How Much Does Partial Hospitalization Cost With Insurance

How Much Does Partial Hospitalization Cost With Insurance?

Get In-Network and Affordable PHP Programs at South Shores

When most people attend rehab for a substance use disorder, they enter under the assumption that for at least 30 days, meeting any other obligations in their personal or professional lives is all but impossible. While it’s true that we recommend the majority of your energy should be invested into your recovery during your treatment period, understandably not everybody can dedicate an entire month to being out of circulation.

Unfortunately, this dynamic stops many of those in desperate need from entering addiction treatment. But not at South Shores.

With us, the answer to ‘How much does partial hospitalization cost with insurance?’ is frequently, little to no out-of-pocket cost at all!

At South Shores Detox, the goal is to accommodate mental health and substance abuse disorder clients from all walks of life through our varying levels of care offered. Our partial hospitalization program is one of many options afforded to our growing list of clients.

In this article, we address the questions regarding partial hospitalization program cost when you have health insurance, including any potential out-of-pocket costs or other expenses.

Up To 100% of Rehab Costs Covered By Insurance
CALL US AT: 833-213-3869

Getting Familiar With Partial Hospitalization Programs

Partial hospitalization programs, otherwise known as PHP treatment, is an intensive treatment program designed for moderate-to-severe cases of substance abuse disorder. Various types of mental health treatment and programs for substance abuse are deployed during PHP treatment, in addition to opportunities for group meetings with peers and family.

The average day during PHP treatment lasts between 6 and 8 hours, with a varying schedule that includes multiple counseling sessions that focus on substance abuse awareness and education, in addition to intensive treatment for behavioral health and trauma-related issues. The level of intensity offered during PHP treatment at our Orange County programs is nearly identical to inpatient or residential, with the primary difference being the exclusion of overnight stays.

In addition, this form of addiction treatment usually only requires a Monday through Friday schedule as opposed to the standard 7-day schedule offered during standard inpatient addiction and mental health treatment.

The Ideal Candidates for Partial Hospitalization Programs

Although partial hospitalization programs are open any and all clients at South Shores Detox, certain prerequisites make this the ideal addiction treatment for certain individuals. PHP treatment is ideal for the following situations:

  • A bridge between standard inpatient addiction treatment and outpatient substance abuse treatment.
  • Dual diagnosis clients who require enhanced mental health treatment.
  • Clients who previously attempted outpatient addiction treatment but found they require a higher level of inpatient or residential treatment.
  • Clients who require inpatient addiction treatment but can’t necessarily commit to the scheduling requirements of a residential program.
  • Clients who are beginning medication management for the first time for mental health, substance abuse, or dual diagnosis treatment.
  • First-time dual diagnosis or trauma-related clients.

Partial hospitalization can provide an intensive form of therapy for clients who otherwise might not have access because of obligations at home, or other roadblocks. The list above is just a small example of the most common client situations during our partial hospitalization program at South Shores. So, what is the primary goal for clients enrolled in a partial hospitalization program?

Individualized Plan Goals of a Partial Hospitalization Program

Individual Plan for Partial Hospitalization Program

When you attend a partial hospitalization program, the mental health and substance abuse therapy is comprehensive and hyper-focused. After a meticulous approach to crafting your personalized treatment plan, including medication management and a structured therapy schedule, several goals are established for the conclusion of treatment. Some of the primary goals include:

  • Long-term sobriety
  • Improving the way you cope with challenging situations
  • Strengthen your support system
  • Prepare you for important social dynamics (employment, housing, etc.)
  • Help you develop a strategy for attending group meetings (AA, NA, etc.)
  • Ensure you’re proactive in continuing work on your behavioral challenges
  • Assist with resources for continued mental and physical health
  • Potentially help you segue into a less intense mental health or substance abuse care level

What’s the Next Step After a Partial Hospitalization Program

Some of our clients opt for a partial hospitalization program and solely use this as a standalone form of treatment – and that’s okay. However, a large portion of our client base uses partial hospitalization as a bridge between two alternative care levels.

Several options exist for those exiting our partial hospitalization program, including:

Standard Mental Health or Substance Abuse Outpatient Program

One of the most common steps after partial hospitalization is a transition to standard outpatient services for mental health or substance addiction. This normally is a step in a longer chain that includes Inpatient/Residential > Partial Hospitalization > Outpatient/Intensive Outpatient > Sober Living or Back Home with Outpatient Support as needed.

It’s worth noting that the specific care level after partial hospitalization can include standard outpatient or intensive outpatient programs, depending on what you’re comfortable with. So, what’s the purpose of moving from one form of care level to another?

As you move from partial hospitalization to outpatient, the intensity level is decreased, giving you time to slowly adjust to a life of sobriety. The care you receive during partial hospitalization programs and other care levels will be a strong pillar of strength, and a gradual step down increases your chances of successful long-term recovery as opposed to the sudden exclusion of all forms of therapy.

What Mental Health and Addiction Issues are Treated at Partial Hospitalization Programs?

Dual Diagnosis Treatment

At South Shores Recovery we are required to treat a wide variety of mental health and substance abuse disorders during our partial hospitalization programs. However, the therapeutic approaches we use normally favor are most effective for the following conditions.

