Colorado Insurance for Drug Rehab
If you’ve been avoiding addiction treatment because of the cost, consider that some forms of treatment are more affordable than others. Also, don’t overlook a health insurance plan as a source to help cover the cost of care. Many insurance plans tend to cover some or all of the cost of treatment for mental health and substance use disorder. You might find that health insurance can give you the help you need to face a drug or alcohol addiction and take the path to recovery. To help you understand how your insurance plan could help you cover the cost of treatment, we’ll go over different plans and coverage levels for drug rehab in Colorado.
Using Insurance for Colorado Addiction Treatment
Colorado has a mental health parity law mandating that individual, small and large group plans must provide coverage for mental health treatment as well as substance abuse treatment. This law also says that the coverage for these services needs to be at the same minimum level as coverage for physical health care. However, certain plans may not be required to follow the parity rule.
To take advantage of your plan’s coverage, you would need to choose the types of treatment and the providers covered by the plan’s network. Some plans also allow you to visit providers outside the network, but you would generally pay a higher amount of your care in those cases. Some insurance carriers only cover certain types of treatment, such as professional office visits. You would also need to check on whether the plan would cover specialty treatment programs, such as luxury rehabs, holistic programs or detox centers.
Insurance Carriers in Colorado
In Colorado, you have access to many health insurance companies through the Connect for Health Colorado state marketplace. These companies include Anthem Blue Cross Blue Shield, Cigna, Bright Health, Denver Health Medical Plan, Kaiser Permanente, Friday Health Plans of Colorado and Rocky Mountain Heath Plans. In addition, the state also has coverage from Aetna, AetnaAARP, Celtic, Assurant Health, Humana, IHC Health, Time Insurance, World Insurance and UnitedHealthOne. Medicaid and Medicare also provides some substance abuse treatment coverage in Colorado. Your health insurance options could be different through an employer compared to the marketplace.
Let’s take a look at what some of the major carriers in the state offer. Anthem Blue Cross and Blue Shield provides HMO plans within Colorado. Cigna has its Connect Flex Bronze 6700 plan and Cigna Connect Flex Silver 4000 plan within the state. UnitedHealthcare’s Colorado plans include Choice, Choice Plus, HRA, HSA, Non-Differential PPO, Edge, CatalystSM and Navigate. You could find many additional plan options through other carriers.
Colorado Drug-Specific Coverage
Does your insurance plan provide coverage for alcohol? What about marijuana, cocaine or heroin? These questions are more related to the treatment program or facility you would seek help with. Some providers treat all types of substance addictions, while others only help with specific drugs. To get coverage for alcohol or a specific drug, you would find a rehab program within your insurance plan’s network that treats that drug. If the provider is within the insurance network and the insurance company deems the treatment necessary, it should provide coverage regardless of the type of substance. However, it’s always a good idea to confirm that the insurance company will provide coverage for your specific situation.
Cigna has a broad variety of health plans in Colorado. They come in different levels on the insurance marketplace metallic scale from bronze to gold. One plan is the Cigna Connect Flex Gold 1300 plan, which is an EPO plan. This plan comes with a deductible of $1,300 for an individual. The plan covers substance abuse care from providers within the plan’s network. If you choose outpatient services, you would pay a $50 copay for an office visit with a professional or a 20 percent coinsurance for other types of outpatient care. Inpatient care also comes with a 20 percent coinsurance on this plan. The coinsurance works so that you would be responsible for paying 20 percent of the total cost of your care. Mental health treatment comes with the same payment amounts on this plan, which is helpful for people with a dual diagnosis of substance use disorder and a mental health disorder.
One example of an Aetna plan in this state is the Health Network Only CO HMO 20 plan, which is an HMO plan. This plan comes with no deductible, so you wouldn’t have a large sum of money you would be responsible for paying before the plan would begin coverage for your care. This plan only covers providers within the plan’s network. Outpatient care on the plan would cost you a $35 copay for each visit, while inpatient care would cost a $250 copay for the stay. A plan like this would help you have very affordable addiction treatment, as it covers most of the cost of care with minimal payments on your end. Nonetheless, you would need to find out the monthly premiums you would pay for this plan to get the full picture of your expenses.
This carrier offers plans through Anthem in Colorado, including the PPO $45/$75 Copay $750D GenRX plan, which is a PPO plan. This plan covers providers that are both in the network and outside the network. Your individual deductible for in-network care would be $750, and for out-of-network care, it would be $1,500. This plan lays out specific guidelines for different types of substance use and mental health treatment. If you visited a professional in an office setting, you would pay a copay of $45 or $75 per visit depending on whether it was a specialist or not. For inpatient care, you would be responsible for paying a 40 percent coinsurance after first paying the deductible. If you went to a provider outside the network, you would pay more. This cost would be a 50 percent coinsurance after the out-of-network deductible, whether you went to an inpatient or outpatient program. This plan also covers inpatient and outpatient care for mental health with the same payment amounts.
You can get an idea of how a Medicare plan would cover substance abuse treatment through the UnitedHealthcare Dual Complete HMO SNP plan. This plan has no premium each month and comes with a deductible of $166 if you receive outpatient care from providers in the network. The plan covers outpatient substance abuse treatment within the network. You could choose individual or group therapy, which would each cost you 20 percent of the care cost for each visit.
Of course, you could find many plans from the above carriers, and there are numerous other carriers to choose from in Colorado. The above plans simply give you an idea of how an insurance plan can cover some of the cost of your addiction treatment. Your plan might vary from the above details, and it’s important to also consider how the cost of your monthly premiums would play into your total costs. When you compare plans, be sure to look at the deductible you would be responsible for, in addition to the costs of substance use treatment both inside and outside the plan’s network. Also, it’s best to check with the insurance company in advance to make sure it will cover certain types of treatment and certain providers. That way, you can make sure the costs will be covered.
Insurance Can Make Treatment Possible
If you’re ready for addiction treatment but unsure about the cost, start with health insurance as a resource. Your current plan could provide coverage, or you could think about signing up for a plan that offers good substance treatment coverage. Insurance plans tend to cover a portion of the cost of care so it doesn’t become such a burden to you and your family. To make the most of your insurance benefits, it’s smart to stay within the plan’s network to cut down on costs. Also, see which types of treatment programs your insurance covers to guide your path to recovery. Don’t assume that addiction treatment is out of reach. Instead, check on how health insurance could help you pay for the cost of care.