction treatment centers, including Ohio Recovery Centers, accept insurance payments. However, not all insurance plans offer the same coverage and benefits. It’s a good idea to work with an insurance expert at the rehab you choose to help you understand your coverage and make your treatment as affordable as possible.

Does health insurance cover outpatient drug rehab? Does health insurance cover outpatient rehab for alcohol? Read on and find out.

How to Get a Rehab Insurance Coverage Check

As costs are often a main concern when beginning recovery from addiction, it’s important that you know what coverage you’re eligible for from your insurance company.

You can quickly check to see if your insurance covers outpatient by using our easy insurance coverage check tool here.

You can also contact your insurance company directly to request information on your rehab coverage. However, this can sometimes have longer wait times than a treatment center coverage check.

ACA (the Affordable Care Act) became law in March 2010 to make health insurance cheaper and easier. It also aimed to expand Medicaid. The ACA says that everyone can get health insurance, even if they have conditions like substance use disorders. Addiction is one of the ten essential health benefits that all insurance plans must cover.

Depending on your plan, insurance may cover the following addiction treatments:

  • Outpatient rehab
  • Detox
  • Mental health treatment
  • Medications
  • Inpatient care
  • Counseling
  • Ongoing therapy

Insurance Coverage for Children up to Age 26

Health insurance plans in the United States commonly provide coverage for dependents up to age 26, including for outpatient rehab services.

This means that if you have a health insurance policy, your children can benefit from the same coverage for addiction treatment and mental health services until they turn 26, regardless of their marital status, living situation, or college enrollment. Under the Affordable Care Act (ACA), this extended coverage includes a wide range of outpatient services, such as individual and group therapy, medication management, and other treatments essential for recovery from substance use disorders.

Parents should check with their insurance provider to understand the specific terms of coverage, including any deductibles, copayments, or out-of-network restrictions.

Many plans cover outpatient rehab because it is often less expensive than inpatient treatment and can provide the necessary support for long-term recovery. Coverage can include therapies like cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and other evidence-based practices that are crucial for treating addiction.

If you’re unsure about your plan’s coverage for outpatient rehab for a dependent up to age 26, contact your insurance company directly. They can provide detailed information about what services are covered, helping you make informed decisions about accessing necessary treatment.

Will FMLA Cover Outpatient Rehab?

Yes, FMLA (the Family and Medical Leave Act) can cover outpatient rehab. FMLA allows eligible workers to take up to 3 months of unpaid leave each year for certain health and family reasons, like getting help for substance abuse. You’ll need a letter from a doctor to show that you need this treatment. While you’re on leave, your job is safe, and your health insurance will still cover you, so you can focus on getting better.

Under FMLA, employees are entitled to up to 12 work weeks of leave in a 12-month period if they are dealing with a serious health condition that makes them unable to perform the essential functions of their job. This coverage can be used for attending outpatient rehab without the risk of losing their job, as long as they meet the eligibility criteria:

  • They have worked for their employer for at least 12 months.
  • They have at least 1,250 hours of service for the employer during the 12-month period before the start of the leave.
  • They work at a location where the employer has at least 50 employees within 75 miles.

To use FMLA leave for outpatient rehab, employees must provide their employer with appropriate documentation from a healthcare provider that outlines the need for treatment and the expected duration. While FMLA does not require the employer to pay for the time off, it does ensure that the employee can return to their position or an equivalent one with the same pay, benefits, and terms and conditions of employment upon rehab completion.

It’s important for employees to communicate with their HR department about their need for time off for outpatient rehab under FMLA. Employers may also require a second or third medical opinion (at the employer’s expense) and periodic recertification of the health condition.

In summary, while FMLA does not cover the costs of outpatient rehab, it does protect your job while you seek the treatment necessary to recover from a substance use disorder or other serious health conditions.

ohio recovery centers facility from curb view, depicting does health insurance cover outpatient rehab

Get Insurance-Covered Outpatient Treatment at Ohio Recovery Centers

At Ohio Recovery Centers, we help people with drug or alcohol addictions through outpatient treatment. This lets you get the care you need while taking care of your everyday tasks. If you need more structured help, we also have more intense outpatient treatment to help you on your journey to lasting recovery.

Our programs in Cincinnati are designed to fit each person’s unique needs, using proven treatments. We combine medication, therapy, and counseling to give you the best chance at recovery. We also offer other therapies like yoga and art to support your healing. Outpatient treatment at Ohio Recovery Centers is covered by health insurance.

Call our friendly team today to get started on your addiction treatment journey at (877) 679-2132.

Table of Contents

an image of author Joe Gilmore

Joseph Gilmore

Joseph Gilmore has been working in the addiction industry for half a decade and has been writing about addiction and substance abuse treatment during that time. He has experience working for facilities all across the country. Connect with Joe on LinkedIn.
An image of Ohio Community Health staff

Christopher Glover CDCA

My name is Christopher Glover, and I am from Cincinnati, Ohio. I am currently in school and working to grow in competence to better support our community. As a recovering individual I know the struggles that you or a loved one can go through and that there is help for anything you may be struggling with.

