Drug and Alcohol Rehab – FAQ

Does my insurance company Cover Rehab?

Your insurance company usually will cover drug rehab. They base coverage on a number of factors which vary based on your plan. Company’s usually provide HMO, PPO, and POS plans.

Your insurance coverage may range from partial to full. You are responsible for whatever they do not cover. If your plan has a deductible, you have to pay the deductible amount before your insurance coverage takes over.

For inpatient or outpatient drug treatment, you may need a doctor’s evaluation and recommendation, and you may need prior authorization from Your insurance company. Copayments may also be required.

Most insurance company plans have coverage for the following:

  • Detoxification
  • Inpatient/residential treatment
  • Partial hospitalization
  • Intensive outpatient programs (IOP)
  • After-care programs
  • Various mental health and behavioral health programs

To manage your insurance company plan, or learn more about it, you can visit their website or contact them with your member ID.

How Long will my insurance company Cover Addiction Treatment?

Your insurance company coverage length varies. Typical coverage lasts from 30 days 90 days.

Are out of network providers allowed with my insurance company?

It depends on the plan:

  • HMO Plans (Health Maintenance Organization) usually have coverage for network doctors only.
  • POS Plans (Point-of-Service) –may let you choose providers who are out-of-network.
  • PPO Plans(Preferred Provider Organization) – often allow you to choose any doctor or specialist without a referral, in or out of network.

Contact your insurance company to confirm your level of coverage, if any, for out-of-network providers, and to determine any additional costs.

Does my insurance company allow for Treatment at a Luxury Rehab Facility?

 

It depends on your plan. Luxury (private) drug rehabs are often where wealthy people and celebrities will go for addiction help. They are often as nice as any hotel or resort you may use for a vacation spot. They usually have massages, acupuncture, hot-tubs, pools, and quality dining, in addition to other exclusive privileges. Examples of famous Luxury Rehab Centers are Passages Malibu, Acqua Recovery, and Sunspire Health in Key Largo, FL. These are considered premier places for addiction treatment, and are among the best treatment facilities in the world.

Inpatient Addiction Treatment vs. Outpatient Treatment

 

This is one of the biggest and most important choices that a patient or their family will make when looking for addiction help. Where you go, and what you do from here on matters and can determine your level of success.

Both options are better than not seeking treatment and could save your life. They each have their own strengths and weaknesses.

An outpatient facility is usually a local option. They give you the chance to meet with your insurance company professionals like doctors, alcohol and drug counselors, or therapists, attend group sessions, and go to recovery meetings while being able to head home afterwards. Co-pays may be required for each visit.

Inpatient facilities, also called residential programs, are most often 28 day programs. They provide structure and are typically remote destinations where you stay in the facility for the duration of the program.

Do I need Insurance to go to Rehab?

 

You are not required to have insurance to get addiction treatment. However, without insurance, the cost of drug rehab facilities is usually very expensive and impractical for most people. You would need to pay out of pocket. You can certainly pay with a credit or debit card, work out a payment plan, or use other methods that each facility accepts.

Typical inpatient rehabs may cost anywhere from $6,000-$20,000 for a 28 day program.

Outpatient Rehab can range from $4,000-$10,000 for 90 days. The cost of outpatient rehab will vary and is mostly based on how many visits are made.

How does my Insurance Company Decide my Claim?

 

Your insurance company usually makes decisions about their coverage based on your health plan. Each claim decision is reviewed on a case by case basis and varies by state. In general, your insurance company will look at services you use. They then follow national guidelines and other policies to determine if you’re covered. Services that may be covered can include drug addiction rehab, blood-tests, surgeries, or hospital stays.

If your claim is denied, your insurance company will notify usually you. You DO have the right to appeal. To start an appeal with your insurance company, call their Member Services number on your insurance company ID card. They typically allow 60 days from the date of the initial payment or denial notice to file, although this period varies by state and by company. If Member Services doesn’t resolve your issue, ask for an appeal.

Most insurance company appeals are responded to compliance with state, federal and NCQA guidelines. It is possible to get appeals expedited. If you have issues with their process, you can certainly contact your attorney general.

What Else does my insurance company Provide?

 

Most insurance company’s have a host of health, wellness options, and discounts.

They also will supply a variety of plans and the ability to manage and adjust your plan.

Per HIPAA laws, anything that you say is kept confidential. You don’t have to worry about anyone knowing you may have trouble with alcohol or drugs.

How to Verify your insurance company Coverage for drug rehab centers?

 

Verifying what insurance will cover can be a time-consuming process. This hassle usually involves lots of waiting and multi phone calls back and forth. Our knowledgeable staff can verify your coverage for you and take the stress and annoyance out of this already difficult time. You have enough to worry about already. Verifying insurance coverage for rehab shouldn’t be an additional burden.

Instead, give us a call now and let us handle this step, at no cost to you! We are totally confidential. Our number is 877-348-7494

NOTICE

Luxury Rehab Options works hard to make sure our information is accurate. Due to constant changes in insurance company policies, we suggest you contact your insurance company with your member ID for any policy questions. This FAQ is only intended as a guide to point you in the right direction.

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