Does health insurance cover rehab?
It depends on which kind of rehab — substance use and rehabilitative therapy (like physical or occupational therapy) are both essential health benefits, but coverage still hinges on medical necessity, network, and any visit limits.
What flips the answer
- Covered when
The rehab is medically necessary and in-network — whether it's addiction treatment or physical/occupational therapy.
- Not covered when
You've hit your plan's annual visit or day limit for rehabilitative therapy, or the level of care isn't authorized.
- Not covered when
The provider or facility is out-of-network on a plan with no out-of-network benefit.
“Rehab” covers two very different things, and both are essential health benefits. Substance use disorder treatment (drug and alcohol rehab) must be covered, and so must rehabilitative and habilitative services like physical, occupational, and speech therapy.
For addiction rehab, plans must cover medically necessary detox, outpatient, and inpatient treatment, with parity protections that keep limits in line with medical care. Higher levels of care usually need prior authorization.
For physical/occupational rehabilitation — after surgery, injury, or a stroke — plans cover medically necessary therapy but often cap the number of visits per year and require the care to show ongoing functional improvement.
In both cases the practical answer depends on medical necessity, whether the provider or facility is in-network, and any per-year visit or day limits in your plan.
That's the general answer. Yours is written in your actual policy.
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