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You might be wondering, “Does insurance cover rehab?” Well, here are the answers to the most commonly asked questions regarding insurance coverage and using insurance to pay for addiction treatment.
What kind of insurance policies do we accept?
At Design for Change, we take most major insurance company policies. Design for Change takes both in and out of network policies, so whether you have a PPO or an HMO insurance provider, you will likely be covered. To find out if your insurance is accepted at Design for Change, call for a free consultation with our admission team.
Will my insurance pay for treatment?
Each insurance company and individual policy is different. However, Design for Change accepts plans from most major PPO and HMO insurance providers. First, our admission team will complete an initial assessment with you or your loved one over the phone, a process utilized to gather as much information as possible to advocate for you or your loved one to your insurance company. Second, we will call your insurance company to obtain your benefits as they relate to substance abuse. Our team will work closely with your insurance company to receive all of the necessary information needed to know if you will have any financial responsibility and exactly how much that would be. This information will allow our admission team to begin the process of customizing a treatment plan for you or your loved one that meets your financial position appropriately. At Design for Change, we believe in providing our clients with all of the facts, and working with each client to find a solution all parties can agree will be the most beneficial.
Insurance companies authorize coverage based upon an individual’s “medical necessity,” determined by their physical and emotional condition, in conjunction with their treatment progress. Our Utilization Review Specialists will assess the client’s information regarding their past or current experiences with drugs and alcohol, emotional health, physical health, and current medical, emotional, physical, material, familial, legal, and relational circumstances. All of this information will be used to coordinate care with your insurance company’s Care Management Advocate. Design for Change works closely with your insurance to provide you with the appropriate intensity and treatment duration using evidence-based practices.
How much will I have to pay for addiction treatment?
At Design for Change, we believe in providing all of the available information about insurance, private pay, and financial responsibilities upfront, eliminating any confusion or misunderstanding about the cost of attending treatment with Design for Change. Our admissions team is available 24/7 to work with your insurance company and give you a quote of out-of-pocket costs (if any!). Each insurance company and policy is different, which is why our dedicated insurance team is available to help you find out what coverage you have for yourself or a loved one.
What does “medical necessity” mean?
Medical necessity is a term that insurance companies use to determine a client’s eligibility for treatment. If treatment is medically necessary, the insurance company will often provide the needed coverage to attend treatment. It is the job of our (intake/insurance/admissions) specialists to provide ample evidence of medical necessity and advocate for our clients to help our clients receive the treatment that they need.
I don’t know my insurance ID number; how will I verify eligibility and benefits?
Our admission team is very diligent about locating policies with limited information. If you’re missing information, or even if you’re not sure if you have an active policy, we will gather alternative information from you to help locate your policy and provide the answers you need to help place you in treatment.
Detox is a vital part of the treatment and recovery process, being the first stage of rehabilitation and the process through which our clients become physically stabilized. Our clients are often fearful that they must go through an extremely uncomfortable detox before entering residential treatment if they are to attend treatment. At Design for Change, we will be working as a team with your insurance company to acquire information about coverage for all levels of care, including detox, residential, partial hospitalization, and outpatient. We will gather all such information before admitting a client; in this way, we’re able to provide information about the recovery process start to finish – from detox to outpatient – before a client steps through our doors. Detox is most likely a covered benefit – and we will work hard to find a detox facility that takes your insurance or even utilize a sub-acute protocol on-site at our facility if your insurance permits!
Will my insurance company cover my treatment outside of my local area?
Major insurance companies are well equipped to help clients seek resources for substance abuse treatment out of their local city or state. Our admissions specialists will be sure that during running your benefits and working with your insurance company to get you the help you need, they inquire about available facilities outside of your local area. Sometimes, it’s best to seek treatment outside of your local area, thus eliminating the temptation of leaving the treatment on a whim.
Do I have to tell my employer I’m attending addiction rehab if my insurance policy was obtained through my employment?
No! At Design for Change, your privacy is our priority. Federal law and HIPAA regulations have made it possible for individuals to seek treatment without concern of their private information being released to their employer, friends, family, or any agency without specified written consent signed by the client. Additionally, Employee Assistance programs (EAP) are widely available through most employers, offering an added layer of security to the process of attending treatment. EAP programs are designed to allow employees the ability to seek help without fear of losing your job, taking time off to attend treatment, or being treated differently because of the decision to attend treatment.
Confidentiality is our number one priority at Design for Change. We will never release any information to any persons or agency without specified written consent and signature from our client. Upon request, we can provide a letter confirming attendance of treatment for an individual should their employer, medical provider, or the courts require such documentation.
Does the Design for Change offer scholarship programs or in-house employment opportunities?
Design for Change does not offer in-house employment opportunities to clients to alleviate financial responsibility or out-of-pocket costs. Design for Change does offer scholarship programs to individuals who have insurance policies with partial coverage. Contact our admissions team at 855-997-1372 to determine if your insurance policy makes you eligible for one of our scholarships!
Does Design for Change take State Funded Insurance?
Unfortunately, Design for Change doesn’t have a contract with any State Funded Insurance. If you seek an alcohol and drug rehab that really works, please call us about rehab insurance coverage.