Health Insurance Coverage

Although some health insurance companies provide benefits for psychiatric treatment at the Austen Riggs Center, this has become less common as the focus of health insurance for mental health benefits has shifted toward crisis stabilization and minimum length of stay. However, about one third of our patients receive some assistance from insurance to supplement the cost of their stay at Riggs.

Staff members work with patients and families to obtain approval for treatment from insurance companies, but we cannot guarantee the outcome of those efforts. Because of our specialty focus, insurance coverage can be more restrictive for services provided by the Austen Riggs Center than for services provided in a general hospital psychiatric unit. The individual accepting financial responsibility for a patient’s treatment signs a guarantee of payment and is ultimately responsible for the cost. We strongly recommend that individuals contact their insurance carriers to determine potential benefits available for treatment. Individuals may wish to become informed about deductibles, co-pays and coverage for room and board, patient care, medications prescribed during your stay and physician and psychotherapy fees.

The following information should assist you in completing your own investigation of potential insurance benefits. The Austen Riggs Center is a private, not-for-profit psychiatric hospital with a completely open and fully voluntary setting and is fully accredited by the Joint Commission on Accreditation of Healthcare Organizations. Riggs is licensed as a hospital and hospital-based continuum of care by the State of Massachusetts Department of Mental Health. It operates without on-premises surgical facilities, but maintains transfer agreements with nearby general hospitals for services.

Nearly all insurance companies require pre-certification of medical necessity by telephone before full benefits are available. Our Admissions staff is ready to assist you in pursuing pre-certification. The assistance of your referring clinician may also be important.

Riggs is not a Medicare or Medicaid provider for clinical care. However, medications administered during a stay at Riggs may be covered by these programs.

If you have questions about the admissions process, or about the cost of treatment, please call our Admissions Department, (800) 51-RIGGS (74447) or contact us. Representatives are available from 8:30 am – 5:00 pm, Monday-Friday.