NIAAA Alcohol Treatment Navigator
Publisher: National Institute on Alcohol Abuse and Alcoholism (NIAAA), U.S. Department of Health and Human Services
alcoholtreatment.niaaa.nih.gov
This site relies on the Navigator for its framing of treatment quality and cost. The Navigator is produced by NIAAA with no commercial sponsors, directs users toward evidence-based treatment, and helps adults find alcohol treatment for themselves or an adult loved one. In its cost section, NIAAA states that "the most expensive option isn't always the best."
Claim limit: The Navigator does not publish a universal treatment price, and this site does not either.
NIAAA: What About Costs and Insurance?
Publisher: NIAAA, U.S. Department of Health and Human Services
alcoholtreatment.niaaa.nih.gov/what-to-know/costs-and-insurance
This page is the backbone of the site's cost-components and coverage-questions sections. NIAAA states that the cost of alcohol treatment can vary widely and depends on the provider, the setting, the services offered, and the individual's needs. Treatment providers can help a person understand costs for a typical course of treatment, accepted insurance plans, services covered versus billed separately, other payment methods, and any payment plans.
NIAAA also explains how billing differs by provider type: individual providers such as medical doctors and therapists generally charge by the hour or per office visit or therapy session, while addiction treatment programs such as hospital inpatient, residential rehab, and outpatient may charge by the day, week, or month. NIAAA advises that the most expensive option is not always the best, nor is the cheapest, and recommends balancing cost and quality.
On insurance, NIAAA notes that most health insurance covers some alcohol or drug treatment, which insurers may call "behavioral health" coverage. Insurers can provide details on covered inpatient days and outpatient sessions, medications, copayments, and whether treatment is limited to in-network providers. For people with limited financial resources, NIAAA lists options including Medicaid eligibility, local or state health departments, and payment assistance or sliding-fee options.
Claim limit: These are descriptions of how costs and coverage generally work, not a price list, a coverage guarantee, or an eligibility determination.
SAMHSA: How to Pay for Mental Health, Drug, or Alcohol Treatment
Publisher: Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services. Last updated 04/24/2023 as printed on the page.
samhsa.gov/find-support/how-to-pay-for-treatment
SAMHSA states that many treatment programs accept Medicaid, the Children's Health Insurance Program (CHIP), Medicare, Veterans Affairs (VA) Health Care, or private insurance, and that free and low-cost treatment options exist across the country. SAMHSA advises asking treatment providers about how to cover the cost of treatment and being honest about what one can afford.
Claim limit: "Many programs accept" and "options exist" are not statements that any specific program, insurer, or government agency will cover a given person's care.
SAMHSA: Mental Health Treatment: What Does Health Insurance Cover?
Publisher: SAMHSA, U.S. Department of Health and Human Services. Last updated 04/24/2023 as printed on the page.
samhsa.gov/find-support/how-to-pay-for-treatment/know-what-your-insurance-covers
This page supports the site's coverage-questions section. SAMHSA states that most health insurance plans cover treatment, but not all do, and some only cover certain levels of care. To learn what a plan covers, a person can call the number on the insurance card and ask about the covered treatment and rate, co-pay or coinsurance, number of covered appointments or days per year, preferred providers, and available case managers. SAMHSA also notes that Medicaid and CHIP cover some mental health, drug, and alcohol treatment, with coverage amounts and services depending on the state, and that TRICARE covers mental health, drug, or alcohol misuse programs.
Claim limit: Coverage varies by plan and state; this page does not and cannot determine what any individual's plan covers.
HealthCare.gov: Mental health & substance abuse coverage
Publisher: U.S. Centers for Medicare & Medicaid Services (HealthCare.gov / Health Insurance Marketplace)
healthcare.gov/coverage/mental-health-substance-abuse-coverage
This page grounds the site's Marketplace coverage explanations. HealthCare.gov states that all Marketplace plans cover mental health and substance abuse services as essential health benefits, including behavioral health treatment (psychotherapy and counseling), mental and behavioral health inpatient services, and substance use disorder treatment. Specific benefits depend on the enrollee's state and chosen plan. Marketplace plans cannot deny coverage or charge more for a pre-existing condition, including mental health and substance use disorder conditions, and cannot place yearly or lifetime dollar limits on essential health benefits. Marketplace plans must also provide parity protections so that limits on mental health and substance abuse services are not more restrictive than limits on medical and surgical services, including financial limits, treatment limits, and care-management requirements.
Claim limit: These are Marketplace plan rules, not a statement about any individual's enrollment, plan selection, or claim outcome.
