How to choose a rehab: the questions to ask, the credentials to check and the red flags to walk away from
Choosing addiction treatment often happens in a crisis, which is exactly when bad actors find people. Here’s how to vet a program calmly, check credentials and spot the scams.
The call usually comes at the worst possible moment. Someone you love is finally ready, or you are, and suddenly you’re searching at midnight, clicking ads, talking to a friendly voice on a hotline who promises a bed tomorrow, a free flight and “insurance will cover everything.”
Slow down for twenty minutes. Learning how to choose a rehab well is one of the most important decisions in a recovery journey, and most of what you need to know fits on one page. This guide covers the level of care to look for, the questions to ask, how to verify licensing and accreditation, and the red flags that signal a program to avoid.
Start with the right level of care
“Rehab” covers a wide range of services, and the most intensive option isn’t automatically the best one. Many people do well in outpatient care while living at home and working. Others need medical withdrawal management or a residential stay first. A good program will base its recommendation on an assessment, often using the American Society of Addiction Medicine (ASAM) criteria, not on whatever beds it needs to fill.
Common levels of care include:
- Outpatient: scheduled counseling sessions while you live at home.
- Intensive outpatient (IOP) and partial hospitalization (PHP): several hours a day, several days a week, then home at night.
- Residential: living on site for a period with structured treatment.
- Inpatient or medically managed withdrawal: 24-hour medical care, sometimes in a hospital.
- Medications for addiction treatment: available at many levels, from a doctor’s office to an opioid treatment program.
A safety note: withdrawal from alcohol, benzodiazepines and some other substances can be medically dangerous. Don’t stop suddenly on your own; talk to a doctor or treatment provider about safe withdrawal management.
NIDA’s research-based principles of treatment are a useful yardstick. Among them: no single treatment is right for everyone, effective treatment addresses the whole person (not just substance use), and staying in treatment long enough matters (NIDA).
The right rehab is the one that fits the person in front of it, not the one with the best pool photos.
Where to search: start with FindTreatment.gov
FindTreatment.gov is the federal government’s confidential, anonymous locator for state-licensed treatment facilities, run by SAMHSA. You can search by location and filter by type of care, medications offered, payment options (including Medicaid, Medicare and sliding-scale fees), language and special programs. It doesn’t sell leads or take referral fees, which makes it a much safer starting point than a search ad.
Other trustworthy routes:
- Your primary care doctor, therapist or psychiatrist
- Your insurance company’s member services line (ask for in-network substance use treatment)
- Your state’s substance use or behavioral health agency
- The SAMHSA National Helpline at 1-800-662-4357, free, confidential and open 24/7
Be cautious with “free” hotlines in ads or search results. Some are run by call centers that route callers to whichever facility pays them, without telling you.
Check licensing and accreditation
State licensing
Treatment programs must generally be licensed by the state where they operate, usually through the state’s health or behavioral health department. Licensing is the legal minimum. Ask for the license number and look it up on the state agency’s website. Individual clinicians should hold active licenses too (for example, licensed counselors, social workers, psychologists, nurses or physicians); you can verify those through the relevant state licensing board.
Accreditation: CARF and the Joint Commission
Accreditation is voluntary and goes beyond licensing. It means an independent organization has reviewed the program against published standards for quality and safety. The two most common accreditors for addiction treatment are:
- CARF International, which accredits behavioral health and addiction programs. You can look up accredited providers on CARF’s website.
- The Joint Commission, which accredits hospitals and behavioral health care organizations. Check status through Quality Check, the Joint Commission’s public lookup tool (jointcommission.org).
Don’t take a logo on a website at face value. Verify it yourself, and confirm the accreditation covers the specific location and services you’re considering.
Questions to ask any rehab before you commit
A good program will answer these clearly and without pressure. Write the answers down.
About the treatment
- How do you decide what level of care someone needs? Who does the assessment?
- What therapies do you use? (Look for evidence-based approaches such as cognitive behavioral therapy, motivational interviewing and contingency management.)
- Do you offer, or support continuing, medications for opioid and alcohol use disorder? Will someone already on buprenorphine or methadone be able to stay on it?
- Do you treat co-occurring mental health conditions like depression, anxiety or PTSD on site?
- Is the length of stay individualized, or is it the same for everyone?
- How are families involved?
About the staff
- Which licensed clinicians are on staff, and how often will my loved one see them?
- Is there a physician or nurse practitioner with addiction medicine experience?
- What’s the staff-to-client ratio, day and night?
About cost and insurance
- Are you in network with my insurance? What will I owe out of pocket?
- Can I get a written estimate of all costs, including lab testing and medications?
- What happens if insurance stops authorizing care partway through?
About what happens next
- What does discharge planning look like? Do you connect people to outpatient care, peer support, medication providers and recovery housing?
- What happens if someone returns to use during treatment? Are they discharged?
- What are the rules around phones, visits and leaving?
A program that gets defensive about simple questions is telling you something important.