Now that you’re familiar with the outline of our partial hospitalization programs – what about partial hospitalization program cost? In the next section, we address partial hospitalization program cost, and whether insurance coverage offers the funding you need to cover treatment.

Up To 100% of Rehab Costs Covered By Insurance
CALL US AT: 833-213-3869

What Are the Out-of-Pocket Costs for Care at PHP Treatment Centers?

The average out-of-pocket cost for partial hospitalization in California generally falls between $200 and $1,000 per day if you don’t have insurance. A standard PHP program, which runs for a duration of 4 to 6 weeks, can cost anywhere between $8,000 and $18,000 USD.

However, the final number is influenced by the geographic location of treatment centers, in addition to the range of services and the exact length of the program. Organizations that offer specialized forms of care or extended hours generally have higher costs associated with them as well.

The final out-of-pocket cost varies depending on the organization. For more information, we would need to contact your insurance coverage provider to find out the specifics of your plan. For questions related to out-of-pocket expenses, please contact a member of our team.

Payment Options for PHP Mental Health and Substance Abuse Disorders

Payment Plans

Naturally, insurance coverage is the ideal method of funding for those who attend PHP programs. Additional methods exist to help cover expenses during rehab. Consider the following sources to help supplement the funds provided by your insurance company to help cover out-of-pocket expenses:

Sliding Scale Costs

Many facilities, including South Shores, offer sliding scale fees depending on a client’s level of income and general ability to meet the financial requirements for treatment. For many with the goal of entering rehab, this can be a lifesaver, making care much more affordable when immediate cash isn’t available.

Receiving this benefit requires filling out a short form with information regarding your employment or other sources of income. Approval is provided almost immediately, allowing you to quickly enter treatment.

Payment Plans

In some cases we are also able to offer payment plans. These are billed at a later date (generally after treatment) and require funding monthly or quarterly, depending on what the prior arrangement is. Remember to get the arrangement in writing, and always get receipts when you make a payment.

6 Tips for Budgeting the Cost of PHP Programs

If you have the plan of attending a PHP program and expect that you may encounter out-of-pocket expenses of any kind, it’s important to plan and budget for these expenses. Although it’s difficult to predict what the future might hold – and even more difficult when you’re battling a substance use or alcohol disorder – creating a budget plan to help satisfy additional costs can help relieve stress later. Consider deploying any of the following changes and strategies to help:

  1. Do your homework about the treatmeent centers in your area. Consider the services you require and compare different facilities based on the quality of care and cost to attend. Many facilities also offer referral bonuses that can help cover the cost of your treatment if you bring potential clients through the door.
  2. If you have questions regarding your specific level of coverage, hop on a call with South Shores or your destination facility. We’re always willing to check your copayment and deductible amounts to help you better prepare for any out-of-pocket costs.
  3. Always factor in the expected amount of out-of-pocket expenses when you pay bills or spend any money at all. Remember, you must always keep (xxx amount) on hand for when it’s time to enter treatment so you don’t have any financial pitfalls when it’s time for admission.
  4. If the costs are substantial, consider alternative avenues like credit cards or personal loans. Family members can also be a source of low or non-interest loans, especially if you have difficulties getting approved from financial institutions.
  5. Contact non-profit or other charitable oragnizations in your area. Churches and other enteties are great starting points, and often help local community members who intend to enter recovery.
  6. Discuss the cost of your treatment with the facility you’re attending. It’s possible to make adjustments to your program, set up a payment plan, or obtain the benefits of sliding scale fees.

One of the easiest ways to avoid large out-of-pocket expenses is ensuring you’re enrolled with a quality insurance provider. Thanks to the Affordable Care Act, it’s simple and easy to sign up for an insurance plan that matches your budget and needs.

Medicare and Medicaid are two of the most common insurance providers, especially for those who are currently out of work or considered low-income. In many cases, both of these providers cover the entire cost of treatment, and South Shores Detox works as an in-network partner for both, including third-party agencies under their respective umbrellas.

How Much Does Partial Hospitalization Cost with Insurance Coverage?

Partial Hospitalization Programs Cost

With the adoption of the Affordable Care Act, all insurance agencies must provide some level of coverage for mental health and substance abuse treatment. In addition, the Mental Health Parity and Addiction Equity Act requires most insurance agencies to provide, at the minimum, at least partial coverage for partial hospitalization specifically.

At South Shores Recovery, we accept insurance coverage plans for mental health and substance abuse from a number of different agencies. Existing as an in-network partner with insurance agencies is important, especially when clients are looking to save as much money as possible. We partner in-network with major companies, such as the following providers:

Up To 100% of Rehab Costs Covered By Insurance
CALL US AT: 833-213-3869

Get PHP Treatment in Orange County at South Shores Today

Being insecure about your ability to fund treatment is common among future rehab clients. Fortunately, South Shores Detox and Recovery provides solutions that allow you to eliminate most of your fears and reservations regarding sources of funding for attendance. We’re more than willing to work with your current insurance provider to obtain information about your policy so you don’t have to.

It is likely that we already partner in-network with your provider. If we don’t, we have additional options to help you cover any out-of-pocket expenses you may encounter. For more information about agencies we partner with and other insurance questions, contact a member of our team today!