HMO Drug Rehab
Table of Contents
My insurance is through an HMO. Will they cover drug rehabilitation?
Under the Affordable Care Act and the Mental Health Parity and Addiction Equity Act of 2008, drug rehabilitation services are considered essential health services and should be available through most insurance plans. How much coverage you have will depend on your specific healthcare plan. Check with your insurer to learn more about your coverage levels.
What types of treatment are offered by an HMO drug rehab treatment center?
Each HMO Drug Rehab Treatment Center will offer different levels of treatment depending on patient needs. Detox services are offered at the beginning of treatment. After that, a patient may have inpatient or outpatient services depending on their preferences and the level of care they need. Some patients do better in residential treatment, as it allows for intensive counseling and removes the patient from triggering environments. Other people prefer the flexibility of outpatient treatment, as it allows them to continue to live at home and to participate in daily activities like going to work and caring for family.
How do I find out if an HMO drug rehab treatment center takes my coverage?
Ask the center which insurance policies they accept. You will also need to find out whether the treatment center is considered in network or out of network under your HMO plan. With HMOs, there will be centers that are considered inside your network, where you can get less expensive treatment after insurance kicks in.
What if the treatment center I want to go to is out of network?
You may still be able to get your insurance to cover your treatment at an HMO Drug Rehab Treatment Center that is considered out of network. In some cases, you may pay out of pocket and be partially reimbursed. Often, HMOs will have agreements to pay a portion of medical bills if the specialist that a patient needs to see is not available in-network.
Can I self-pay for treatment that is not covered by my HMO?
If your insurance will not cover the treatment that you feel is best, you have the option of paying out of pocket. You may also have the option of paying a portion of drug rehabilitation treatment costs while your insurer covers an additional portion. For instance, if your HMO covers 80% of costs, you would pay $20 of a $100 fee while the insurer paid the balance.