America’s Rehab Campuses is certified by the Joint Commission, and this enables us to accept a wide range of Preferred Provider Organization (PPO) and Health Maintenance Organization (HMO) insurance plans. This includes services for, but is not limited to:
- Dual Diagnosis
- Inpatient Resident Treatment
- PTSD and Trauma Therapy
- Individual and Group Therapy and Counseling
- Medical Detoxification
- Intensive Outpatient Treatment
America’s Rehab Campuses is in-network and we are in partnership with over 15 insurance companies, including Alliance, Anthem, Blue Cross, Blue Shield, Cigna, HealthPartners, and UnitedHealthCare. Our collaboration with these insurance companies enables patients to defray their treatment costs.
Facing an opioid use disorder or any addiction can feel overwhelming, especially when it comes to figuring out how to pay for the treatment you or a loved one needs. One of the most common questions that comes up in this journey is: Will my insurance cover rehab? The answer isn’t always straightforward. Whether you’re dealing with opioid use disorder, alcohol dependence, or another substance use disorder, understanding your insurance coverage is crucial to making the path to recovery as smooth and affordable as possible. Let’s break down how insurance works in rehab coverage and what you need to know to make the most of your benefits.
In-Network vs Out-of-Network
In-network and out-of-network differ in terms of cost. For instance, one insurance company may agree to provide full coverage for the services of an in-network rehab center, while providing partial coverage for an out-of-network provider.
In other cases, insurance providers may provide coverage for services that are only in-network, which means you would need to cover the costs for those services that are out-of-network.
However, the coverage you get depends on your insurance plan. For example, if you have a PPO plan, you don’t need a referral from a primary care physician to seek treatment. But to get discounted rates, you need to receive treatment from an in-network provider.
Given that healthcare insurance plans differ, America’s Rehab Campuses can help you determine whether your plan covers addiction treatment and, if it does, to what extent. Our mission is to ensure that clients seeking help with their addiction get the care they need. But to do this, we need to evaluate your insurance plan to determine what is covered.
The Affordable Care Act (ACA)
One of the biggest changes in insurance coverage for rehab came with the Affordable Care Act (ACA). If you’re covered by a marketplace plan or most private health insurance, the ACA has made sure that addiction treatment is no longer an optional add-on — it’s an essential benefit, right alongside other medical services. This means that your treatment for opioid use disorder or alcohol addiction must be covered just like any other medical procedure. The Mental Health Parity and Addiction Equity Act (MHPAEA) goes even further, ensuring that addiction care isn’t treated differently than other physical health treatments. Whether it’s outpatient therapy or a medically supervised detox, your insurance plan is legally obligated to provide at least some level of coverage for addiction recovery.
Types of Healthcare Insurance Plans
Health insurance plans are many and differ in terms of coverage. Some offer full coverage, while others provide partial coverage. However, at America’s Rehab Campuses, we accept different insurance plans, as long as the plan covers addiction treatment.
Some of the most beneficial health care insurance plans include:
Preferred Provider Organization (PPO)
This plan is quite flexible as it allows individuals to choose their provider without needing a referral from a primary care physician. Providers who are part of the PPO network are inexpensive, but the plan may also cover some of the costs of an out-of-network provider if you seek one.
Health Maintenance Organization (HMO)
HMO plans are usually referred to are not as flexible than PPO plans. HMO plans do not offer any kind of coverage to out-of-network providers, and clients require a referral to seek the services of an in-network specialist. However, they offer lower rates than PPOs.
High Deductible Health Plan(HDHP)
With HDHP plans, clients are required to pay some amount of money before the insurance provider can cover any healthcare services.
Health Savings Account(HSA)
HSA account is a savings account for people with high-deductible healthcare plans, which is set aside in case a person needs to pay a high medical bill. These accounts have tax advantages, and they are quite flexible when it comes to settling medical expenses.
Exclusive Provider Organization (EPO)
With an EPO plan, you have the freedom to choose your healthcare provider without requiring a referral from a primary care physician. Unlike PPOs, EPOs do not provide coverage for out-of-network providers, although they have lower premiums than PPOs.