Red flags: when to walk away
The addiction treatment industry has a well-documented problem with fraud, particularly targeting people with private insurance. Federal law now makes it a crime to pay or receive kickbacks for referrals to recovery homes, treatment facilities and labs (the Eliminating Kickbacks in Recovery Act of 2018), but bad actors still operate. Watch for:
Patient brokering
“Body brokers” are paid by facilities to recruit patients, often through social media, recovery meetings, sober homes or call centers. A warning sign is anyone who seems a bit too eager to get your loved one into a specific program, and can’t or won’t say how they’re paid.
Free travel, cash or perks
Offers of free airfare to another state, free rent, gift cards, cigarettes or cash for enrolling are classic signs of brokering. Legitimate programs may help with logistics, but they don’t pay people to come.
Insurance schemes
- Someone offers to sign you up for a new insurance plan, or pay your premiums, so you can enter their program.
- The program asks for your insurance details before telling you its own name and address.
- You later see bills for frequent, expensive urine or lab tests that seem excessive.
Other warning signs
- Guarantees. No one can promise a cure or a success rate for your loved one.
- Pressure. “The bed won’t be there tomorrow” urgency, or reluctance to let you think it over.
- Vagueness. No clear answers on licensing, accreditation, staff or costs.
- Anti-medication stance. Refusing anyone on medications for opioid use disorder, or requiring people to stop them, goes against current evidence.
- Isolation. Cutting off all family contact without a clear clinical reason.
- A hotline that won’t name the facility you’re actually being referred to.
If you suspect fraud, you can report it to your state attorney general, your state’s licensing agency and your insurance company.
Paying for treatment
Cost is a real barrier, but there are more options than many people realize:
- Private insurance. Most plans cover some substance use treatment. Federal parity law generally requires many health plans to cover mental health and substance use care no less favorably than medical care. Call member services and ask what’s covered, at what level of care, and whether pre-authorization is needed.
- Medicaid. Medicaid covers substance use treatment in every state, though covered services vary. If your income has dropped, check whether you now qualify.
- Medicare. Covers some outpatient and inpatient substance use services, including opioid treatment programs.
- State-funded and sliding-scale programs. Many states fund treatment for people without insurance. FindTreatment.gov lets you filter for these.
- Employee assistance programs (EAPs). If you’re employed, your EAP may offer free, confidential counseling and referrals.
An expensive program isn’t necessarily a better one. Some of the best care in the country happens in modest outpatient clinics and community programs.
Plan for after rehab before you start
Treatment is a beginning, not a finish line. The weeks right after a residential stay can be a vulnerable time, especially for people with opioid use disorder whose tolerance has dropped. Before you choose a program, ask how it bridges that gap:
- Will there be a written discharge plan with real appointments already booked?
- Can you continue medication without a gap?
- Do they connect people to outpatient therapy, peer support and recovery housing near home?
- Will they make sure you leave with naloxone and know how to use it?
A program that talks about aftercare from the first phone call is usually a program that takes outcomes seriously.
How to choose a rehab: a simple decision checklist
- Get an assessment to understand the right level of care.
- Search on FindTreatment.gov or through your doctor or insurer.
- Shortlist two or three programs.
- Verify the state license and accreditation yourself.
- Ask the questions above and compare answers.
- Get costs in writing.
- Walk away from anything that feels like a sales pitch.
Key takeaways
- Match the level of care to an assessment, not to the program with an open bed.
- Start your search at FindTreatment.gov or with a trusted clinician or insurer.
- Verify state licensing and CARF or Joint Commission accreditation yourself.
- Ask about evidence-based therapy, medication, mental health care, staff and aftercare.
- Walk away from free travel offers, insurance sign-up schemes, guarantees and pressure.
Frequently asked questions
How do I know if a rehab is legitimate?
Check that it holds a current state license and, ideally, accreditation from CARF or the Joint Commission, which you can verify on their websites. Ask about licensed staff and evidence-based treatment, get costs in writing and avoid programs that offer travel, cash or insurance deals.
What is FindTreatment.gov?
FindTreatment.gov is SAMHSA’s free, confidential locator for state-licensed treatment facilities in the U.S. You can filter by type of care, medications offered, payment options, language and more.
What is patient brokering?
Patient brokering is when someone is paid to refer or recruit people into a specific treatment program or recovery home, often with offers like free travel or rent. It’s illegal under federal law and many state laws, and it puts people into programs chosen for profit rather than fit.
Is CARF or Joint Commission accreditation better?
Both are respected, independent accreditors with published standards. Either is a positive sign. What matters most is that the accreditation is current and covers the specific location and services you’re considering.
How long should rehab be?
There’s no single right length. NIDA notes that staying in treatment for an adequate period is important, and the right duration depends on the person’s needs and progress. Be wary of programs that assign the same length to everyone.
Should a rehab allow medication for opioid use disorder?
Yes. Buprenorphine, methadone and naltrexone are FDA-approved, evidence-based treatments. A program that refuses people on these medications, or requires them to stop, isn’t following current best practice.
Last updated October 28, 2026. Stories reflect personal experience and are not medical advice.
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