A woman speaks with an alcohol rehab center about paying for treatment with HMO or PPO insurance

Paying for Alcohol Rehab with In-Network or Out-of-Network Insurance

By DFCAdmin in Blogs | | 15 Jan 2018
 

When someone struggling with alcohol addiction begins to consider seeking treatment, one of their primary fears is often whether they can afford treatment or not. The best addiction recovery outcomes usually depend on the quality of treatment you receive, and higher quality programs may cost more. Residential treatment programs may lead to longer periods of abstinence and lower relapse rates, but they also cost more than outpatient programs. Fortunately, many HMO (in-network) or PPO (out-of-network) health plans can help pay for alcohol rehabilitation programs.

Choosing an Alcohol Rehabilitation Program

Some factors to consider when choosing an alcohol rehabilitation program that fits your needs or the needs of a loved one are:

  • Range of Services – No two addictions are alike. So, your alcohol recovery plan shouldn’t be treated with a “one size fits all” mentality. Instead, choose a facility that will work with you to determine a plan that meets your unique needs.
  • Location – In some cases, it might be better to choose a recovery center outside your local area. If there are concerns about exiting or leaving early on a whim, patients may be less likely to do so in an unfamiliar location. Putting distance between relationships that might trigger relapse or otherwise delay recovery can be helpful as well.
  • Treatment Duration – Residential care typically lasts longer and costs more than outpatient programs, but as noted earlier, the results tend to be better.
  • Forms of Accepted Payment – Does the program work with HMO or PPO Plans? An admissions specialist at your chosen alcohol rehabilitation center might be able to help determine what level of coverage your policy provides if you’re uncertain. They can also inform you if loans or scholarship programs are available.

In-Network & Out-of-Network Insurance for Alcohol Rehab at Design for Change

At Design for Change, we take both in- and out-of-network policies. Your PPO or HMO insurance provider is likely included. Our dedicated admission team is available 24/7 to work with you and your insurance provider to help determine the coverage available for you or your loved one along with any expected out-of-pocket costs. If you don’t have your insurance ID number handy, our team can work with limited information to make sure you have an active policy and how much it may cover.

How Long Will HMO Insurance Cover Alcohol Rehab?

Medical necessity is an evaluation of your physical and emotional state as well as your progress in treatment. This will be used to determine your eligibility for reimbursement. At Design for Change, our Utilization Review Specialists will assess the following information:

  • Past and current experience with alcohol and other drugs
  • Emotional health
  • Physical health
  • Medical, material, familial, legal and relational circumstances

Our team will use that information to coordinate care with your insurance company’s Care Management Advocate. We work closely with them to provide a treatment plan customized for you, and we continue to provide evidence of medical necessity while advocating on your behalf.

HMO & PPO Alcohol Rehab in California

Alcoholism is a destructive disease. Don’t let financial fears prevent you from taking your first step towards recovery. The admissions team at Design for Change is always standing by ready to help you assess your insurance coverage situation. You may also qualify for one of our scholarship programs if your policy only provides partial coverage. We can begin by verifying your insurance information, or you can talk to one of our admissions specialists today.