Is Sober Living Covered By Insurance

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The process of recovering from substance abuse and/ or addiction can be both time-consuming and costly. Sober living homes offer individuals that have recently completed a substance abuse and/ or addiction treatment program a transitional residence prior to returning home. The costs associated with each sober living facility will differ, as they will depend on certain factors such as location, amenities, residence, and more. Some sober living homes accept insurance as a form of payment, while others do not. 

In the not too distant past, insurance companies were not obligated to provide coverage for services related to addiction treatment. However, addiction, also known as substance use disorder, is currently listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as a brain disorder that is characterized by compulsively engaging in rewarding stimuli regardless of the negative consequences. As such, health insurance companies are now forced to provide coverage for substance abuse and/ or addiction treatment services in the same fashion as they would for other mental health ailments. The extent to how much coverage, if a monetary or frequency limit is placed on certain services, whether services must be rendered by an in-network provider to be covered, and more will all depend on an individual’s health insurance plan. 

Licensures 

It is important to note that according to the California Department of Alcohol and Drug Programs (ADP) only residential programs that offer the following non-medical services are required to obtain licensure: 

  • Detox for physical dependence upon any substance
  • Group therapy sessions
  • Personal therapy sessions
  • Educational workshops to help in understanding addiction, recovery from addiction, and drug-related issues
  • Treatment planning for ongoing recovery from addiction

Therefore, most sober living homes are not legally required to hold any licensures, which often hinders insurance companies’ ability to provide partial or full coverage for individuals residing in them. 

Understanding Medical Insurance 

There is an abundance of detailed, often confusing intricacies associated with the variety of different medical insurance coverage plans. Firstly, each medical insurance company offers its own set of tiered medical coverage plans that consist of different in and out-of-network benefits, deductibles, monthly premiums, and related coverage. Typically plans that require less expensive monthly premiums often provide less expansive coverage. In order to know if your healthcare insurance plan will cover the costs of a sober living home, you must not only make sure the sober living home accepts insurance as a form of payment, but also must understand the mental health and addiction treatment benefits specially provided under your plan. On the back of your insurance card there is a member’s services phone number that you can call to ask detailed questions regarding coverage to understand how much, if any, your insurance company is able to contribute to paying for the cost of residing in the sober living home, and what your out-of-pocket contribution will be. 

For Information and Support 

If you are concerned for yourself or a loved one in regards to substance abuse and/ or addiction we recommend reaching out for help as soon as possible. If left untreated, substance abuse can result in long lasting and potentially life-threatening consequences. Keep in mind: you are not alone! There is an entire network of professionals that are available to help and support you and your loved one throughout the recovery process. The earlier you seek support, the sooner your loved one can return to a happy, healthy, and fulfilling life.

Please do not hesitate to reach out with any questions regarding our specific program at Haven House Addiction Treatment and/ or general substance abuse and/ or addiction treatment related information. Our highly trained staff is readily available to discuss how we might best be able to help you and your loved one. We can be reached by phone at 424-318-3777. You are also welcome to contact anytime us via email at admissions@hhtxc.com.

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