Making the decision to seek out addiction treatment for yourself or a loved one is a monumental first step towards a life free of addiction. Being able to complete a drug or alcohol rehab program takes a commitment of time, energy, and finances. While many rehab facilities work to make treatment as affordable as possible, it’s always a good idea to check and see what coverage you can take advantage of through your PPO network.
A Preferred Provider Organization, or PPO, is the network of medical professionals covered by your insurance, meaning they don’t require a referral in order to see them. These plans tend to have a specified amount to be paid for each visit, known as a co-pay, with benefits typically beginning once you’ve paid for a certain amount out of pocket, a system known as meeting your deductible.
Do All PPO Plans Address Addiction?
One of the key updates made to health coverage through the Affordable Care Act is the requirement that insurance plans treat mental health issues with the same respect they treat physical ones with. Both the cost of visits and quality of care covered for mental health are now in line with physical treatments, making mental health care and addiction programs more accessible than ever.
It’s important to understand that each PPO plan will have different levels of coverage, but as long as they offer mental health coverage, you can assume that drug addiction is included. Plans rarely dictate which mental illnesses are considered valid under their plan so don’t be concerned about an addiction program being denied due to the nature of the treatment.
Is Medication-Assisted Treatment Covered?
Treating addiction is a lifelong endeavor. Even after successfully completing a treatment program, you’ll need to be equipped with the tools and resources needed to overcome future cravings and impulses. The changes made to the central nervous system during prolonged drug use are not quickly undone, with some damage being permanent.
Proper aftercare is how America’s Rehab Campus helps alumni maintain a sober life with relapse prevention specialists available for the most challenging moments after treatment. For many of these patients who need additional support, medication is a pillar for aftercare treatment.
Cases of severe addiction to drugs such as heroin and other opioids are often met with medication such as methadone or buprenorphine. Each medication acts differently, with some acting as a low-strength version of the drug being abused to wean users off while others make the act of drug use quickly cause adverse side effects to deter future consumption.
The coverage for these medications is one aspect that insurance providers are still torn on. Some will provide total coverage and view it as a vital part of recovery while others will require the attending physician to provide documentation proving that the medication is medically necessary for success.
Inpatient and Outpatient Program Coverage
Depending on the individual seeking treatment, the type of program they’ll be enrolled in will differ based on their unique needs for personalized care. The two most common styles of addiction treatment are inpatient and outpatient, both using similar methods but with a different approach.
Inpatient programs are more intensive and require you to stay at the treatment center for the duration. Ideal for those who need a stronger support system during recovery, inpatient treatment is also more expensive and tends to have different coverage compared to its outpatient counterpart.
Outpatient programs only need participants to visit the campus a few times a week for therapy sessions and life skill building courses. The primary difference between the two forms of treatment is inpatient is residential where you eat, live and sleep using the center’s resources. That being said, more and more PPO insurance plans are offering coverage for inpatient and residential treatment options.
Find Addiction Treatment Your PPO Covers
America’s Rehab Campus prides itself on offering luxury amenities and professional treatment at an accessible price point. That being said, we know that not everyone is in a position to pay for an entire round of treatment out of pocket. To combat this, we’ve partnered with the most common insurance providers and even have an online insurance verification option
For any questions on insurance coverage or treatment options, please don’t hesitate to reach out to the ARC team today!