January 8, 2025

Does Insurance Cover Sober Living Homes?

Sober living homes are structured, substance-free environments for those transitioning from addiction treatment to independent life. These homes help individuals maintain long-term recovery and provide accountability, community, and support. However, for those exploring sober living, a common question is “Does insurance cover sober living homes?”

This guide will break down what to expect from insurance coverage, alternative payment options, and additional resources to help make sober living accessible for those looking for continued support in recovery.

Insurance Coverage for Drug and Alcohol Rehab

Many people with private insurance in the U.S. still face challenges in finding adequate drug and alcohol rehab coverage. Even though substance abuse treatment is recognized as an essential health benefit under the Affordable Care Act (ACA), awareness and access to this coverage are still limited.

Studies have shown that over a third of individuals with drug use disorders aren’t sure if their insurance covers treatment. Among those who knew they had coverage, only 13% of covered individuals actually received treatment.

However, the ACA requires that all Marketplace insurance plans cover substance abuse services as part of their essential health benefits. This means:

Coverage starts immediately. Treatment for substance use disorders is covered from the start of your plan with no waiting period, even for pre-existing conditions.
There are no coverage limits. Marketplace plans cannot impose yearly or lifetime limits on benefits, including substance use treatment.
Pre-existing conditions are covered. Marketplace plans must cover you without additional charges or exclusions due to a history of substance abuse.

Even though the ACA ensures access to necessary treatments, barriers such as limited provider networks, lack of treatment options, and insufficient awareness on coverage can still restrict access to care.

Why Insurance Typically Doesn’t Cover Sober Living Homes

Insurance generally doesn’t cover sober living homes because these residences do not provide formal addiction treatment services. Unlike rehab facilities that offer structured programs like therapy and medical care, sober living homes are supportive, substance-free environments without clinical care.

This makes them ineligible for insurance coverage under laws like the ACA and the Mental Health Parity and Addiction Equity Act (MHPAEA). Here’s a closer look at why insurance doesn’t cover sober living:

Sober homes are not a treatment facility with the clinical treatment that’s required for insurance coverage.
ACA and MHPAEA require coverage for recognized addiction treatments (e.g., detox, inpatient and outpatient rehab) but do not extend to sober living as it’s outside the treatment continuum.
Medicare does not include sober living as part of its coverage for substance use disorder treatments since it lacks clinical, evidence-based services.

Who Pays to Live in a Sober Living Home?

In most cases, the resident is responsible for covering the cost of living in a sober living home. This payment typically includes rent, utilities, and sometimes supportive resources like counseling or group meetings that support recovery.

How Much Sober Living Costs

The cost of sober living homes can vary but generally falls between $1,500 and $2,000 per month, with an average cost of around $1,750 per month. This fee may change depending on the location, level of amenities, and support services that may be provided.

Additional Ways to Pay for Sober Living

Since insurance doesn't typically cover sober living, those looking to move into a home often look at other alternative ways to pay. These options can range from personal savings and family support to specialized scholarships and government assistance programs.

Self-Payment

Self-payment is common in covering sober living expenses. Residents may use personal savings, contributions from family members, or financial support from friends to meet monthly costs.

Financing

Financing options like personal loans from banks or credit unions may also be available for covering sober living costs. While taking on a loan can be a big commitment, it provides immediate funds to secure housing. Those who are considering this option should carefully review interest rates, loan terms, and repayment plans, especially if they want to avoid long-term debt as they work towards financial stability in recovery.

Scholarships and Grants

Scholarships and grants can be valuable resources for those who qualify. A number of non-profit organizations and some sober living facilities provide scholarships to help people cover the costs of sober living. Some organizations to consider include:

Herren Project - This is a national non-profit that offers free resources and support for those struggling with substance use disorder. The Herren Project provides scholarships for sober living with the goal of removing financial barriers to recovery.
Zachary Horton Foundation - This foundation combats addiction stigma by providing education, outreach, and scholarships. Their scholarship program supports individuals in recovery and helps them transition into sober living environments.
Clean Cause, Inc. - Clean Cause uses its proceeds to support the CLEAN Cause Foundation which funds recovery housing initiatives across the country. The foundation focuses on closing the gap between addiction treatment and early recovery by promoting best practices and positive change in recovery housing.

Scholarship applications may require information about one’s recovery and financial need. It’s best that applicants research each program’s requirements and application deadlines to increase their chances of receiving support.

Government Assistance

Government funding for sober living is limited, but some states have begun to introduce legislation to support these housing programs. For example, in California, Assembly Bill 2479 proposes to allocate up to 25% of the state’s homeless housing funds toward sober living homes. This bill seeks to amend a 2016 law that prohibits state funding for housing services that mandate sobriety.

Check Your Insurance Coverage Anyway

If the above options are not available to you or if you’re curious about coverage, it might still be worth contacting your insurance provider to learn what options might be available. Certain insurance policies may offer partial coverage for related addiction treatment services like outpatient counseling or recovery support. These services could complement sober living even if your insurance doesn’t cover the residence itself.

Insurance policies vary, so discussing your plan’s specific terms with a representative can clarify any benefits that could be beneficial in your recovery.

Start Your Recovery in a Sober Living Home Today

Choosing sober living is a big step toward long-term recovery. Although insurance may not cover sober living homes, there are several options that can make them more accessible. If you’re ready to take the next step in your recovery, reach out to our team to learn more about sober living, financial assistance, and how to get started.