Point-of-Service Plan (POS)
A PPO plan allows you to choose a healthcare provider of your choice, but you do need to have a primary care physician who will coordinate your care as well as refer you to a specialist if the need arises.
Medicare and Medicaid Coverage
If you’re on Medicare or Medicaid, you’re not left out when it comes to accessing rehab services. While private health insurance gets a lot of attention, public insurance programs like Medicare and Medicaid offer crucial support for individuals struggling with opioid use disorder and addiction. Medicare Part A can cover inpatient rehab, offering partial coverage for stays in facilities where medical supervision and therapy are the focus. Medicare Part B may also provide outpatient rehab services, allowing you to get help while maintaining your daily life. Meanwhile, Medicaid is a lifeline for many, covering both inpatient and outpatient treatment, depending on your state’s regulations. For those who are eligible, these programs can make recovery more accessible, even if other insurance options fall short.
What You Are Expected to Pay for Recovery Treatment
Whether you have an HMO, PPO, or HDHP plan, you are required to pay some amount of money in the form of copayments, coinsurance, and deductibles. In addition to these, you are required to pay a monthly premium, which is not deducted to cover your treatment costs.
- Copayment – Copayment is a fixed amount of money you are expected to pay before you receive treatment. Usually, this amount is significantly smaller.
- Coinsurance – This is a fixed percentage of the total cost of your treatment that you are expected to pay before you receive any care.
- Deductible – This is an amount of your insurance provider expects you to pay before they can cover your treatment costs.
What Are The Benefits?
Since the inclusion of mental addiction and mental health care services into the Affordable Care Act, the coverage provided must be the same as with any other medical service. Some of the addiction services covered include:
- Inpatient treatment
- Medical detoxification
- Residential rehabilitation programs
- Outpatient care
- Stabilization
- Counseling
If we determine that you need medical treatment for your addiction, we will evaluate your insurance plan to determine if this is covered. If not, we can help you work out a payment plan or advise you on which insurance plan to get to afford this type of treatment.
How to Get Insurance Coverage for Our Drug and Alcohol Rehab Programs
Depending on your insurance plan, there are certain requirements you may need to meet before your insurance provider can provide coverage. But there are ways of getting coverage without too much hassle. Here is how:
Consult Your Doctor
Your doctor may refer you to our facility, making it easier to deal with your insurance provider.
Evaluate Your Coverage
Remember, health insurance plans may not offer the same type of coverage. Some may provide cover for all the services, while others may provide cover for just some services. By evaluating your coverage, we can be able to determine what your insurance plan covers. However, first, ensure that we are on your list of in-network providers.
If we are not an in-network provider according to your insurance provider, this does not mean that you cannot get some coverage. We can help you calculate the cost of your treatment and what you need to pay.
Contact Your Insurance Provider
When you find that some of the details of your insurance plan are confusing, contact your insurance provider. They can help you determine what your insurance plans cover and what it doesn’t.
Financial Assistance and Payment Plans
Insurance doesn’t always cover every aspect of rehab, but that doesn’t mean you’re out of options. Many rehab centers offer financial assistance, including payment plans or sliding scale fees based on your income. If you’re facing financial barriers to treatment, you may also qualify for grants or scholarships designed to help with the cost of care. This means you don’t have to delay or forgo treatment just because of cost concerns. Take the time to talk to your rehab center’s admissions team or financial counselors. They can help you explore financial aid and create a payment plan that works for you, even if your insurance doesn’t cover the entire treatment cost.
America’s Rehab Campuses Is Here To Help
Our mission is quite clear: we are here to help addicts achieve sobriety and live a productive life after leaving our treatment program. We have taken steps to ensure that clients access our services and get quality care without worrying about costs.
To verify your insurance plan, please fill out the insurance verification form or give us a call at 1-833-272-7342 with any questions. We are here to guide you and help you understand what coverage your insurance plans provide. All information we receive from you is kept confidential.
