Paying for Treatment
Cost is one of the most common reasons people delay getting help. This guide explains the main ways treatment is paid for, what to say when you call a facility, and what questions to ask so there are no surprises.
Medicaid and Medicare
Medicaid is the joint federal-state insurance program for people with low incomes. Most state Medicaid programs cover substance-use disorder and mental-health treatment, including outpatient therapy, medication-assisted treatment, and residential programs. Eligibility rules vary by state, but if you have Medicaid, it is worth calling a facility and asking whether they accept it.
Medicare is federal insurance for people 65 and older and for some people with disabilities. It covers a range of behavioral health services, including outpatient and inpatient treatment. When you call a facility, say: “I have Medicaid” or “I have Medicare — do you accept it?” The intake staff are used to that question and can tell you immediately.
Sliding Fee Scale
A sliding fee scale means the facility charges you based on your income — you pay what you can afford. Many publicly funded and nonprofit facilities use this model. If you have low or no income, your cost could be very low or nothing at all. Ask: “Do you use a sliding fee scale?” and “What do I need to bring to verify my income?”
Payment Assistance
Some facilities have funds set aside specifically to help people who cannot pay. This is sometimes called a scholarship, a grant slot, or a hardship fund. It is not widely advertised, but it exists. If cost is a barrier, ask directly: “Do you have any payment assistance or scholarship spots available?” The worst answer is no.
Treatment Without Insurance
You do not need insurance to get help. Many facilities accept self-pay at reduced rates, use sliding scale fees, or have grant-funded spots that cost nothing. Start with facilities that list free or sliding-scale payment options.
Search for free or sliding-scale facilities →
Questions to Ask About Cost
- Do you accept my insurance? (Name your plan when you call.)
- If I don’t have insurance, what does treatment cost — and is there a sliding scale?
- Do you have any payment assistance, scholarship slots, or grant-funded openings?
- Will I owe anything before I start, or can I start and arrange payment during intake?
The facility’s intake staff can verify what your insurance will cover and walk you through financial options — that is part of what they do every day. We never make promises about what any specific plan will cover, because coverage details change and vary by state and employer. The best source is always the facility itself.