Using Insurance in a Sober Living Home - Solutions Recovery

Using Insurance in a Sober Living Home

Finding evidence-based detox and rehabilitation programs is often the first, and most important, step in overcoming addiction; however, finding social support for long-term recovery is also vital. Those who work hard to overcome addiction need ongoing assistance changing their behaviors and staying away from drugs.

For many people, living in a sober living home helps them to avoid drugs or alcohol, focus on creating a drug-free life, and get emotional support from peers who are experiencing similar issues. The National Institutes of Health (NIH) found that, when people who have completed a rehabilitation program re-enter the world, staying in a residence free of triggers, stress, and substances reduces the risk of relapse.

Sober Living Home Expectations and Standards

A person applying to sober living is expected to:

  • Seek employment, job retraining, or educational opportunities
  • Attend peer support groups, therapy, and/or outpatient rehabilitation to adjust to living a sober lifestyle
  • Assist in creating a safe, drug-free environment by supporting other residents, avoiding drugs or alcohol, and potentially submitting to regular drug testing

There are few national standards for sober living homes, so each one is slightly different. These residences may have few governing rules and involve just peer support in a co-housing situation, or they may have an onsite supervisor who maintains standards, such as required attendance at 12-Step meetings and drug testing. Examining a sober living home’s rules, regulations, available staff, and any available onsite programs can help one determine whether this living situation would be beneficial. State and nonprofit certifications, accreditations, and licenses will also inform the quality of the home.

Financial concerns also come into play. A person just leaving a rehabilitation program, especially a 90-day residential program, needs help developing a new, daily life. This person may not have a job, and they may have few financial resources. Understanding how sober living homes work, including how a person rents space, can help determine if this is a viable next step or if another option for stepping down into a new level of treatment might work better.

Will Insurance Cover Sober Living

As of 2014, the Affordable Care Act (ACA) requires insurance companies to provide coverage for mental and behavioral health, including substance use disorder treatments that are evidence-based. However, this means that employer-based, private, or Medicaid-based insurance covers much of the cost of detox and rehabilitation – most often, outpatient rehabilitation – but does not cover other important aspects of treatment, including sober living homes.

A person living in a sober home while they attend an outpatient treatment, for example, may have financial help through their insurance to pay for the rehabilitation program; however, because only a few states truly regulate sober living homes, these non-standard treatment options are not covered by insurance companies.

Many sober living homes are based on the Florida Model, meaning the residential setting is separate from the medical aspects of treatment, which include managing prescriptions and attending therapy sessions. Insurance will cover medical treatments, including evidence-based therapies like Cognitive Behavioral Therapy; it will not cover aspects of treatment that may reduce the risk of relapse, but which are seen as non-medical. Many complementary treatments, like yoga, meditation, massages, or nutritional classes, may not be covered by insurance, even though these supplementary treatments may help one stay sober. Living in a sober residence is considered the same – a complementary form of treatment, but not medically necessary.

How to Pay Rent in a Sober Living Home

It may be worth contacting one’s private insurance, or a state program like Medicaid, to see if there is financial help to enter a sober living home. A person could inquire with their doctor to determine if sober living might be medically necessary. Paying rent may involve using personal savings, a credit card, or donations from friends and family for the first few weeks or months before gaining employment.
Methods for paying for a sober living home include:

  • Employment, just as one would otherwise pay rent or a mortgage
  • Setting up a crowdfunding page, via sites like YouCaring or GoFundMe, to get help from friends and family
  • Asking family or friends directly for money
  • Using personal savings
  • Using a credit card, then paying it off after finding employment
Sober living is protected by both the Fair Housing Act (FHA) and the Americans with Disabilities Act (ADA). This can help mitigate rental cost and protect residents from discrimination in the neighborhood. The specific cost of renting from a sober living home can vary based on rental rates in the area; for example, renting a room in a smaller town will be less costly than in a large city. Check with prospective sober living homes to determine monthly rent costs.

Staying in a sober home means a person can live in a drug-free environment for as long as they need to. This helps them apply new behaviors learned in rehabilitation, find stable employment, and develop a new, drug-free life. Sober living homes are important stepping stones for many people, and although insurance does not cover them, the costs are generally in line with, or cheaper than, standard rents in the area.

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