Treatment for addiction might seem too expensive, especially when you see ads for luxury rehab facilities. But different types of treatment programs and ways to pay put treatment in everyone’s reach. If you or your family needs treatment for a drug or alcohol addiction, your health insurance plan should be the first place you look. Just as they cover physical health services, most health insurance plans provide coverage for mental health and substance use treatment. This means that insurance can help addicted people get the support and care they need. Nonetheless, the coverage varies based on the insurer and the plan. Keep reading for information on how health insurance helps cover drug rehab in Arizona.
Insurance Options in Arizona for Drug and Alcohol Rehab
You will find many insurance companies and plans available in Arizona to help cover the cost of treatment. Major carriers that provide coverage in the state include Aetna, Blue Cross Blue Shield, Cigna, and Humana. There is also coverage through World Insurance, Time Insurance, United Security, All Savers, Health Choice, UnitedHealthOne, IHC Health, Assurant, Phoenix Health Plans, Celtic and Health Net. AARP also offers plans through Aetna. In Arizona, you could receive coverage for certain treatment options through Medicare or Medicaid plans. You can find a mix of HMO and PPO plans in Arizona to fit your needs.
Arizona is part of the federal health insurance marketplace. Under the rules of the marketplace, all plans need to cover treatment for substance abuse and mental health care. These services are included in a list of essential health benefits. This means that a plan from the marketplace will cover substance abuse treatment, while a plan separate from the marketplace may or may not. Keep in mind that the federal health insurance system could change, which could potentially affect substance abuse coverage. Also, in some cases, an insurance carrier will only provide coverage in Arizona through a workplace rather than through the federal marketplace.
Which Substances Does Insurance Cover?
It’s reasonable to wonder whether insurance will cover rehab for different kinds of drugs, such as marijuana, heroin, alcohol or meth. After all, you would need your insurance to cover treatment for the types of substances you use. If a health insurance plan covers addiction treatment, that coverage should extend to any type of addictive substance. In this case, it would be more important to look at whether the treatment facility or program provides treatment for the specific substance since they can be specialized. You would need to find a provider that treats the specific drug and is also in your insurance plan’s network. Nonetheless, it’s best to check with your insurance company to make sure it will cover your care.
Available Plans for Arizona Drug Rehab
With the abundance of insurance carriers in this state, there is a wide range of available plans. Many of these plans provide coverage for substance use disorder. In addition, many also cover mental health services, which is important for people who have a dual diagnosis and need treatment for both substance use and a mental disorder. Plans can vary especially by where you live in the state and by whether you choose an individual plan or a group plan through an employer.
Blue Cross Blue Shield of Arizona offers EverydayHealth, Portfolio, SimpleHealth and possibly other plans in Arizona. Many of its plans are PPO plans. One option is a platinum level plan, which is the EverydayHealth 500 Statewide plan. This plan comes with an in-network deductible of $500. Substance abuse services and mental health services are included in the plan. If you go to an outpatient provider in the plan’s network, you pay a copay depending on the type of medical professional or a 10 percent coinsurance for a provider other than an office or walk-in clinic. An inpatient program comes with a 10 percent coinsurance. This means that you would be responsible for paying 10 percent of the cost of your addiction treatment. You would pay more if you went to a provider outside the network, which would be a 50 percent coinsurance and balance bill for either inpatient or outpatient services. Inpatient services on this plan require precertification by the insurance company to avoid a fee. There are also many other Blue Cross Blue Shield plans you could choose from that come with differing deductible and payment amounts.
Aetna offers a Banner Aetna Leap Everyday plan in this state. This HMO plan comes with an in-network individual deductible of $6,075. You are responsible for paying the deductible amount before this plan will provide coverage. At that point, the plan completely covers the rest of the cost of your care. This is the same whether you choose an inpatient or outpatient program, as well as for mental health services. Out-of-network providers are not covered on this plan, so you would need to find a program within the plan’s network. This plan could be a good choice if you are expecting to have a high cost of care, as the amount you would pay would be limited to the deductible and the insurance company would cover the rest.
In Arizona, Cigna offers the Cigna Connect 5500 plan, which is an HMO plan. This plan comes with a deductible of $5,500 for an individual. This is a good plan if you decide to have office visits with a professional. In this case, each office visit would come with a $75 copay. Other types of outpatient care or inpatient services would come with a 20 percent coinsurance, so you would need to pay for 20 percent of the cost of care. On this plan, out-of-network providers are not covered. If you have a dual diagnosis, this plan comes with the same costs for mental health treatment.
UnitedHealthcare offers numerous plans in the state, including Choice, Choice Plus, Definity HRA, Definity HSA, Non-Differential PPO, EdgeSM, and FlexPointsSM. It also offers Medicare coverage in the state, including its Dual Complete HMO SNP plan. This plan has no premium each month and comes with an in-network deductible of only $166 that applies to outpatient services. On this plan, you would pay 20 percent of the cost of care. This plan only covers outpatient care, including outpatient individual or group therapy. This is only for in-network providers. If you needed mental health services, you would pay 20 percent of the cost of outpatient individual or group therapy visits. Inpatient mental health services are covered for 90 days on this plan, with a $1,288 fee for admission, a $322 copay each day from days 61 to 90 and a $644 copay each day after that up to 150 days.
You can see from looking at these plans that each one covers substance abuse and mental health treatment. Yet each plan comes with a different deductible amount that you would be responsible for, in addition to providing different levels of coverage. You would need to compare all of these types of costs, in addition to each plan’s monthly premiums, to decide which one might be best for your care needs. It’s also worth noting that not all plans cover providers that are outside the plan’s network. Also, most plans cover inpatient and outpatient services. You would have to check whether the plan covered other types of treatment such as luxury facilities, detox centers, and holistic treatment programs.
Learn More About Paying for Treatment With Insurance
Many people think they would need to pay for addiction treatment by themselves, but most health insurance plans will at least cover a portion of the cost just like they do for other health concerns. If you already have an insurance plan, see if it covers treatment for substance use. Otherwise, think about finding an insurance plan that could help pay for your addiction treatment and overall health needs. Insurance can make the cost of care much more reasonable and achievable. Nonetheless, it’s always important to check on the types of addiction treatment and providers the plan would cover so you can make the most of your benefits and be sure to save money on the cost of care.