Starting addiction treatment is a brave decision, but for many, the big question is: Will insurance cover it? Sorting through policies, provider networks, and fine print can feel overwhelming, especially when you’re already facing the stress of substance use and recovery. The good news is that most health insurance plans are required to cover mental health and substance use treatment; still, there are other details you should be aware of.
At The Walker Center, we work every day with people from across Idaho, including Twin Falls, Boise, Gooding, @Sun Valley, and the Magic Valley, helping them understand their insurance options and making treatment more accessible. Here’s what you need to know about insurance coverage for addiction treatment in Idaho and how to find out what your plan will pay for.
Why Insurance Must Cover Addiction Treatment
The Mental Health Parity and Addiction Equity Act (MHPAEA) requires most insurance providers to treat addiction and mental health services the same as physical health services. That means your Idaho health plan can’t make it harder to get addiction treatment than it is to get care for something like diabetes or asthma.
Under the Affordable Care Act (ACA), substance use treatment is considered an “essential health benefit.” If you purchase coverage through Idaho’s marketplace—Your Health Idaho—your plan will include some level of treatment coverage. This includes services such as:
Detox programs
Inpatient or residential rehab
Outpatient treatment
Medication-assisted treatment (MAT)
Counseling and therapy
That being said, the amount of coverage, deductibles, and co-pays vary depending on your provider.
How To Check if Your Insurance Covers Addiction Treatment
When you’re ready to take the next step toward recovery, it’s crucial to know what your insurance will cover. Here’s how to check:
1. Call Your Insurance Provider
The most direct way is to call the member services number on the back of your insurance card. Ask:
Does my plan cover substance use disorder treatment?
Which types of programs (detox, inpatient, outpatient, PHP, IOP) are included?
Do I need a referral or prior authorization for this service?
What are my out of pocket costs for deductibles and copay?
Are there limits on the number of visits or the duration of stay?
Which providers are in-network?
2. Log In to Your Online Member Portal
Most Idaho insurance carriers, including SelectHealth, Blue Cross of Idaho, PacificSource, Molina, and Regence BlueShield, offer online portals that display your benefits. Look under “behavioral health” or “substance use treatment.”
3. Contact the Treatment Center Directly
At The Walker Center, our admissions team verifies insurance for individuals and families. We work directly with your insurance provider to explain your benefits, confirm coverage, and assist with any necessary paperwork. Many people find this easier than trying to interpret policy documents on their own.
What to Expect from Insurance Coverage in Idaho
Idaho has several insurance carriers, and most plans cover at least part of the cost of addiction treatment. However, there are differences:
Medicaid (Idaho Behavioral Health Plan): Covers a wide range of treatment services, including outpatient and inpatient rehab, often with little to no out-of-pocket cost.
Marketplace Plans (Your Health Idaho): Carriers like SelectHealth, Blue Cross of Idaho, and Mountain Health CO-OP cover addiction treatment. Subsidies may help lower monthly premiums.
Employer-Sponsored Insurance: Most employer plans in Idaho include addiction treatment, but co-pays and deductibles vary.
Keep in mind that in-network treatment centers usually cost less; however, you may also have options for partial coverage out-of-network.
Barriers To Be Aware of and How To Handle Them
Even with coverage, some people worry about out-of-pocket expenses. Deductibles, co-insurance, and prior authorizations can all create confusion. Here’s how to move forward:
Don’t delay care: Many insurance companies approve treatment faster than families expect once the need is documented.
Ask about financial assistance: At The Walker Center, we offer payment plans and options to help bridge the gap between what insurance covers and what you owe.
Appeal when necessary: If your claim is denied, you have the right to appeal the decision. Many denials are overturned when treatment is shown to be medically necessary.
Choosing Outpatient & Residential Programs in Idaho
Choosing a treatment center close to home has benefits beyond convenience. With outpatient and residential programs in Southern Idaho, The Walker Center allows families to stay connected while receiving professional support. This local connection also makes it easier to continue aftercare, attend support groups, and access community resources once treatment ends.
Taking the Next Step
Addiction treatment is life-saving care. If you’re wondering whether your Idaho insurance covers rehab, you don’t have to figure it out alone. The Walker Center is here to guide you through every step, from verifying your benefits to beginning treatment.
Recovery is possible, and it can start today. Contact our team to verify your insurance coverage and explore the ideal program for you or your loved one.
