If you need help right now
If you are having withdrawal symptoms, thoughts of harming yourself or a medical emergency, do not wait to sort out admission. Call 911 for an emergency, or call or text 988 for a mental health or substance use crisis. Getting safe comes before finding the right program.
Find out exactly why
“We can't admit you” can mean several different things, and each one leads to a different next step. Before the call ends, ask the program to be specific.
It might mean your insurance plan does not cover this program, or the program is outside your plan's network. It might mean the program has no space at the moment. It might mean the assessment pointed to a different level of care from the one the program provides, such as needing medical withdrawal care the program cannot offer, or needing less intensive care than a residential stay. Or it might mean the program cannot meet a particular need, such as a health condition, a medication or a language.
Try: “Can you tell me the main reason you can't admit me, so I know what to look for next?”
Ask the program what it recommends
The staff member you spoke to has heard about your situation and knows what the program could not provide. Ask what kind of care they think would fit, and why.
You can ask: “What level of care would you recommend for someone in my situation?” and “What should I tell the next place so I don't have to start from scratch?” If an assessment was done, ask whether you can have a copy of the recommendation, or whether it can be shared with the next service you contact.
If the issue is space, ask whether there is a waiting list, how long it usually is and whether they would call you if a place opens. Ask what they suggest you do while you wait.
If the issue is your insurance, ask whether the program offers a self-pay rate, a payment plan or reduced fees, and get any figures in writing before you agree to anything.
Call your insurer
Your insurance plan is the other place that can help. The phone number is usually on your insurance card or in your plan's member account. Use that official number rather than a number from an advertisement.
Tell the insurer what the program recommended, or what kind of care you are looking for. Then ask which programs or clinicians in your area are in your plan's network for that level of care. Ask whether prior authorization is needed, what you would pay and whether the plan has a care management or behavioral health line that can help you.
If the insurer says a service is not covered, ask for the reason in writing and ask about the review or appeal process. Share any written decision with a clinician who can respond to the clinical reasons.
Write down the date, the name of the person you spoke to and any reference number.
If you do not have insurance
If you were turned away because you have no insurance, go back to the program and ask what payment options it has, including reduced fees or a payment plan, and how those would work in writing. Ask the staff member what kind of care they would expect to fit your needs at a lower cost, and what you would need to ask about when you find it.
If you have insurance later, your insurer becomes the second place to call.
Keep a record as you go
A turndown can easily become a series of calls where you repeat your story each time. A short record helps. For each contact, note the name of the program or insurer, the date, what they said and the next step.
For example: “Program A, Tuesday: no space in residential; recommended intensive outpatient; suggested I check in-network options with my insurer. Insurer, Tuesday: gave two in-network intensive outpatient programs; no prior authorization needed.” That turns a no into a direction.
If you are calling for someone else
If you contacted a program for a family member or friend, the program may be limited in what it can tell you, especially if the person has not given consent. You can still ask what kind of care the program generally recommends for the situation you described. Share what you learn with the person, and let them decide what to do next.
Activities from this guide
Your checklist
Read the steps now. A free account lets you save your own checklist.
- 1. Ask the program exactly why
- 2. Ask what it recommends and why
- 3. Call your insurer about in-network options
About this guide
AI-generated editorial image; it does not depict a real person or event discussed in this guide.
Examples in this guide are illustrative, not reported experiences.
SoberSphere provides independent general information, not individual medical, legal or financial advice. No provider referral, affiliate arrangement or specialist review is claimed.