Addiction treatment, clinical in-patient treatment, eating disorder programs, residential therapeutic treatment and wilderness programs, can be pricey.
Combining academic support, clinical needs, medical care, psychotherapeutic treatment, recreational therapeutic support, and room and board often adds up to a significant bill. Many families are worried about their choices: opt for the comprehensive care that improves the odds of long-term recovery and pay the hefty bill, or pay less for outpatient treatment or a combination of treatment services that may or may not address all their loved one’s needs. The good news is that there are a number of ways to cover the cost. Families almost always used a combination of options in order to pay the whole bill.
Mental health care insurers find themselves with a large gap in the middle: they will reimburse for outpatient weekly therapy and at times for psychiatric hospitalization.
Unfortunately, there is not much in the middle. Insurers have fought and avoided paying for residential treatment, despite the efficacy and cost-efficiency and overall benefit to the insured battling with a psychological problem. While insurers will reimburse for specific visits to psychiatrists and psychologists, it is the rare exception that pays for residential services. Many families are forced to seek legal remedy and there are now insurance advocates and legal services to fight for insurance coverage.
Private pay residential treatment centers do not often contract directly with insurance companies, nor do they accept assignment of benefits. However, upon request, many programs are able to provide what’s called an “insurance superbill” to submit for reimbursement from your insurance provider.
Here are the most common sources utilized.
Health insurance should always be the first stop when it comes to pulling together the funds to pay for treatment.
Substance abuse treatment services are one of the 10 “elements of essential health benefits” included under the Affordable Care Act.
Here’s where it can be confusing – nowhere is it defined exactly which substance abuse treatment services must be covered. Nor are there any indications how much should be covered, either in percentage or dollar amount. Therefore, there can be some tussle back and forth between the family and the insurance provider as they determine whether or not inpatient care will be covered. Many providers, for example, would like proof that residential treatment is “medically necessary” and the increased chance of relapse should treatment occur on an outpatient basis does not fill this requirement. Other providers may require that patients undergo outpatient treatment first and only when this less intensive measure proves ineffective will they agree to cover inpatient care. Again, this is around “substance abuse treatment” centers only. Residential therapeutic boarding schools and wilderness programs do not fit this category.
We all know that credit cards should only be used for emergencies. The amount of interest that accumulates month after month adds up fast. Still, when this is the only means you have to pay for your child’s residential treatment then it could be worth looking into. Use the credit card with the lowest possible interest rate.
Children with disabilities are entitled to a free, appropriate public education (FAPE), including placement at residential programs when necessary.
In some cases, school districts offer such placements. In other cases, parents are forced to turn to the courts. Under the Individuals with Disabilities Education Act (IDEA), all children are entitled to a FAPE in a placement that is the least restrictive environment (LRE).
This placement is determined through an individualized educational program (IEP). When a child has a disability that prevents them from access to education, then a FAPE consists of the support and services necessary to assist the child in accessing education along with appropriate placement. In cases where a child’s mental health condition impedes their access to education, a FAPE includes the mental health services the student requires to access education.
Most families will finance all or part of the cost of treatment. Many families will be able to create a payback plan that makes sense for their schedule at a monthly payment that works for their budget. All or part of the cost of treatment can be covered through financing. Rates and payback plans are determined on a case-by-case basis.
Often extended family members are willing to contribute to the cause of treatment. In some cases, it may be appropriate to create a formal contract for the loan, providing how and when the money will be paid back. Others may prefer to make a gift of the funds in order to cover part of the cost of treatment.
Many families turn to personal savings and determine whether or not they feel comfortable using all or part to cover the cost of needed services. Funds allocated for other purposes (e.g., college, retirement, etc.) may be tapped when necessary, however, emergency funds and investments are usually the best places to start. Additionally, the sale of a luxury item can help to increase the amount of cash readily available in order to pay for treatment.