Health insurance may cover some or all of the cost of substance use disorder treatment, but coverage depends on the individual plan, provider network, level of care, medical-necessity criteria, authorization requirements, and cost-sharing.
Important: Verification of benefits is not a guarantee of authorization, coverage, payment, or admission.
To get started with insurance verification, you typically visit a treatment center or fill out a form on their website. Treatments centers often work directly with most state or national insurance providers, so the information stays confidential and doesn’t go through a third-party. Does insurance cover rehab? Let’s find out more.
Insurance Coverage for Rehab in California
Phoenix Rising Recovery serves clients in California. Coverage depends on the individual health plan, current network relationships, medical necessity, authorization, and the level of care requested. Contact the insurer and Phoenix Rising Recovery to verify current benefits.
What Type of Addiction Treatment Does Insurance Cover?
Most insurance companies recognize addiction as a condition or disease that needs medical treatment. Therefore, insurance companies approve of a wide range of treatments to ensure that you have a successful recovery. While all insurance companies differ in what they will cover, most providers will provide coverage for the treatment such as:
- Addiction assessment and follow-up evaluations
- Medication-assisted detox and rehab
- Inpatient, outpatient, and partial hospitalization programs
- Individual and family therapy and counseling
- Evidence-based treatment such as CBT or DBT
- Intervention and alcohol & drug testing
All of these treatments are covered under the Affordable Health Care Act Insurance. Eligibility for coverage depends on your addiction, any mental health disorders, the level of coverage, and what is outlined in your policy.
What Happens During Insurance Verification?
So that you understand insurance verification, here are some things you need to know, such as:
- Deductible: This is how much you have to pay before your insurance provider starts to pay. If you have a $2,000 deductible, then you have to pay the first $2,000 of the bill out-of-pocket.
- Copayment: A copayment is a fixed part of your payment for the bill. The copayment comes in after you have met your deductible. The insurance provider pays the other part of the bill.
- Coinsurance: Coinsurance is different from a copayment in that your fee is a percentage of the cost of treatment that you pay once you pay your deductible. For instance, if the fee for a service is $100, and your coinsurance is 20 percent, then you pay $20.
- Out-of-Pocket Maximum: Your out-of-pocket maximum is how much you are still required to pay after you have paid your deductible, copay, and coinsurance. Once you reach the maximum, your provider pays 100 percent of any additional cost.
Does Insurance Cover Rehab? Learn More at Phoenix Rising
Does insurance cover rehab? So to find out more about insurance verification or treatment options, call us at 8552328211. We can work with your insurance provider to give you exceptional care. At Phoenix Rising, we can get you on the road to recovery.