If you’re looking into virtual rehab programs, one of your first questions is probably about cost. Many insurance plans cover online addiction treatment services, though coverage details vary by policy and state. But understanding exactly what your plan covers and how to verify your benefits can feel like navigating a maze of medical jargon and fine print.
Let’s break down what you need to know about insurance coverage for virtual rehab, what’s typically included, and how to check your specific benefits before you start treatment.
Virtual rehab programs are outpatient addiction treatment services delivered through secure telehealth visits with licensed providers.
Virtual rehab programs, also called telehealth addiction treatment or online outpatient programs, have become increasingly common in recent years. Between 2019 and 2020 alone, the percentage of substance use treatment facilities offering telehealth services more than doubled, jumping from 27.5% to 58.6%. That rapid growth means more insurance companies are recognizing virtual care as a legitimate, effective treatment option.
Under the Affordable Care Act, all Marketplace insurance plans must cover mental health and substance use disorder services as essential health benefits. This includes both in-person and virtual treatment options. Insurance companies also can’t put yearly or lifetime dollar limits on coverage for these services, and they must provide “parity” protections, meaning limits on mental health and substance use services can’t be more restrictive than those on medical and surgical services.
But here’s where it gets tricky: many ACA-compliant plans include coverage for substance use disorder treatment, the specifics of that coverage—including whether telehealth is included, what services are covered, and how much you’ll pay out-of-pocket—can vary significantly from plan to plan.
Insurance coverage for online addiction treatment often depends on medical necessity and individual plan design, but many virtual rehab programs include the following services:
Medication for opioid or alcohol use disorder (sometimes called medication-assisted treatment or MAT) combines FDA-approved medications like buprenorphine (Suboxone), naltrexone, or acamprosate with counseling and support (when clinically appropriate and based on individual assessment). These medications help manage withdrawal symptoms and reduce cravings, making it easier to focus on recovery. Recent federal regulations have made permanent the ability for providers to prescribe buprenorphine via telemedicine, allowing you to start and receive up to six months of medication through virtual appointments before requiring an in-person visit.
Most insurance plans cover MAT medications and the associated provider visits, though you may have copays or coinsurance depending on your plan.
One-on-one therapy sessions with licensed counselors or therapists are a core component of most virtual rehab programs. These sessions help you better understand patterns related to substance use, develop coping strategies, and work through underlying issues that may contribute to substance use. Insurance typically covers these sessions just as they would in-person therapy, though you may need to meet your deductible first or pay a copay.
Group counseling provides peer support and shared learning experiences with others in recovery. Virtual group sessions offer the same benefits as in-person groups while allowing you to participate from home. Coverage for group therapy varies but is generally included in comprehensive treatment plans.
If you’re dealing with both addiction and mental health conditions like anxiety, depression, or PTSD, your virtual rehab program should address both. Insurance coverage for psychiatric services follows the same parity rules as other mental health benefits.
Insurance plans use a few common cost terms that can affect what you pay for virtual rehab. Even with insurance coverage, you’ll likely have some out-of-pocket expenses. Here’s what you might be responsible for:
Your deductible is the amount you must pay out of pocket before your insurance starts covering services. Plans vary widely; some have deductibles of a few hundred dollars, others several thousand. Once you meet your deductible, your insurance begins paying its share of covered services.
A copay is a fixed dollar amount you pay at each appointment. For example, you might pay $20 for each therapy session or $10 for each medication management visit. These amounts are set by your insurance plan and usually apply whether you’re receiving care virtually or in person.
After you’ve met your deductible, coinsurance is the percentage of costs you share with your insurance company. If your plan has 20% coinsurance, you pay 20% of the cost and your insurance covers the remaining 80%.
If your virtual rehab program isn’t in your insurance network, you’ll typically pay significantly more. Some plans don’t cover out-of-network care at all, while others apply higher deductibles and coinsurance rates.
Before starting any treatment program, it’s important to verify exactly what your insurance will cover. Here’s how to get that information:
The most reliable way to understand your coverage is to call the Member Services number on the back of your insurance card. When you call, ask these specific questions:
Is [provider name] in-network with my policy for behavioral health services?
What is my deductible for behavioral health services, and how much have I already met this year?
What are my copays for outpatient therapy sessions and medication management visits?
What is my coinsurance percentage for substance use disorder treatment?
Is prior authorization required for outpatient addiction treatment?
Do I need a referral from my primary care doctor to receive treatment coverage?
Does my plan cover telehealth/virtual addiction treatment the same as in-person services?
How many therapy sessions does my plan cover per year?
Are medications for substance use disorder covered at pharmacies, and what’s my copay?
Write down the answers you receive, including the name of the representative you spoke with and the date of the call. If possible, ask for this information in writing.
Many virtual rehab programs, including Eleanor Health, offer free insurance verification services. When you call to inquire about treatment at (866) 465-0590, the team can help review your benefits, explain potential coverage, and estimate possible out-of-pocket costs. This takes the guesswork out of the process and helps you understand your financial responsibility before your first appointment.
Your insurance company provides a Summary of Benefits and Coverage (SBC) that outlines what’s covered under your plan. You can usually find this document on your insurance company’s website or by requesting it from Member Services. Look specifically for information about mental health and substance use disorder benefits, outpatient services, and telehealth coverage.
If you have coverage through multiple insurance plans—for example, a primary plan through your employer and secondary coverage through a spouse—you may be able to coordinate benefits to reduce out-of-pocket costs. Contact both insurance companies to understand which is your primary payer and how to submit claims to maximize your coverage.
If you’re uninsured or underinsured, don’t let that stop you from seeking treatment. Many virtual rehab programs offer:
Organizations like SAMHSA’s National Helpline (1-800-662-4357) can connect you with facilities that charge on a sliding fee scale or accept Medicare or Medicaid if you qualify.
If insurance questions have been a barrier, starting with a benefits check can help clarify your options. If you’re ready to explore virtual addiction treatment, reach out to verify your coverage. Addiction is a medical condition that deserves medical treatment, and virtual rehab programs offer a flexible way to access care while maintaining your daily commitments.
To verify your benefits with Eleanor Health, call us at (877) 759-5017. We’ll help you understand exactly what your insurance covers.
“DEA and HHS Issue Final Telemedicine Rule for Buprenorphine Access.” SAMHSA, 2025, www.samhsa.gov/about/news-announcements/statements/2025/dea-and-hhs-issue-final-telemedicine-rule-for-buprenorphine-access.
“Mental Health and Substance Abuse Health Coverage Options.” HealthCare.gov, 2019, www.healthcare.gov/coverage/mental-health-substance-abuse-coverage/.
“Telemedicine Services in Substance Use and Mental Health Treatment Facilities | CBHSQ Data.” SAMHSA, 2021, www.samhsa.gov/data/report/telemedicine-services.
Many insurance plans include coverage for virtual rehab programs, though benefits vary by policy and state. Covered services may include medication support, individual therapy, group counseling, and psychiatric care. Out-of-pocket costs depend on deductibles, copays, coinsurance, and network status. The best way to understand coverage is to contact your insurer or request a benefits check through a provider. If you don’t have insurance, self-pay options and state-funded programs may still make care accessible.
