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In-Network vs. Out-of-Network: How to Choose a Residential Addiction Treatment Facility

By Acqua Recovery on January, 27 2021


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If you or a loved one has been struggling with addiction, get help sooner than later. Residential addiction treatment is a 30-90 day program that allows those struggling with addiction to take time away from the triggers in their personal life and get clean and sober. When looking for the right residential treatment program, insurance may be a big factor in choosing a facility. Does it matter if a residential addiction treatment program is in-network or out-of-network? Here are some of the insurance basics and how insurance could help you get the addiction treatment you need.

What’s a Deductible?

A deductible is the given cost you must pay for out-of-pocket, before your insurance will cover their portion of your healthcare cost. Once you’ve reached your deductible, your insurance will begin to pay for a given percentage of coverage dependent on your plan. Not all plans are created equal. Some insurance plans will have deductibles, some won’t. Typically, the deductible for out-of-network costs will be higher than in-network costs, meaning you’d have to pay more upfront before your coverage would begin, but that shouldn't stop you from considering a treatment facility that's right for you.

In-Network Coverage for Residential Addiction Treatment

If a residential addiction treatment facility is in-network, that means they are contracted with your insurance provider. How much you pay for addiction treatment depends on your insurance benefits and the level of care you pay for. Typically, the higher the level of care you have, the higher your monthly insurance premium will be, but the less you will pay for the cost or copay of treatment. 

Typically, if your insurance provider is in-network with a treatment facility, your insurance will cover a higher percentage of the cost and in some cases it could cover all. If you’re looking for residential addiction treatment facilities, in-network may be a great, more affordable option for you. However, don’t think that you won’t be able to afford addiction treatment if a facility isn’t in-network with your insurance provider. Give us a call today to find out how we can make treatment affordable for you.

Out-of-Network Coverage for Residential Addiction Treatment

When a residential addiction treatment facility is out-of-network, it means that your insurance provider is not contracted with them. This doesn't mean you can't go to that treatment facility, but your insurance carrier may cover a smaller percentage of treatment cost. Depending on your insurance plan and your out-of-network deductible, it’s still possible that you will pay a minimal amount, so don’t rule out an out-of-network addiction treatment program just yet! To learn more, check out our guide to paying for addiction treatment, HERE.

What’s an Out-of-Pocket Maximum and How Can it Help?

If you’ve reached your out-of-pocket maximum, meaning the total copay, out-of-pocket costs, and coinsurance costs you’ve personally paid for throughout that year have reached the specified maximum amount, your insurance must cover 100% of out-of-network expenses. In this case, you could be paying almost nothing for residential addiction treatment.

Insurance Verification: Am I In-Network or Out-of-Network?

To figure out if your insurance is in-network or out-of-network, simply give us a call. At Acqua Recovery, our caring admissions team, Matt, Brian, or Ashlee, will verify your benefits. This means that they will run your insurance to figure out how much of your deductible is left, your percentage of coverage, and your copay cost. 

If you have concerns about affording addiction treatment, our admissions team will also work with you to help make it affordable. We believe that insurance coverage shouldn’t stop someone from getting the residential addiction treatment they need and deserve. The truth is, not all addiction treatment facilities are equal. Finding the right residential addiction treatment facility is crucial, to not only get you sober, but the right program will help you stay sober.

At Acqua Recovery, our holistic Dual Diagnosis approach treats the addiction and the underlying trauma that may be causing it. Our program customizes treatment modalities such as, individual therapy, group therapy, relapse prevention, and experiential activities, to create a treatment plan that aligns with your needs, goals, and healing. Reach out to us today, to find out how we can help you afford residential addiction treatment.

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The Complete Guide to Paying for Addiction Treatment

The Complete Guide to Paying for Addiction Treatment

Deciding to get help for addiction is a process that can take years. If you’re at the point of readiness, don’t let yourself be derailed at the last minute by financial issues. Maybe you found an addiction treatment center you like, but you’re out-of-network. Or, maybe you don’t have insurance at all, and the price of treatment is too staggering. No matter your financial situation, it is possible to receive the substance abuse treatment you deserve. Don’t give up. Find out how you can afford residential addiction treatment with this ultimate guide to paying for treatment.

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