Self-pay and sliding scale rehab

Questions to ask

• What is the total cash price, and what does it include?
• Do you offer a sliding scale based on income?
• Is there a payment plan? Any interest or fees?
• What is your refund policy if I leave early?
• Will you give me a receipt I can submit to my insurer for out-of-network reimbursement?

Lower-cost alternatives

If cost is a barrier, look at outpatient and IOP, county-funded programs through the Beneficiary Access Line at (800) 723-8641, and free mutual-help groups like AA, NA and SMART Recovery alongside treatment.

When paying directly can make sense

• You have no insurance and do not qualify for Medi-Cal
• Your plan does not cover the program or level of care you need
• You want to avoid insurance paperwork for privacy reasons
• You plan to submit receipts for out-of-network reimbursement

Ways to lower the cost

• Start with a lower level of care, such as IOP, if it is clinically appropriate
• Ask for the self-pay discount; many programs have a lower cash rate
• Ask about a payment plan with no interest
• Look at nonprofit and county-funded programs
• Use an HSA or FSA if you have one; addiction treatment is generally an eligible medical expense

Get it in writing

Before admission, ask for a written agreement with the total price, what it includes, the payment schedule, and the refund policy if you leave early. Keep a copy.

Out-of-network reimbursement

If you have a PPO with out-of-network benefits, you can pay a program directly and submit an itemized bill (a “superbill”) to your insurer for partial reimbursement. Ask the program to include diagnosis codes, service codes and its license number, and keep copies of everything.