Does Insurance Cover Dual Diagnosis Rehabs in Los Angeles, CA?

Last Updated: August 12, 2025

Yes, insurance can cover the cost of dual diagnosis rehab treatment in Los Angeles, CA. Coverage amount can vary and will depend on you or your loved one’s individual insurance plan. Reach out to us at 855-652-9048 to verify if your insurance may be able to cover the cost of dual diagnosis treatment at Harmony Place today!

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What is Dual Diagnosis Addiction Treatment?

Dual diagnosis addiction treatment is a specialized approach for individuals who have both a substance use disorder and a co-occurring mental health condition, such as depression, anxiety, PTSD, or bipolar disorder. This type of care addresses both issues at the same time, rather than treating them separately, which can improve recovery outcomes and reduce relapse risk.

Treatment often combines medical detox, therapy, psychiatric care, medication management, and holistic support. By targeting both mental health and addiction together, dual diagnosis programs help individuals build coping skills, stabilize their mental health, and work toward long-term sobriety.

Signs You Need Dual Diagnosis Addiction Treatment

Signs you or a loved one may need dual diagnosis addiction treatment may include:

• Frequent Mood Swings or Emotional Instability: Experiencing intense highs and lows, irritability, or emotional outbursts alongside substance use.
• Using Substances to Cope with Mental Health Symptoms: Drinking or using drugs to manage anxiety, depression, or trauma.
• Declining Mental Health Despite Treatment: Mental health symptoms persist or worsen even with medication or therapy.
• Multiple Failed Attempts to Quit: Repeatedly trying to stop substance use without success.
• Withdrawal Symptoms That Include Mental Distress: Experiencing anxiety, paranoia, or severe depression when not using substances.
• Difficulty Maintaining Relationships or Work: Ongoing interpersonal or job problems caused by both mental health issues and substance use.
• History of Trauma: Unresolved trauma that influences both mental health and addiction patterns.

What Dual Diagnosis Programs Does Insurance Cover?

Insurance often covers a range of dual diagnosis treatment programs, but coverage depends on your plan, provider network, and medical necessity. Many plans include inpatient rehab, outpatient treatment, partial hospitalization programs, and intensive outpatient programs when both a substance use disorder and a mental health condition are diagnosed.

To determine what is covered, you typically need a formal assessment from a licensed professional and prior authorization from your insurance company. Coverage may include therapy, medication management, detox services, and aftercare planning, as long as they are deemed necessary for treating both conditions. Checking your policy details and speaking directly with your insurer can clarify your exact benefits.

How Much Does Dual Diagnosis Rehab Cost?

The cost of dual diagnosis rehab, which treats both substance use and co-occurring mental health disorders, can vary greatly depending on the level of care, location, program length, and amenities offered. Medical detox typically costs between $300 and $800 per day, with higher prices for more complex medical needs. Inpatient residential treatment averages $500 to $2,000 per day, or roughly $10,000 to $60,000 for a 30-day stay, though luxury programs and extended care can exceed these amounts. Outpatient and intensive outpatient programs (IOP) generally range from $100 to $500 per session, totaling $1,000 to $10,000 per month, while partial hospitalization programs (PHP) often cost $350 to $450 per day, or $10,500 to $13,500 for 30 days. Sober living or post-rehab housing typically runs $500 to $2,500 per month. Insurance can help reduce or cover the cost of rehab.

Which Insurance Providers & Plans Can Cover Dual Diagnosis Rehab?

Many major insurance providers offer coverage for dual diagnosis rehab, but the extent of coverage varies by plan and policy. Common providers that often include dual diagnosis treatment benefits are Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, Humana, and Kaiser Permanente.

Plans such as employer-sponsored health insurance, Marketplace plans under the Affordable Care Act, Medicare, and Medicaid may cover inpatient and outpatient rehab services when medically necessary. Coverage usually includes therapy, medication management, detox, and psychiatric care related to both substance use and mental health disorders.

It is important to check your specific insurance policy or contact your provider directly to understand what dual diagnosis services are covered, any out-of-pocket costs, pre-authorization requirements, and provider networks to ensure you receive the best benefits for your treatment.

How to Use Insurance to Cover Dual Diagnosis Rehab?

To use insurance for dual diagnosis rehab, start by reviewing your policy or contacting your insurance company to confirm coverage for substance use and mental health treatment. Ask about in-network providers, covered services, and any limits on treatment length or types of care.

Next, get a formal assessment from a licensed healthcare professional who can diagnose both your substance use disorder and mental health condition. Your treatment provider will often help submit the necessary documentation and request prior authorization from your insurer.

Once approved, your insurance can cover costs like detox, inpatient or outpatient programs, therapy, and medication management according to your plan’s benefits. Keep track of your coverage limits and any required copayments or deductibles throughout your treatment to avoid unexpected expenses.

How Long Can Insurance Cover Dual Diagnosis Rehab?

The length of time insurance covers dual diagnosis rehab varies depending on your specific plan, the level of care, and medical necessity. Many insurance policies cover up to 30 days of inpatient treatment, but some plans allow for longer stays if your healthcare provider documents the need.

Outpatient and intensive outpatient programs often have flexible coverage durations, sometimes lasting several months. Insurance companies typically require periodic reviews or reauthorizations to continue coverage, ensuring the treatment remains necessary. It is important to check with your insurer about limits and approval processes to understand how long your rehab stay will be covered.

Can Insurance Cover Medication-Assisted Treatment (MAT) in Dual Diagnosis Rehab?

Yes, many insurance plans cover medication-assisted treatment (MAT) as part of dual diagnosis rehab. MAT combines medications with therapy to treat substance use disorders alongside co-occurring mental health conditions.

Coverage for MAT often includes prescribed medications, medical monitoring, counseling, and support services. However, the extent of coverage can vary by insurer and plan, so it’s important to verify your benefits and understand any requirements like prior authorization or treatment limits.

Medicaid & Medicare Coverage for Dual Diagnosis Rehab

Both Medicaid and Medicare provide coverage for dual diagnosis rehab, but the specifics depend on your state and plan. Medicaid often covers a broad range of substance use and mental health treatment services, including inpatient rehab, outpatient therapy, medication-assisted treatment, and counseling. Coverage and eligibility vary by state since Medicaid programs are state-administered.

Medicare covers certain mental health and substance use treatments under Parts A and B. This includes inpatient hospital care, outpatient services, and some prescription drugs related to treatment. Medicare Advantage plans may offer additional benefits for dual diagnosis rehab. It is important to review your plan details and speak with your provider to understand what services are covered and any out-of-pocket costs.

Get Help Today

If you or a loved one is struggling with addiction and are unsure of where to start, call us today at 855-652-9048 to learn more about your options. Recovery is within reach.