Questions to Ask on a First Call to a Rehab

Making the first call to a rehab or helpline can feel like a big step, and most calls are short conversations you can hang up on whenever you like. This page walks through who you might reach, the questions they may ask you, what to ask in return and what happens afterward, and ends with a one-page checklist to print and keep by the phone. If you or someone else is in danger or may have overdosed, call 911; in a crisis, call or text 988.

Who Answers When You Call?

Who answers depends on the number dialed. A program’s own line reaches its admissions staff. Public helplines are run for everyone; numbers listed on directory or referral sites may reach a particular provider.

The Substance Abuse and Mental Health Services Administration (SAMHSA) runs the National Helpline, 1-800-662-HELP (4357), a treatment referral and information service: free, confidential, open 24/7, 365-day-a-year, in English and Spanish. The Centers for Disease Control and Prevention lists a text option, your 5-digit ZIP code to 435748 (HELP4U), and a TTY line, 1-800-487-4889; replying HELP reaches an information specialist.

On any call, ask first who is speaking and which facility or service they work for.

The 988 Suicide & Crisis Lifeline is for distress or crisis, with alcohol or drug use concerns among the reasons to call or text 988 or chat online: available 24/7/365, with free and confidential conversations. The Lifeline describes the flow: a recorded message offers Veterans (Press 1) and Spanish-language (Press 2) options, or stay on for your local 988 contact center; hold music plays until a live counselor connects, introduces themselves, asks whether you are safe, listens, offers support and may share resources.

If you have not told anyone yet, how to ask for help is where to start.

What Will They Ask You?

The call usually starts with a few questions about your health, what you use, your history and how you plan to pay, which helps the person you speak with suggest a level of care that might fit. Take your time answering, and there is no pressure to share anything before you feel ready.

Programs may ask because they match each caller to a level of care using an assessment of several life areas. The American Society of Addiction Medicine describes the ASAM Criteria as “the most widely used and comprehensive set of standards for placement, continued service, and transfer” of patients with addiction and co-occurring conditions, based on an assessment of six dimensions, sometimes called life areas. The National Institute on Alcohol Abuse and Alcoholism suggests asking a provider whether it begins with “a complete assessment and diagnosis” and how it builds a treatment plan.

Honest answers, especially about recent use and withdrawal, help them give you safe advice, such as whether stopping may call for medical care like medical detox. Programs differ, so not every caller hears every question.

Some programs may ask whether you feel safe right now. In a crisis, call or text the 988 Suicide & Crisis Lifeline, or call 911. You do not have to be ready for treatment to reach out.

Questions to Ask Before You Hang Up

Ask enough to judge whether a program is legitimate and a good fit. The Substance Abuse and Mental Health Services Administration (SAMHSA) names five things to check: state licensing, family involvement, FDA-approved medication, treatments proven to work and ongoing support after treatment.

Quality (SAMHSA’s five signs)

SAMHSA notes FDA-approved medication for opioid or alcohol use disorder exists, but not for other substances, and proven approaches include motivational therapy, cognitive behavioral therapy, counseling, risk education and peer support. These five questions test each sign:

1. Does your program hold a state license or certification, and is it in good standing?
2. Do you have FDA-approved medication available for alcohol or opioid use disorder?
3. Are your treatments for substance use disorders proven to work?
4. Do you include family members in treatment?
5. Is ongoing support available after treatment ends?

Fit

Four of the 10 recommended questions from the National Institute on Alcohol Abuse and Alcoholism (NIAAA), whose Navigator helps adults find alcohol treatment for themselves or an adult loved one and has no commercial sponsors, cover whether a program fits you:

1. How do you build a treatment plan? Do you start with a full assessment?
2. Which level of care would you suggest for my situation, and why?
3. How do you support people with mental health or medical issues?
4. What are your staff’s qualifications? Does the doctor hold board certification in addiction medicine or in addiction psychiatry?

Cost

One cost term is worth knowing: HealthCare.gov defines preauthorization, sometimes called prior authorization, as a health insurer’s decision that a service, treatment plan, prescription drug or durable medical equipment is medically necessary, and notes it is not a promise the plan will cover the cost.

1. Can you help me figure out the cost? Will my insurance cover it?
2. Do you work in-network with my insurance plan, and what would my out-of-pocket cost be?
3. Will my insurance need to give prior authorization before I start?

Next steps

1. May I ask who I am speaking with, and which facility you work for?
2. If I pick your program, when could treatment start?
3. What happens if a person starts using again while in treatment?
4. What support is there after treatment ends?

Write the answers down; the printable checklist keeps them together. Calling two or three programs to compare is fine, and what to know before you go covers getting ready. Be wary of any program that will not say who it is, how it is licensed or what treatment costs.

What to Have Ready Before You Call

Before you dial, have your insurance card, your medication list and something to write on close by. The call goes faster, and the program can begin verifying your benefits while you talk.

HealthCare.gov says “All Marketplace plans cover mental health and substance abuse services as essential health benefits” and “can’t deny you coverage or charge you more just because you have any pre-existing condition”, including a substance use disorder. Parity rules also mean the limits a plan sets on mental health and substance use care “can’t be more restrictive” than its limits on medical and surgical care. Checking your insurance benefits shows how to confirm what your plan pays before you call.

If you do not have insurance, you can still call: the guides to getting into rehab with no money and what rehab costs without insurance cover the payment options.

What Happens After the Call?

In most cases the program verifies your insurance coverage, might schedule a more complete assessment, and goes over when you could start. Nothing is final until you agree. A typical path looks like this:

1. A benefits check, where the program verifies your coverage and estimates what you would owe.
2. A fuller assessment or intake visit, which can happen the same day.
3. A plan for detox first, if you need it.
4. A start date, along with what to bring.

One caution: HealthCare.gov says, “Preauthorization isn’t a promise your health insurance or plan will cover the cost,” so treat a benefits check as an estimate. When a program turns out not to be the right fit, you can request a referral from it, reach the National Helpline run by the Substance Abuse and Mental Health Services Administration (SAMHSA), or search FindTreatment.gov, which SAMHSA calls “a confidential and anonymous resource for persons seeking treatment for mental and substance use disorders” that helps you “find state-licensed treatment near you.”

It also helps to read about how to prepare for rehab and what happens in rehab, and you can print the First Call Checklist to keep notes from each call in one place.

Frequently Asked Questions