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How Many Times Will Insurance Cover Treatment?

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How Many Times Will Insurance Cover Treatment?

Relapse happens. These missteps are just a simple fact for many people in recovery. And for full blown relapses when you’ve either hit rock bottom again or are quickly headed that direction, a trip back to rehab is usually the best course correction. These times are scary and overwhelming enough on their own, and your treatment history is usually the farthest thing from your mind. But cyclical relapses eventually become a red flag, and they may jeopardize your ability to continue asking for help. So how many times will insurance cover treatment after you’ve relapsed?

How Many Times Will Insurance Cover Treatment?

Taking Rehab Seriously

Addiction is classified as a disease in the US. That means the cost of treatment gets covered by many insurance companies. This provides the ability for addicts seeking recovery to find a safe haven where they can work on getting better.

Although relapse understandably becomes part of many people’s stories, chronic relapse becomes problematic. Especially if these relapses happen within short periods of time. Rehab should be taken seriously. If an individual continues to dip in and out of a treatment environment, it sends signals to their insurance that treatment is not effective. So what does that mean?

How Many Times Will Insurance Cover Treatment?

Each insurance provider varies with how many times they’ll cover treatment. Some of these considerations are based on your plan itself, and others factor in your treatment history. There are four main points they consider:

  • How many times have you been to treatment this year?

    When you start making multiple trips to rehab within the same year, most insurance companies will assign you a care manager. This person tracks your treatment history to determine how likely it is that the next stint in rehab will be successful.

  • Type of Policy

    Different insurance plans cover different types of treatment and facilities. The coverage may change depending on your recent treatment history, however.

  • Previous lengths of stay in rehab

    Did your last stay in rehab only last a few days? Or did you complete the recommended treatment, followed up by another level of care? These questions affect what your insurance will cover this time around.

  • What are you doing differently this time?

    Treatment offers many options for methods to get and stay clean. Some people prefer 12 step, others find success with individual therapy. Trying a new way to get clean signifies that you’re serious about trying to turn a new leaf.

All of these factors combined will determine if your insurance will cover treatment again after you’ve relapsed. So what can you do to make sure that relapse doesn’t affect your ability to access further needed treatment?

Relapse is a Step in the Process

Many people new to recovery feel that relapse means they’ve failed. But it is simply a step in the stages of change.

That said, it’s important to take treatment seriously. No matter where relapse pops up in your story, ideally, people in recovery operate in the mindset that those relapses will stay in the past. Because if you start to accept that “relapse just happens,” you’ve essentially already given up. And that usually shifts relapse from possible to inevitable. If those relapses start getting too close together, treatment may become inaccessible. It’s a nasty cycle that can be preempted by truly devoting yourself to making a change the first time around.


If you or a loved one is seeking help for a substance abuse problem, our counselors are available 24/7 by phone: 855-737-7363

Posted in Addiction, Detox, Recovery, Relapse, Residential