The hardest part is asking for help and we are here as a team to best support you and your decision to start your journey towards a better future. Connect with Chris on LinkedIn

An image of Ohio Community Health staff

Amanda Kuchenberg PRS CDCA

I recently joined Ohio Community Health Recovery Centers as a Clinical Case Manager. I am originally from Wisconsin but settled in the Cincinnati area in my early 20s.  My career started in the fashion industry but quickly changed as I searched to find my drive and passion through helping others who struggle with addiction. 

As someone who is also in recovery, I wanted to provide hope, share lived experience, and support others on their journey.  I currently have my Peer Recovery Support Supervision Certification along with my CDCA and plan to continue my education with University of Cincinnati so I can continue to aid in the battle against substance addiction. Connect with Amanda on LinkedIn.

An image of Ohio Community Health staff

Patrick McCamley LCDC III

 Patrick McCamley (Clinical Therapist) is a Cincinnati native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2019. Patrick received his bachelors degree in psychology from University of Cincinnati in 2021 and received his LCDC III (Licensed Chemical Dependency Counselor) license from the Ohio Chemical Dependency Professionals Board in 2022. Patrick has worked in Clinical Operations, Clinical Case Management, and Clinical Therapy throughout his career.

Patrick has tremendous empathy and compassion for the recovery community, being in recovery himself since 2018. Patrick is uniquely qualified to be helpful because of the specific combination of his academic background and his own experience in recovery.

An image of Ohio Community Health staff

Bill Zimmerman CDCA

Bill Zimmerman is a Greater Cincinnati Area native who has worked in substance use disorder/co-occurring mental health disorder treatment since 2018. Bill received his (Chemical Dependency Counselor Assistant) license from the Ohio Chemical Dependency Professionals Board in 2020.

Bill has worked in Clinical Operations in both support and supervision, and Program facilitating and 12 step recovery support during his career. Bill has a passion for the recovery community, having been in recovery himself since 1982. Connect with Bill on LinkedIn

An image of Ohio Community Health staff

Taylor Lilley CDCA, PRS

Growing up in Louisiana with addiction running rampant on both sides of my family. A life away from drugs and alcohol seemed impossible for someone like me. I remember what it was like sitting across from someone thinking there is no way they could ever understand what I was going through.

Sharing my experience offers a credibility and a certain type of trust with clients that only someone who has walked down this road can illustrate. To immerse myself further into the field of addiction, I am currently studying at Cincinnati State for Human and Social Services.  I hope I never forget where I came from, if I can do it, so can you!

An image of Ohio Community Health staff

Thomas Hunter LSW

Hello my name is Thomas Hunter. I was born and raised in Cincinnati, Ohio. I am a licensed social worker.In my scope of practice I have worked in the areas of mental health and recovery for thirty years. The clients I have worked with in my career have ranged in age from seven to seventy.

I strive each day to serve my purpose of helping those in need and I believe I do so by utilizing all of my experiences to accomplish my goal of supporting those who desire to establish their sobriety and maintain it in their recovery. Connect with Thomas on LinkedIn.

An image of Ohio Community Health staff

Mary D.Porter,LICDC

 My name is Mary D. Porter. I received my Masters of Social Work in 2008 from The University of Cincinnati. I received My Licensed Independent Chemical Dependency Counselor Licensure in 2001. I retired from The Department of Veteran Affairs Medical Center on April 14, 2014. Currently, I am the Associate Clinical Director for The Ohio Community Health Recovery Centers in Cincinnati.. Due to the fourth wave of the Opioid Epidemic in 2019,  I decided to enter back into the workforce to assist the addicted population.

The overdoses were astounding and I wanted to help.  I consider myself  to be an advocate for the addicted population. My compassion, resilience, empathy, wisdom, knowledge, experience and  love I have for this forgotten population goes beyond words. I consider what I do for the addicted population as a calling versus a “career,” because I too was once an “addict and alcoholic.” Today I am 45.5 years alcohol and substance free.

An image of Ohio Community Health staff

Ben Lemmon LCDC III

Hello, my name is Ben Lemmon, and I’m the Vice President and Clinical Director at Ohio Community Health Recovery Centers. I’ve been working in the addiction and mental health field since 2013 and decided to enter the field after overcoming my own challenges with addiction.

When I first meet a client, I always explain to them that the reason we are meeting is because they are not capable of obtaining or maintaining sobriety, and my goal is to create a person that can maintain sobriety. I believe a person’s personality is made up of their thoughts, feelings and actions and my job is to help clients identify the thoughts, feelings and actions that have them disconnected from recovery and provide them with the tools to live a healthy and happy life. Connect with Ben on LinkedIn