Is IOP Covered by Insurance?

Drug recovery can be stressful all on its own. The difficulty with alcohol and illicit substances is that they rewire the brain and convince the individual that they can’t survive without using. That’s why stepping away from the habit and admitting the need for help can significantly weigh down on a person’s psyche.

And while that might be difficult enough to cope with on its own, the added stress of recovery treatment fees and payments can further compound the struggle. In fact, that’s also one of the reasons why some people turn away from treatment altogether. That’s why most people find themselves asking — does insurance cover IOP and what other payment options do I have?

How Much Does Outpatient Mental Health Cost?

First things first — how much does an IOP program cost? To answer that question, it’s equally important to keep in mind that different treatment centers offer services at different prices depending on a range of factors. Some of these may include:

• Experience, expertise, and education of their staff and personnel
• Size, location, and amenities available
• Type of treatment required for the individual
• Use of supportive medicated therapy
• Frequency of sessions required per individual
• Duration of treatment

That said, the numbers aren’t really set in stone. Some of the more affordable treatment programs cost around $10,000 for a three-month period, while others can reach upwards of $30,000. Some centers offer daily rates to stagger the payments, which may cost between $130 to $300.

While that might be well within reach for some individuals, it’s important to remember that drug and alcohol addiction can significantly impact a person’s financial capabilities. Another thing is that individuals entering IOP most often come from residential programs which may have costed them significantly more.

Can Insurance Pay for IOP?

The short answer is yes, it can, but not every time. There are some specifics that may disqualify a person from having their insurance cover their intensive outpatient treatment.

First off, IOP must be considered a medical necessity for insurance providers to agree to pay for the services. That means clients need to undergo medical assessments to ensure that the treatment is something they need. Most IOP centers will provide this evaluation often at no cost so clients can receive the documents and paperwork necessary to file a claim.

Another thing is that some people may be underinsured. That said, individuals who lack sufficient coverage may still have their insurance pay for a part of their treatment up to the limit of the policy. That also means they would have to pay for the remainder of the balance out of their own pocket.

Are There Other Payment Options for IOP?

It’s the belief held by most treatment centers that no individual should be deprived access to treatment simply because they can’t afford it. This is why most centers provide alternate treatment options for those who don’t have insurance or don’t have enough coverage.

The sliding fee scale adjusts the prices of the program to match the financial capability of those hoping to receive treatment. This often takes a variety of factors into consideration including their annual income, the size of their household, and the extent of treatment they require.

Another way to pay for treatment would be through government funding. Individuals may apply for funding by submitting a number of documents to a variety of government bodies that provide assistance for these types of causes.

Federally-funded, state-run drug and alcohol addiction programs often have a waiting list because a large number of those who don’t have the means to pay for recovery with insurance or with their own funds turn to these programs.

Some IOP program requirements that state-run programs require include:

• Proof of residence (most of these programs provide assistance only to those who reside within the program’s state)
• Degree and history of addiction
• Proof of inability to pay for treatment

Alternatively, there, are some IOP providers that offer to process insurance applications for the under and uninsured. These centers have close ties with insurance providers, allowing them to speed through the process of application and make it possible for individuals to receive treatment as soon as possible.

In some areas, there may be non-profit treatment centers that allow clients to receive therapy for zero cost. The only trade-off however is that they may have to render work in exchange of treatment. What’s more, most of these programs only offer in-patient treatment, however there are a limited few that also have outpatient services.

For those who might not be able to exercise these options may try to have their recovery funded by private individuals. There are lots of people out there who are willing to pay for treatment as part of their personal advocacy, although it may be difficult to find them. Some government officials and public personalities might also offer the same opportunity.

Do I Have to Pay for Services Up Front?

Some treatment centers require full payment upon joining the program, especially high end centers that cater to an affluent market. Even most centers that cater to low- and middle-income clients may require upfront payment before any services are rendered.

On other hand, those directed strictly towards low-income communities may allow their clients to pay for services on a daily basis. Others also provide monthly payment options that help to ease the financial burden and stagger payments so they’re easier to afford. Some even go the extra mile by providing services while payment arrangements are settled so individuals receive prompt care as soon as possible.

Paying for Recovery

No doubt, recovery can be hard enough on its own so no one should have to worry about the cost of getting treatment. These days, treatment centers provide a range of payment options for those hoping to achieve lasting sobriety. That said, you should be able to find a way to pay for an intensive outpatient program in Dallas, TX whether or not you have sufficient insurance coverage to pay for it entirely.